Arthroscopic Broström–Gould repair has comparable radiological and clinical outcomes compared to traditional open Broström–Gould repair in high-demand patients

Baek, Jong Hun; Kim, Jin Hyung; Jeong, Bi O

doi:10.1007/s00167-022-07289-5

Cited by 7 publications

(6 citation statements)

References 41 publications

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“…Previous reports demonstrated that arthroscopic lateral ankle repair for CLAI in high-demand athletes aimed to return to sports activity within 3 months after surgery using intensive rehabilitation. 3,37 In the current study, postoperative rehabilitation was performed with the goal of returning to sports 3 months after surgery. In addition, return to sports was permitted after confirming that patients were in sufficient condition to return to sports.…”

Section: Discussionmentioning

confidence: 99%

“…20,29 However, a previous study reported that excessive stress to the lateral region of the ankle and subtalar joints might result if the CFL is not repaired, leading to ankle and subtalar joint arthritis. 3,25 Hunt et al 12 reported that a loose or incompetent CFL potentially mitigates long-term consequences, such as ankle or subtalar joint arthritis, indicating that the CFL repair may be beneficial during lateral ankle ligament repair. Several studies also found better stability after a combined ATFL and CFL repair than ATFL repair alone because CFL plays an essential role in resisting ankle inversion in the coronal plane.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for the Recurrence of Instability After Lateral Ankle Ligament Repair

et al. 2023

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Background: Arthroscopic anterior talofibular ligament (ATFL) repair is widely performed for chronic lateral ankle instability (CLAI). Although many studies have reported excellent outcomes with this procedure, the recurrence of instability remains a common concern. Therefore, this study aimed to analyze the risk factors for the recurrence of instability after arthroscopic repair for CLAI. Methods: Fifty-six ankles of 53 patients with a mean age of 31.8 ± 14.7 years were retrospectively reviewed. All patients underwent arthroscopic ATFL repair. If instability remained immediately after ATFL repair, calcaneofibular ligament (CFL) repair was performed. The Ankle Activity Score (AAS) was assessed preoperatively, and clinical outcomes including the Japanese Society for Surgery of the Foot scale, Karlsson-Peterson scores, and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) were evaluated preoperatively and at the final follow-up. Talar tilt angle (TTA) was assessed preoperatively and 1 year postoperatively. Ankles were divided into 2 groups—nonrecurrence (postoperative TTA, <6 degrees) and recurrence (postoperative TTA, ≥6 degrees)—and clinical outcomes were compared. Results: Sixteen ankles showed recurrent instability, whereas 40 did not. AAS, TTA, and social functioning in the SAFE-Q were significantly higher in the recurrence group than those in the nonrecurrence group preoperatively. In addition, the rate of poor ATFL remnant quality and the number of CFLs not repaired despite the preoperative injury diagnosis were significantly higher in the recurrence group than in the nonrecurrence group. Conclusion: Arthroscopic repair for ATFL and CFL deficiencies with preoperative high activity, poor remnant quality, and neglected CFL injury can result in the recurrence of instability. Appropriate surgical procedures to prevent the recurrence of instability should be selected for these ankles. Level of Evidence: Level IV, retrospective case series.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk Factors for the Recurrence of Instability After Lateral Ankle Ligament Repair

et al. 2023

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“…AOFAS and K-P scores are commonly used in clinical evaluation of ankle joint function. Tegner activity score was first characterized as an activity level assessment system for knee joints; however, it has also been used to assess activity following ankle damage or surgery ( 8 , 15 – 17 ). All measurements were made at 6 months, 12 months, 24 months and 48 months after surgery, and clinically evaluated by the same experienced rehabilitation physician who did not take part in surgery and was unaware of how the surgery was carried out.…”

Section: Methodsmentioning

confidence: 99%

Arthroscopic vs. open Broström-Gould for repairing anterior talofibular ligament: mid-term outcomes comparison

