Original ResearchThe “All Inside” Arthroscopic Broström Procedure: A Prospective Study of 40 Consecutive Patients
Section snippets
Patients and Methods
A prospective study of 40 consecutive patients (40 ankles), treated from August 2011 to November 2012, with chronic lateral ankle instability was performed with a mean follow-up of 12.13 ± 4.27 (range 6 to 21) months. In all patients, a period of conservative treatment had failed, and all patients complained of continued pain and functional or mechanical instability preoperatively 5, 15. The patients were excluded from this technique if they had undergone a previous lateral ankle ligament
Surgical Technique
Each patient received a popliteal block administered by the anesthesia department preoperatively. The patient was then placed on the operating table in a supine position, and general anesthesia was administered. A well-padded thigh tourniquet was applied, and a thigh holder was positioned to have the foot elevated off the operating table a few inches. It is imperative to outline with a surgical marker the distal fibula, the course of the peroneal tendons, and the superficial peroneal nerve
Results
A total of 40 patients (40 ankles) underwent ankle arthroscopy with an “all-inside Broström” procedure. Of the 40 patients, 27 (67.5%) were females and 13 (32.5%) were males, with 15 (37.5%) right and 25 (62.5%) left ankles. The mean age was 45.6 (range 15 to 83) years. