Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2022

13.04.2022 | ANKLE

Arthroscopic modified Broström procedure achieves faster return to sports than open procedure for chronic ankle instability

verfasst von: Zong-chen Hou, Tong Su, Ying-fang Ao, Yue-lin Hu, Chen Jiao, Qin-wei Guo, Shuang Ren, Nan Li, Dong Jiang

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 10/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To compare the clinical outcomes, rate of return to sports, postural control, and muscle strength between the arthroscopic and open modified Broström procedure for chronic lateral ankle instability (CLAI) patients.

Methods

From September 2018 to April 2019, 70 patients diagnosed with CLAI were prospectively included with arthroscopic modified Broström procedure (n = 36) and open modified Broström procedure (n = 34). They were evaluated at five time points (preoperation and 3 months, 6 months, 1 year and 2 years postoperatively). The main results examined the rate of return to sports, American Orthopaedic Foot and Ankle Society Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS), centre of pressure (COP) excursion velocity, time to boundary (TTB), plantar pressure, isokinetic muscle strength and complications.

Results

Compared with the open group, the arthroscopic group demonstrated a significantly shorter period of return to the preinjury sport (13.2 ± 2.4 weeks vs. 18.7 ± 3.1 weeks, P = 0.023) and a higher early sport ratio (80.6 vs. 61.8%, P = 0.011) combined with better FAAM sports and AOFAS at 3 months and 6 months postoperatively and VAS at 3 months postoperatively. In addition, better anterior–posterior postural control stability, less time to peak force under lateral hindfoot and better dorsiflexion strength were shown in the arthroscopic group at 6 months postoperatively. No significant difference was found in clinical scores, posture control or muscle strength at the 1- or 2-year follow-up between the two groups.

Conclusions

Shorter period and higher rates of return to sport activities and better clinical scores, posture control and muscle strength were achieved in the arthroscopic group at 6 months postoperatively, and no clinical differences were found between arthroscopic and open modified Broström procedure 1 year or 2 years postoperatively. Arthroscopic modified Broström procedure is a reliable procedure for CLAI injuries with the demand for fast exercise recovery.

Clinical registration

ChiCTR1900023999.

