Biomechanical Analysis of Brostrom Versus Brostrom-Gould Lateral Ankle Instability Repairs

Behrens, Steve B.; Drakos, Mark C.; Lee, Byung J.; Paller, Dave; Hoffman, Eve; Koruprolu, Sarath; DiGiovanni, Christopher W.

doi:10.1177/1071100713477622

Cited by 63 publications

(43 citation statements)

References 29 publications

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“…After a follow-up of at least 2 years, both groups had the same clinical function. Behrens and collaborators 4 performed the Broström-Gould surgery on 10 fresh cadaveric specimens. Two double-loaded, 3.5-mm-diameter corkscrew suture anchors (Arthrex, Inc, Naples, FL) were used for suture.…”

Section: Discussionmentioning

confidence: 99%

Functional Results of All-Inside Arthroscopic Broström-Gould Surgery With 2 Anchors Versus Single Anchor

et al. 2020

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Background: The all-inside arthroscopic Broström-Gould technique gained particular attention among clinicians and researchers due to its high rate of satisfactory results. Thus far, there is a lack of evidence regarding the differences in clinical outcomes between the use of 1 anchor and 2 anchors. The purpose of this study was to compare the differences in clinical function and activity levels in patients treated with 1 or 2 anchors in all-inside arthroscopic Broström-Gould surgery for chronic lateral ankle instability (CLAI). Methods: The data of 75 patients with CLAI (unilateral) admitted from May 2013 to July 2016 were retrospectively analyzed. All patients were treated with all-inside arthroscopic Broström-Gould surgery. The patients were divided into a single-anchor group ( n = 36) and double-anchor group ( n = 39) according to the number of anchors used. There was no statistical difference in general characteristics between the 2 groups before surgery. After 36 to 72 months of follow-up, the pain visual analog scale (VAS) score, American Orthopaedic Foot & Ankle Society (AOFAS) score, Karlsson Ankle Functional Score (KAFS), and Foot and Ankle Outcome Score (FAOS) were used to evaluate and compare the clinical function results between the 2 groups. Results: The incidence of wound complications; reaction to the suture; injury to the nerve, blood vessel, or tendon; and length of postoperative hospitalization were similar between the 2 groups. At the last follow-up, there was no significant difference in the VAS and AOFAS scores between single- and double-anchor groups, but the KAFS and FAOS in the double-anchor group were significantly higher than in the single-anchor group. Additionally, more patients in the double-anchor group returned to preinjury sports activities. Conclusion: All-inside arthroscopic Broström-Gould surgery for the treatment of CLAI yielded a better functional effect and better recovery to preinjury mobility when 2 anchors were used instead of a single anchor. Level of Evidence: Level III, comparative study.

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Section: Discussionmentioning

confidence: 99%

Functional Results of All-Inside Arthroscopic Broström-Gould Surgery With 2 Anchors Versus Single Anchor

et al. 2020

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“…However, surgical treatment is needed for mechanical lateral ankle instability. Because the residual ATFL ligament in CLAI is still of good quality, and the position of the ligament is superficial, the Broström procedure and modified Broström procedure for suturing extensor retinaculum have become the standard procedures for treatment of CLAI since Broström reported successful treatment of CLAI in 1996 by the direct repair of ATFL. Although the previous reports indicated that use of the Broström procedure of direct repair of ATFL for CLAI has achieved satisfactory clinical results, there was still a 6% to 25% complication rate including ankle pain, ankle swelling, and recurrence of lateral ankle instability.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Anatomical Repair of Anterior Talofibular Ligament for Chronic Lateral Instability of the Ankle: Medium‐ and Long‐Term Functional Follow‐Up