et al. 2023

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IntroductionThere have been few mid-term follow-up studies comparing arthroscopic and open Broström-Gould repair of the anterior talofibular ligament (ATFL). The purpose of this study was to evaluate the mid-term therapeutic effectiveness of arthroscopic ATFL repair with open Broström-Gould repair for chronic lateral ankle instability.MethodsWe retrospectively reviewed the database of patients with chronic lateral ankle instability undergoing repair of the ATFL from June 2014 to June 2018. The choice of surgical approach will depend on computer-generated randomization. In total, 49 patients underwent the arthroscopic Brostrom-Gould technique (group AB), while the other 50 patients underwent the open Broström-Gould technique (group OB). The surgery duration, hospitalization time, postoperative complications, the preoperative/postoperative manual anterior drawer test (ADT), Visual analog scale (VAS) scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores, Karlsson-Peterson (K-P) scores, and Tegner activity scores were collected for comparative analysis during the follow-up period of 48 months.ResultsAt the final follow-up, the clinical outcomes, including ADT, VAS, AOFAS, K-P, and Tegner activity scores, were significantly improved after either arthroscopic or open treatment. Specifically, the AOFAS and K-P scores in the group AB were significantly higher than those in the group OB at 6 months post-surgery (P < 0.05). Additionally, there were no significant differences in other clinical outcomes and postoperative complications between the two groups.ConclusionsArthroscopic has predictable and good mid-term results after ATFL and may be a secure and effective alternative to open Broström-Gould repair.

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“…In the last decade, the emergence of publications reporting excellent clinical results has helped to popularize the arthroscopic all‐inside ligament repair [18, 25, 30, 33, 37, 41]. As a consequence, several comparative studies investigating arthroscopic and open ankle stabilizing techniques have been recently reported [3, 4, 15, 17]. However, the majority of these studies are reviews, meta‐analysis or comparisons of the open Broström to an arthroscopically assisted technique and not to an all‐inside arthroscopic procedure [3, 4, 15, 17].…”

Section: Introductionmentioning

confidence: 99%

“…As a consequence, several comparative studies investigating arthroscopic and open ankle stabilizing techniques have been recently reported [3, 4, 15, 17]. However, the majority of these studies are reviews, meta‐analysis or comparisons of the open Broström to an arthroscopically assisted technique and not to an all‐inside arthroscopic procedure [3, 4, 15, 17].…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic all‐inside ligament repair has similar or superior clinical outcomes compared to open repair for chronic ankle instability without concomitant intra‐articular pathology at 5 years follow‐up

Guelfi,

Baalbaki,

Malagelada

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose Open ligament repair is widely considered the gold standard treatment for chronic ankle instability. Nevertheless, arthroscopic treatment of ankle instability has gained popularity becoming the preferred technique for many surgeons. This study aimed to compare the clinical outcomes of all-inside arthroscopic versus open lateral ligament repair for chronic ankle instability at 5 years follow-up. Methods Ninety consecutive patients were surgically treated for chronic ankle instability without concomitant intra-articular pathology observed on MRI: 41 patients [median age 28 (range 15-54) years] underwent an open lateral ligament repair (OLR); 49 patients [median age 30 (range 19-47) years] underwent an all-inside arthroscopic ligament repair (ALR). Functional outcomes using the Foot Functional Index (FFI), the American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot Score, and the Foot and Ankle Ability Measure-Sports Subscale (FAAM-SS) were assessed preoperatively and at the latest follow-up. At the latest follow-up, the satisfaction rate and complications were also recorded. ResultsThe mean follow-up was 58 ± 17.6 (range 47-81) months. In both groups FFI, AOFAS and FAAM-SS score significantly improved compared to preoperative values (p < 0.001). There was no statistically significant difference in postoperative outcomes between groups in the AOFAS (n.s) and FAAM-SS (n.s), but the FFI results were significantly better in the ALR group (p < 0.05). No major complications were reported in either group. Conclusion Open and arthroscopic ligament repair to treat chronic ankle instability without concomitant intra-articular pathology produced excellent comparable clinical outcomes at 5 years follow-up. The complications were minimal in both study groups with no significant differences in AOFAS and FAAM-SS scores. However, arthroscopic repair showed significantly better results on the FFI. Therefore, when treating chronic lateral ankle instability, surgeons should consider arthroscopic ligament repair. Level of evidence III.

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Arthroscopic Broström–Gould repair has comparable radiological and clinical outcomes compared to traditional open Broström–Gould repair in high-demand patients

Cited by 7 publications

References 41 publications

Risk Factors for the Recurrence of Instability After Lateral Ankle Ligament Repair

Risk Factors for the Recurrence of Instability After Lateral Ankle Ligament Repair

Arthroscopic vs. open Broström-Gould for repairing anterior talofibular ligament: mid-term outcomes comparison

Arthroscopic all‐inside ligament repair has similar or superior clinical outcomes compared to open repair for chronic ankle instability without concomitant intra‐articular pathology at 5 years follow‐up

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