Level of evidence

II.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Attia AK, Taha T, Mahmoud K, Hunt KJ, Labib SA, D’Hooghe P (2021) Outcomes of open versus arthroscopic Brostrom surgery for chronic lateral ankle instability: a systematic review and meta-analysis of comparative studies. Orthop J Sports Med 9(7):23259671211015210PubMedPubMedCentralCrossRef Attia AK, Taha T, Mahmoud K, Hunt KJ, Labib SA, D’Hooghe P (2021) Outcomes of open versus arthroscopic Brostrom surgery for chronic lateral ankle instability: a systematic review and meta-analysis of comparative studies. Orthop J Sports Med 9(7):23259671211015210PubMedPubMedCentralCrossRef
2.
Zurück zum Zitat Aydog E, Aydog ST, Cakci A, Doral MN (2004) Reliability of isokinetic ankle inversion- and eversion-strength measurement in neutral foot position, using the Biodex dynamometer. Knee Surg Sports Traumatol Arthrosc 12(5):478–481PubMedCrossRef Aydog E, Aydog ST, Cakci A, Doral MN (2004) Reliability of isokinetic ankle inversion- and eversion-strength measurement in neutral foot position, using the Biodex dynamometer. Knee Surg Sports Traumatol Arthrosc 12(5):478–481PubMedCrossRef
3.
Zurück zum Zitat Baumbach SF, Braunstein M, Herterich V, Bocker W, Waizy H, Polzer H (2019) Arthroscopic repair of chronic lateral ankle instability. Oper Orthop Traumatol 31(3):201–210PubMedCrossRef Baumbach SF, Braunstein M, Herterich V, Bocker W, Waizy H, Polzer H (2019) Arthroscopic repair of chronic lateral ankle instability. Oper Orthop Traumatol 31(3):201–210PubMedCrossRef
4.
Zurück zum Zitat Brostrom L (1966) Sprained ankles. VI. Surgical treatment of “chronic” ligament ruptures. Acta Chir Scand 132(5):551–565PubMed Brostrom L (1966) Sprained ankles. VI. Surgical treatment of “chronic” ligament ruptures. Acta Chir Scand 132(5):551–565PubMed
5.
Zurück zum Zitat Brown AJ, Shimozono Y, Hurley ET, Kennedy JG (2020) Arthroscopic versus open repair of lateral ankle ligament for chronic lateral ankle instability: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 28(5):1611–1618PubMedCrossRef Brown AJ, Shimozono Y, Hurley ET, Kennedy JG (2020) Arthroscopic versus open repair of lateral ankle ligament for chronic lateral ankle instability: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 28(5):1611–1618PubMedCrossRef
6.
Zurück zum Zitat Cho BK, Park JK, Choi SM, SooHoo NF (2018) The effect of peroneal muscle strength on functional outcomes after the modified Brostrom procedure for chronic ankle instability. Foot Ankle Int 39(1):105–112PubMedCrossRef Cho BK, Park JK, Choi SM, SooHoo NF (2018) The effect of peroneal muscle strength on functional outcomes after the modified Brostrom procedure for chronic ankle instability. Foot Ankle Int 39(1):105–112PubMedCrossRef
7.
Zurück zum Zitat Choi SM, Cho BK, Park WS, Woo KJ (2021) The changes of joint-position sense, peroneal strength, postural control, and functional performance ability after the modified Brostrom procedure for chronic ankle instability. J Orthop Surg (Hong Kong) 29(3):23094990211052096CrossRef Choi SM, Cho BK, Park WS, Woo KJ (2021) The changes of joint-position sense, peroneal strength, postural control, and functional performance ability after the modified Brostrom procedure for chronic ankle instability. J Orthop Surg (Hong Kong) 29(3):23094990211052096CrossRef
8.
Zurück zum Zitat Cong Y, Lam WK (2021) Effects of shear reduction shoes on joint loading, ground reaction force and free moment across different cutting angles. J Sports Sci 39(12):1386–1394PubMedCrossRef Cong Y, Lam WK (2021) Effects of shear reduction shoes on joint loading, ground reaction force and free moment across different cutting angles. J Sports Sci 39(12):1386–1394PubMedCrossRef
9.
Zurück zum Zitat De Cock A, De Clercq D, Willems T, Witvrouw E (2005) Temporal characteristics of foot roll-over during barefoot jogging: reference data for young adults. Gait Posture 21(4):432–439PubMedCrossRef De Cock A, De Clercq D, Willems T, Witvrouw E (2005) Temporal characteristics of foot roll-over during barefoot jogging: reference data for young adults. Gait Posture 21(4):432–439PubMedCrossRef
