Arthroscopic versus open modified Brostrom procedure for chronic ankle instability

Study Type: Therapy
OE Level of Evidence: 2
Journal Level of Evidence: 1
Synopsis
50 patients with chronic ankle instability and previously failed conservative treatment were randomized to undergo a modified Brostrom procedure (anterior talofibular ligament repair) arthroscopically or via open surgery. The purpose of this study was to compare clinical and radiographic outcomes between groups over the first 12 months after surgery. Results demonstrated no Please login to view the rest of this report. Please login to view the rest of this report.
Funding: Non-Industry funded
Sponsor: Soonchunhyang University
Conflicts: None disclosed
CONTENT IS LOCKED
Why was this study needed now?
Lateral ankle sprains are a common athletic injury that can lead to chronic instability. Surgical intervention with the modified Brostrom procedure is usually considered for persistent ankle instability that has failed conservative treatment. It is currently unknown if results differ between open and arthroscopic modified Brostrom procedures, with no previous randomized controlled trials performed on the topic.
What was the principal research question?
In the treatment of persistent ankle instability, is there any significant difference in clinical or radiographic outcome after 12 months between an arthroscopic and open modified Brostrom procedure?
Population: 50 patients with persistent ankle instability following lateral ligament injury, and failed nonoperative management.
Intervention: Arthroscopic group: Following diagnostic arthroscopy and preparation, repair of the anterior talofibular ligament was performed using an absorbable anchor loaded with two sutures, inserted using an anterolateral portal. Accessory anteroinferior and far-lateral portals were used to facilitate suture passage and tying. Suture knots were tied with the foot in eversion and dorsiflexion. (n=25; 25 analyzed) (Mean age: 35.2+/-11.8)
Comparison: Open group: Following diagnostic arthroscopy and preparation, repair of the anterior talofibular ligament was performed using Ethibond sutures through a 5cm incision made anterior to the fibular border. (n=25; 23 analyzed) (Mean age: 34.3+/-14.1)
Outcomes: Clinical outcomes included the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, the Karlsson score, and a visual analog scale (VAS) for pain. Stress radiographs with 150N were taken to measure talar tilt and anterior talar translation. Any associated complications were documented.
Methods: RCT
Time: Follow-up scheduled for 6 weeks, 6 months, and 12 months.
What were the important findings?
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.