Feng

Sun

Wang

et al. 2020

Orthopaedic Surgery

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Objective: To evaluate the functional outcomes of arthroscopic anatomical repair of anterior talofibular ligament (ATFL) in the treatment of chronic lateral ankle instability (CLAI) during medium-and long-term follow-up.Methods: From September 2014 to August 2017, the data of 37 patients (23 males, 14 females; 12 left ankles, 25 right ankles) aged between 21 and 56 years, with an average age of 32.17 AE 6.35 years, presenting with CLAI, was retrospectively analyzed. Among them, 32 injuries were caused by sprain and five injuries were caused by car accidents. The course of the disease lasted for 12 to 60 months, with an average of 26.07 AE 13.29 months. All patients had intact skin around the ankle and no skin lesions. All patients underwent arthroscopic anatomical repair of ATFL, with the fixation of one to two anchors. Pre-and post-operative visual analogue scales (VAS), the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS), and the Karlsson Ankle Functional Score (KAFS) were compared to evaluate the curative effect of the operation. Results:The operation was successful in all 37 cases. The operation time ranged from 40 to 75 min, with an average of 51.25 AE 11.49 min. After surgery, all incisions healed in stage I and there were no complications such as nerve, blood vessel and tendon injury, implant rejection, or suture rejection. Hospital stays of postoperative patients were 3 to 5 days, with an average of 3.77 AE 1.36 days. All patients were followed for 24 to 45 months, averaging 33.16 AE 10.58 months. For three patients with CLAI combined with mild limitation of subjective ankle movement, joint activity was normal after rehabilitation function exercise and proprioceptive function training for 2 months. At the final follow-up, ankle pain had disappeared completely. The ankle varus stress test and ankle anterior drawer test were both negative. Range of joint motion was good. There was no lateral instability of the ankle and all patients returned to normal gait. The mean VAS score decreased to 1.12 AE 0.13, the AOFAS score increased to 92.53 AE 4.87, and the KAFS score increased to 93.36 AE 6.15. All the follow-up indexes were significantly different from those before surgery.Conclusion: Arthroscopic anatomical repair of ATFL for CLAI is precise, with less surgical trauma and reliable medium-and long-term effect.

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“…There is also concern that when using the IER, this is not strictly an anatomical repair since its calcaneal attachment is 10 mm anterior to that of the calcaneofibular ligament (CFL) and this may thus restrict full plantar flexion of the ankle. The need to reinforce lateral ligament repair with the IER is therefore debatable [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic anterior talofibular ligament repair for lateral instability of the ankle

Takao

Matsui

Stone

et al. 2015

Knee Surg Sports Traumatol Arthrosc

115

101

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Although several arthroscopic procedures for lateral ligament instability of the ankle have been reported recently, it is difficult to augment the reconstruction by arthroscopically tightening the inferior extensor retinaculum. There is also concern that when using the inferior extensor retinaculum, this is not strictly an anatomical repair since its calcaneal attachment is different to that of the calcaneofibular ligament. If a ligament repair is completed firmly, it is unnecessary to add argumentation with inferior extensor retinaculum. The authors describe a simplified technique, repair of the lateral ligament alone using a lasso-loop stitch, which avoids additionally tighten the inferior extensor retinaculum. In this paper, it is described an arthroscopic anterior talofibular ligament repair using lasso-loop stitch alone for lateral instability of the ankle that is likely safe for patients and minimal invasive.Level of evidence Therapeutic study, Level V.

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Biomechanical Analysis of Brostrom Versus Brostrom-Gould Lateral Ankle Instability Repairs

Abstract: These data suggest that the additional reinforcement of an ankle's lateral ligament complex repair of the ankle with the inferior extensor retinaculum may be marginal at the time of surgery.

Cited by 63 publications

References 29 publications

Functional Results of All-Inside Arthroscopic Broström-Gould Surgery With 2 Anchors Versus Single Anchor

Functional Results of All-Inside Arthroscopic Broström-Gould Surgery With 2 Anchors Versus Single Anchor

Arthroscopic Anatomical Repair of Anterior Talofibular Ligament for Chronic Lateral Instability of the Ankle: Medium‐ and Long‐Term Functional Follow‐Up

Arthroscopic anterior talofibular ligament repair for lateral instability of the ankle

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