10.
Zurück zum Zitat Feng SM, Maffulli N, Ma C, Oliva F (2021) All-inside arthroscopic modified Brostrom-Gould procedure for chronic lateral ankle instability with and without anterior talofibular ligament remnant repair produced similar functional results. Knee Surg Sports Traumatol Arthrosc 29(8):2453–2461PubMedCrossRef Feng SM, Maffulli N, Ma C, Oliva F (2021) All-inside arthroscopic modified Brostrom-Gould procedure for chronic lateral ankle instability with and without anterior talofibular ligament remnant repair produced similar functional results. Knee Surg Sports Traumatol Arthrosc 29(8):2453–2461PubMedCrossRef
11.
Zurück zum Zitat Gribble PA, Delahunt E, Bleakley C, Caulfield B, Docherty C, Fourchet F et al (2014) Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. Br J Sports Med 48(13):1014–1018PubMedCrossRef Gribble PA, Delahunt E, Bleakley C, Caulfield B, Docherty C, Fourchet F et al (2014) Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. Br J Sports Med 48(13):1014–1018PubMedCrossRef
12.
Zurück zum Zitat Guelfi M, Nunes GA, Malagelada F, Cordier G, Dalmau-Pastor M, Vega J (2020) Arthroscopic-assisted versus all-arthroscopic ankle stabilization technique. Foot Ankle Int 41(11):1360–1367PubMedCrossRef Guelfi M, Nunes GA, Malagelada F, Cordier G, Dalmau-Pastor M, Vega J (2020) Arthroscopic-assisted versus all-arthroscopic ankle stabilization technique. Foot Ankle Int 41(11):1360–1367PubMedCrossRef
13.
Zurück zum Zitat Hollander K, Liebl D, Meining S, Mattes K, Willwacher S, Zech A (2019) Adaptation of running biomechanics to repeated barefoot running: a randomized controlled study. Am J Sports Med 47(8):1975–1983PubMedPubMedCentralCrossRef Hollander K, Liebl D, Meining S, Mattes K, Willwacher S, Zech A (2019) Adaptation of running biomechanics to repeated barefoot running: a randomized controlled study. Am J Sports Med 47(8):1975–1983PubMedPubMedCentralCrossRef
16.
Zurück zum Zitat Jang J, Migel KG, Kim H, Wikstrom EA (2021) Acute vibration feedback during gait reduces mechanical ankle joint loading in chronic ankle instability patients. Gait Posture 90:261–266PubMedCrossRef Jang J, Migel KG, Kim H, Wikstrom EA (2021) Acute vibration feedback during gait reduces mechanical ankle joint loading in chronic ankle instability patients. Gait Posture 90:261–266PubMedCrossRef
17.
Zurück zum Zitat Kabbaligere R, Lee BC, Layne CS (2017) Balancing sensory inputs: sensory reweighting of ankle proprioception and vision during a bipedal posture task. Gait Posture 52:244–250PubMedCrossRef Kabbaligere R, Lee BC, Layne CS (2017) Balancing sensory inputs: sensory reweighting of ankle proprioception and vision during a bipedal posture task. Gait Posture 52:244–250PubMedCrossRef
18.
Zurück zum Zitat Kawaguchi K, Taketomi S, Mizutani Y, Inui H, Yamagami R, Kono K et al (2021) Hip abductor muscle strength deficit as a risk factor for inversion ankle sprain in male college soccer players: a prospective cohort study. Orthop J Sports Med 9(7):23259671211020290PubMedPubMedCentralCrossRef Kawaguchi K, Taketomi S, Mizutani Y, Inui H, Yamagami R, Kono K et al (2021) Hip abductor muscle strength deficit as a risk factor for inversion ankle sprain in male college soccer players: a prospective cohort study. Orthop J Sports Med 9(7):23259671211020290PubMedPubMedCentralCrossRef
19.
Zurück zum Zitat Khalaj N, Vicenzino B, Heales LJ, Smith MD (2020) Is chronic ankle instability associated with impaired muscle strength? Ankle, knee and hip muscle strength in individuals with chronic ankle instability: a systematic review with meta-analysis. Br J Sports Med 54(14):839–847PubMedCrossRef Khalaj N, Vicenzino B, Heales LJ, Smith MD (2020) Is chronic ankle instability associated with impaired muscle strength? Ankle, knee and hip muscle strength in individuals with chronic ankle instability: a systematic review with meta-analysis. Br J Sports Med 54(14):839–847PubMedCrossRef
20.
