scholarly journals No Differences in Clinical Outcomes of Suture Tape Augmented Repair Versus Broström Repair Surgery for Chronic Lateral Ankle Instability

2020 ◽  
Vol 8 (9) ◽  
pp. 232596712094849
Author(s):  
Hong Li ◽  
Yujie Zhao ◽  
Wenbo Chen ◽  
Hongyun Li ◽  
Yinghui Hua
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Complication Rate ◽  
Ankle Instability ◽  
Foot And Ankle ◽  
Recurrent Instability ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Suture Tape

Background: Suture tape (ST) augmented repair, an alternative to traditional Broström repair (BR), may protect the repaired anterior talofibular ligament during ligament healing. No systematic review of cohort studies has been conducted to compare traditional BR with ST-augmented repair for chronic lateral ankle instability. Purpose: To review the current evidence in the literature to ascertain whether ST-augmented repair is superior to traditional BR in managing chronic lateral ankle instability. Study Design: Systematic review; Level of evidence, 3. Methods: A literature search was performed to identify relevant articles published in PubMed, Embase, and Cochrane Library databases in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included cohort studies comparing the efficacy of BR and ST-augmented repair procedures in terms of incidence of instability recurrence, functional scores, talar tilt angle (TTA), anterior talar translation (ATT), and complication rate. Methodological quality was assessed using the Jadad scale for randomized studies and the Newcastle-Ottawa Scale for nonrandomized studies. Results: A total of 4 clinical trials with 254 patients were included. No significant differences were detected between BR and ST-augmented repair procedures in terms of incidence of recurrent instability, American Orthopaedic Foot & Ankle Society score, Foot and Ankle Outcome Score, Foot and Ankle Ability Measure, TTA, ATT, or complication rate. The ST group appeared to have a shorter operation time compared with the BR group. Conclusion: No significant differences were found between ST-augmented repair and BR surgery regarding incidence of recurrent instability, functional outcome scores, or complication rates. Although technically challenging, the ST-augmented repair procedure appears to be a safe and fast option.

scholarly journals Outcomes of Open Versus Arthroscopic Broström Surgery for Chronic Lateral Ankle Instability: A Systematic Review and Meta-analysis of Comparative Studies

2021 ◽  
Vol 9 (7) ◽  
pp. 232596712110152
Author(s):  
Ahmed Khalil Attia ◽  
Tarek Taha ◽  
Karim Mahmoud ◽  
Kenneth J. Hunt ◽  
Sameh A. Labib ◽  
...  
Keyword(s):  
Systematic Review ◽  
Complication Rate ◽  
Comparative Studies ◽  
Open Surgery ◽  
Ankle Instability ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Vas Scores ◽  
Talar Tilt

Background: Nearly 20% of acute ankle sprains progress to chronic lateral ankle instability that requires surgical intervention. In recent years, there has been a growing interest in arthroscopic Broström techniques as an alternative to open surgery. Purpose: To review the most up-to-date evidence comparing the outcomes of open and arthroscopic Broström procedures for chronic lateral ankle instability. Study Design: Systematic review; Level of evidence, 3. Methods: This review was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Relevant comparative studies in English up to May 2020 were identified. The primary outcomes were (1) functional scores (Karlsson Ankle Function Score and American Orthopaedic Foot & Ankle Society [AOFAS] score) and (2) the 10-point visual analog scale (VAS) score for pain. The secondary outcomes were differences in (1) postoperative anterior drawer and talar tilt, (2) surgical time and complication rate, and (3) time to return to sports and weightbearing. Results: A total of 408 patients in 8 studies met the inclusion criteria. Of these, 193 (47.3%) patients underwent open surgery, while 215 (52.7%) patients underwent arthroscopic surgery. There were significant differences between the open and arthroscopic repair groups in mean 6-month AOFAS scores (82.4 vs 92.25, respectively; mean difference [MD], 11.36; 95% CI, 0.14-2.56; I 2 = 90%; P = .03), 1-year AOFAS scores (80.05 vs 88.6; MD, –11.96; 95% CI, –21.26 to –2.76; I 2 = 82%; P = .01), 6-month VAS scores (1.7 vs 1.4; MD, –0.38; 95% CI, –0.54 to –0.21; I 2 = 78%; P < .001), and 1-year VAS scores (2.05 vs 1.45; MD, 0.31; 95% CI, 0.09-0.54; I 2 = 0%; P < .001). The mean time to weightbearing was 14.25 and 9.0 weeks in the open and arthroscopic repair groups, respectively (MD, 1.89; 95% CI, 1.24-2.54; I 2 = 99%; P < .001). There were no statistically significant differences in the remaining outcomes evaluated. Conclusion: While technically more demanding, arthroscopic Broström was superior to open Broström-Gould surgery in postoperative AOFAS scores, VAS pain scores, and time to return to weightbearing. The operative time, complication rate, talar tilt, and anterior drawer tests were excellent and statistically comparable. Long-term clinical trials are required before recommending arthroscopic Broström as the new gold standard.

