Arthro-Broström with Endoscopic Retinaculum Augmentation using All-inside Lasso-loop Stitch Techniques

Abstract

Background: There is still controversy about the augmentation of the inferior extensor retinaculum (IER) after arthroscopic anterior talofibular ligament (ATFL) repair. The aim of this study was to evaluate the arthro-Broström procedure with endoscopic retinaculum augmentation using all-inside lasso-loop stitch techniques for chronic lateral ankle instability. Methods: Thirty-four cases with type-2 or type-3 chronic ATFL lesions who underwent the arthro-Broström procedure with endoscopic retinaculum augmentation using all-inside lasso-loop stitch techniques were assessed retrospectively. A total of 30 cases (30 ankles) were followed up for a mean of 26.67 ± 4.19 months (range, 24 - 36 months). Five cases were excluded due to insufficient medical records or loss of follow-up reports. The Cumberland Ankle Instability Tool (CAIT) scores, The Karlsson-Peterson scores and Visual Analogue Scale (VAS) scores were evaluated before surgery and at the final follow-up time. Also, the results of stress fluoroscopic tests and complications were recorded. Results: At the final follow-up, the average of the Cumberland Ankle Instability Tool (CAIT) scores, The Karlsson-Peterson scores and VAS scores were 86.63 ± 6.69 (range, 77 - 100), 90.17 ± 4.64 (range, 85 - 100) and 0.53 ± 0.63 (range, 0 - 2), respectively. Moreover, the results of stress fluoroscopic tests were improved significantly after surgery. Mild keloid formation and/or knot irritation were observed in four cases. No wound infections, nerve injuries and recurrent instability were recorded. Also, no stiffness or arthritis of the subtalar joint was encountered. Conclusions: The arthro-Broström procedure combined with endoscopic retinaculum augmentation using all-inside lasso-loop techniques is reliable and safe due to satisfactory clinical results and avoiding nerve injuries.