Zurück zum Zitat Koldenhoven RM, Feger MA, Fraser JJ, Saliba S, Hertel J (2016) Surface electromyography and plantar pressure during walking in young adults with chronic ankle instability. Knee Surg Sports Traumatol Arthrosc 24(4):1060–1070PubMedCrossRef Koldenhoven RM, Feger MA, Fraser JJ, Saliba S, Hertel J (2016) Surface electromyography and plantar pressure during walking in young adults with chronic ankle instability. Knee Surg Sports Traumatol Arthrosc 24(4):1060–1070PubMedCrossRef
21.
Zurück zum Zitat Larkins CG, Brady AW, Aman ZS, Dornan GJ, Haytmanek CT, Clanton TO (2021) Evaluation of the intact anterior talofibular and calcaneofibular ligaments, injuries, and repairs with and without augmentation: a biomechanical robotic study. Am J Sports Med 49(9):2432–2438PubMedCrossRef Larkins CG, Brady AW, Aman ZS, Dornan GJ, Haytmanek CT, Clanton TO (2021) Evaluation of the intact anterior talofibular and calcaneofibular ligaments, injuries, and repairs with and without augmentation: a biomechanical robotic study. Am J Sports Med 49(9):2432–2438PubMedCrossRef
22.
Zurück zum Zitat Lee JH, Lee SH, Choi GW, Jung HW, Jang WY (2020) Individuals with recurrent ankle sprain demonstrate postural instability and neuromuscular control deficits in unaffected side. Knee Surg Sports Traumatol Arthrosc 28(1):184–192PubMedCrossRef Lee JH, Lee SH, Choi GW, Jung HW, Jang WY (2020) Individuals with recurrent ankle sprain demonstrate postural instability and neuromuscular control deficits in unaffected side. Knee Surg Sports Traumatol Arthrosc 28(1):184–192PubMedCrossRef
23.
Zurück zum Zitat Lee JH, Jung HW, Jang WY (2022) Proprioception and neuromuscular control at return to sport after ankle surgery with the modified Brostrom procedure. Sci Rep 12(1):610PubMedPubMedCentralCrossRef Lee JH, Jung HW, Jang WY (2022) Proprioception and neuromuscular control at return to sport after ankle surgery with the modified Brostrom procedure. Sci Rep 12(1):610PubMedPubMedCentralCrossRef
24.
Zurück zum Zitat Lee JH, Lee SH, Jung HW, Jang WY (2020) Modified Brostrom procedure in patients with chronic ankle instability is superior to conservative treatment in terms of muscle endurance and postural stability. Knee Surg Sports Traumatol Arthrosc 28(1):93–99PubMedCrossRef Lee JH, Lee SH, Jung HW, Jang WY (2020) Modified Brostrom procedure in patients with chronic ankle instability is superior to conservative treatment in terms of muscle endurance and postural stability. Knee Surg Sports Traumatol Arthrosc 28(1):93–99PubMedCrossRef
25.
Zurück zum Zitat Lopez-Gonzalez L, Falla D, Lazaro-Navas I, Lorenzo-Sanchez-Aguilera C, Rodriguez-Costa I, Pecos-Martin D et al (2021) Effects of dry needling on neuromuscular control of ankle stabilizer muscles and center of pressure displacement in basketball players with chronic ankle instability: a single-blinded randomized controlled trial. Int J Environ Res Public Health 18(4):2092PubMedPubMedCentralCrossRef Lopez-Gonzalez L, Falla D, Lazaro-Navas I, Lorenzo-Sanchez-Aguilera C, Rodriguez-Costa I, Pecos-Martin D et al (2021) Effects of dry needling on neuromuscular control of ankle stabilizer muscles and center of pressure displacement in basketball players with chronic ankle instability: a single-blinded randomized controlled trial. Int J Environ Res Public Health 18(4):2092PubMedPubMedCentralCrossRef
26.
Zurück zum Zitat Martin RL, Irrgang JJ, Burdett RG, Conti SF, Van Swearingen JM (2005) Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int 26(11):968–983PubMedCrossRef Martin RL, Irrgang JJ, Burdett RG, Conti SF, Van Swearingen JM (2005) Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int 26(11):968–983PubMedCrossRef
27.
Zurück zum Zitat May NR, Driscoll M, Nguyen S, Ferkel RD (2022) Analysis of return to play after modified Brostrom lateral ankle ligament reconstruction. Orthop J Sports Med 10(2):23259671211068540PubMedPubMedCentralCrossRef May NR, Driscoll M, Nguyen S, Ferkel RD (2022) Analysis of return to play after modified Brostrom lateral ankle ligament reconstruction. Orthop J Sports Med 10(2):23259671211068540PubMedPubMedCentralCrossRef