Postoperative Rehabilitation of Chronic Lateral Ankle Instability: A Systematic Review

2021 ◽  
Vol 29 (2) ◽  
pp. 146-152
Author(s):  
Aurora Clements ◽  
Eleanor Belilos ◽  
Laura Keeling ◽  
Michael Kelly ◽  
Nicholas Casscells
Keyword(s):  
Systematic Review ◽  
Ankle Instability ◽  
Postoperative Rehabilitation ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability

scholarly journals A Retrospective Chart Review to Examine Failed Modified Brostrom Procedures for Chronic Lateral Ankle Instability

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0040
Author(s):  
Kaitlyn Rizzo ◽  
Greggory Brandle ◽  
Nicholas A. Cheney ◽  
Brian C. Clark
Keyword(s):  
Chart Review ◽  
Ankle Instability ◽  
Retrospective Chart Review ◽  
Tilt Test ◽  
Recurrent Instability ◽  
Lateral Ankle ◽  
Anterior Drawer ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Modified Broström Procedure

Category: Ankle; Other Introduction/Purpose: Recurrent ankle injuries can lead to chronic ankle instability requiring surgical stabilization. Since the anterior talofibular ligament (ATFL) is the weakest of the lateral ankle ligaments, repair is often required in cases of chronic lateral ankle instability. Damage to the calcaneofibular ligament (CFL) is less common than the ATFL, but additional repair of it in these cases may be necessary to avoid this recurrent instability. A modified Brostrom procedure has been a widely accepted surgical approach to chronic lateral ankle instability if conservative measures fail. However, cases of recurrent instability even after initial stabilization surgery can present. The purpose was to examine reasoning for and rate of revision surgeries attempting to fix chronic lateral ankle instability as it relates to the ATFL and CFL integrity. Methods: A retrospective chart review was conducted to assess outcomes of a modified Brostrom procedure to determine underlying reasoning of the need for revision surgery by utilizing results of the anterior drawer and varus tilt tests. The files of these patients were examined via electronic health records to determine the reasoning for surgery. The preoperative and postoperative results of the anterior drawer test (ADT) and varus tilt test were used to examine ATFL and CFL integrity, respectively, in addition to operative notes. Results: 172 patients met criteria having undergone a modified Brostrom dual ligament repair procedure for lateral ankle instability by a single orthopedic foot and ankle surgeon. With a 3.49% revision rate in the patient population, the only similarity found in all of the patients was the presence of a positive varus tilt test indicating the CFL was a major contributor of failed correction via the modified Brostrom procedure. One patient had a positive ADT, and one had a mildly positive ADT. These ADT and varus tests were performed at various time points in the care of the patients. The average length between surgeries was calculated to be 624.2 days. This revision rate is higher than past studies but was limited to a few years under examination. Conclusion: In conclusion, the anterior drawer and varus tilt tests are utilized to determine the integrity of the ATFL and CFL in the lateral ankle ligament complex. In failed modified Brostrom procedures examined, the positive result was consistently in the varus tilt test, indicating that the CFL is the ligament most affected in these patients requiring additional surgery. However, these physical exam tests are only one way to examine the ankle and do not take additional pathologies of the lateral ankle into account. Additional studies are needed to examine long-term outcomes of the modified Brostrom procedure and reasoning for failure.

scholarly journals Modified Broström Repair With and Without Augmentation Using Suture Tape for Chronic Lateral Ankle Instability

2019 ◽  
Vol 11 (4) ◽  
pp. 671-678 ◽  
Author(s):  
Ding‐Li Xu ◽  
Kai‐Feng Gan ◽  
Hao‐Jie Li ◽  
Shu‐Yi Zhou ◽  
Zhen‐Qi Lou ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Suture Tape

scholarly journals Validation of the Indonesian version of the foot and ankle score in patients with chronic lateral ankle instability

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
I Putu Gde Surya Adhitya ◽  
Wen-Yu Yu ◽  
Putu Ayu Sita Saraswati ◽  
I Made Niko Winaya ◽  
Mau-Roung Lin
Keyword(s):  
Rating Scale ◽  
Ankle Instability ◽  
Short Form ◽  
Correlation Coefficients ◽  
Principal Component ◽  
Foot And Ankle ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Sf 36 ◽  
Lateral Ankle Instability

Abstract Background This study aimed to examine the psychometric performance of the Foot and Ankle Outcome Score (FAOS) used in Indonesian patients with chronic lateral ankle instability (CLAI). Methods The FAOS was translated into Indonesian through standardized procedures. Among 224 patients with unilateral CLAI recruited from 14 physical therapy clinics during a 1-year period, reliabilities, construct validities, and responsiveness levels of the FAOS were examined. Active and passive range of motion of ankle dorsiflexion or plantiflexion, figure-of-eight, numeric pain rating scale (NPRS), and Short Form (SF)-36 were used to test the construct validities. Results The five subscales indicated adequate internal consistency (Cronbach’s alpha, 0.74 ~ 0.96) and interrater test-retest reliabilities (interclass correlation coefficients, 0.80 ~ 0.94). Subscales of the FAOS moderately converged with those selected measures with similar constructs ($$r$$ r values, 0.32 ~ 0.53), with the exception of the correlation of pain with the NPRS ($$r$$ r , -0.06). Results of the principal component analysis showed that the five-factor structure of the FAOS was appropriate for the Indonesian data, although six items (four in the pain and two in the other symptoms (OSs) subscales) did not perfectly fit their original subscales. Guyatt’s responsiveness index for the FAOS’s subscales changed in the SF-36’s physical function over a 1-month period and ranged 0.37 to 1.27. Conclusions The Indonesian version of the FAOS demonstrated acceptable reliabilities and responsiveness, and fair construct validities among CLAI patients, although certain items in the pain and OSs subscales may need to be further explored and improved.

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