Background
The procedure described by Broström has been used to address chronic lateral ankle instability; the long-term results of this procedure have not been reported.
Hypothesis
The Broström procedure provides good results over the long term for active patients with chronic lateral ankle instability.
Study Design
Case series; Level of evidence, 4.
Methods
Thirty-one male patients (32 ankles) who underwent the Broström procedure for chronic lateral ankle instability while enrolled as students at the United States Naval Academy were identified. Each patient was mailed a questionnaire that included a functional outcome measure as described by Roos et al, a score described by Good et al, and a single-number ankle functional assessment. The mean age was 20.7 years (range, 18-23 years) at the time of operation. A functional outcome score was completed on each patient, with a mean follow-up of 26.3 years (range, 24.6-27.9 years).
Results
The follow-up included 22 of the 31 original patients. The mean numeric score for overall ankle function was 91.2 of 100 (standard deviation, 10.2). The foot and ankle outcome score (described by Roos et al) was 92.0 (92%; standard deviation, 12.8) averaged over 5 functional areas. Ninety-one percent of the patients described their ankle function as good or excellent using the scale devised by Good et al.
Conclusion
The long-term results of the Broström procedure for chronic lateral ankle instability are excellent with 26-year follow-up.
These observations reveal that joint instability resulting from ACL injury rapidly results in degenerative changes characteristic of those seen in idiopathic OA at arthroplasty and in experimental OA following ACL surgery. These changes may contribute to the development of post-traumatic OA that is commonly observed following ACL injury. The observations support and extend conclusions from other studies on human and animal articular cartilage and synovial fluids post-ACL injury that have revealed a rapid onset of damage to type II collagen and an initial increase in proteoglycan content characteristic of experimental OA post-ACL injury. This study provides direct evidence for the rapid development of degenerative changes characteristic of OA following ACL injury.
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