28.
Zurück zum Zitat Nery C, Raduan F, Del BA, Asaumi ID, Cohen M, Maffulli N (2011) Arthroscopic-assisted Brostrom-Gould for chronic ankle instability: a long-term follow-up. Am J Sports Med 39(11):2381–2388PubMedCrossRef Nery C, Raduan F, Del BA, Asaumi ID, Cohen M, Maffulli N (2011) Arthroscopic-assisted Brostrom-Gould for chronic ankle instability: a long-term follow-up. Am J Sports Med 39(11):2381–2388PubMedCrossRef
29.
Zurück zum Zitat Simpson JD, Rendos NK, Stewart EM, Turner AJ, Wilson SJ, Macias DM et al (2019) Bilateral spatiotemporal postural control impairments are present in participants with chronic ankle instability. Phys Ther Sport 39:1–7PubMedCrossRef Simpson JD, Rendos NK, Stewart EM, Turner AJ, Wilson SJ, Macias DM et al (2019) Bilateral spatiotemporal postural control impairments are present in participants with chronic ankle instability. Phys Ther Sport 39:1–7PubMedCrossRef
30.
Zurück zum Zitat Ulku TK, Kocaoglu B, Tok O, Irgit K, Nalbantoglu U (2020) Arthroscopic suture-tape internal bracing is safe as arthroscopic modified Brostrom repair in the treatment of chronic ankle instability. Knee Surg Sports Traumatol Arthrosc 28(1):227–232PubMedCrossRef Ulku TK, Kocaoglu B, Tok O, Irgit K, Nalbantoglu U (2020) Arthroscopic suture-tape internal bracing is safe as arthroscopic modified Brostrom repair in the treatment of chronic ankle instability. Knee Surg Sports Traumatol Arthrosc 28(1):227–232PubMedCrossRef
31.
Zurück zum Zitat Wenning M, Gehring D, Mauch M, Schmal H, Ritzmann R, Paul J (2020) Functional deficits in chronic mechanical ankle instability. J Orthop Surg Res 15(1):304PubMedPubMedCentralCrossRef Wenning M, Gehring D, Mauch M, Schmal H, Ritzmann R, Paul J (2020) Functional deficits in chronic mechanical ankle instability. J Orthop Surg Res 15(1):304PubMedPubMedCentralCrossRef
32.
Zurück zum Zitat Wu X, Song W, Zheng C, Zhou S, Bai S (2015) Morphological study of mechanoreceptors in collateral ligaments of the ankle joint. J Orthop Surg Res 10:92PubMedPubMedCentralCrossRef Wu X, Song W, Zheng C, Zhou S, Bai S (2015) Morphological study of mechanoreceptors in collateral ligaments of the ankle joint. J Orthop Surg Res 10:92PubMedPubMedCentralCrossRef
33.
Zurück zum Zitat Yeo ED, Lee KT, Sung IH, Lee SG, Lee YK (2016) Comparison of all-inside arthroscopic and open techniques for the modified Brostrom procedure for ankle instability. Foot Ankle Int 37(10):1037–1045PubMedCrossRef Yeo ED, Lee KT, Sung IH, Lee SG, Lee YK (2016) Comparison of all-inside arthroscopic and open techniques for the modified Brostrom procedure for ankle instability. Foot Ankle Int 37(10):1037–1045PubMedCrossRef
34.
Zurück zum Zitat Zhou YF, Zhang ZZ, Zhang HZ, Li WP, Shen HY, Song B (2021) All-inside arthroscopic modified Brostrom technique to repair anterior talofibular ligament provides a similar outcome compared with open Brostrom-Gould procedure. Arthroscopy 37(1):268–279PubMedCrossRef Zhou YF, Zhang ZZ, Zhang HZ, Li WP, Shen HY, Song B (2021) All-inside arthroscopic modified Brostrom technique to repair anterior talofibular ligament provides a similar outcome compared with open Brostrom-Gould procedure. Arthroscopy 37(1):268–279PubMedCrossRef
Metadaten
Titel
Arthroscopic modified Broström procedure achieves faster return to sports than open procedure for chronic ankle instability
verfasst von
Zong-chen Hou
Tong Su
Ying-fang Ao
Yue-lin Hu
Chen Jiao
Qin-wei Guo
Shuang Ren
Nan Li
Dong Jiang
Publikationsdatum
13.04.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 10/2022
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-022-06961-0

Weitere Artikel der Ausgabe 10/2022

Knee Surgery, Sports Traumatology, Arthroscopy 10/2022 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

15.05.2024 Vordere Kreuzbandruptur Nachrichten

Mit dem Hebelzeichen-Test lässt sich offenbar recht zuverlässig feststellen, ob ein vorderes Kreuzband gerissen ist. In einer Metaanalyse war die Vorhersagekraft vor allem bei positivem Testergebnis hoch.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.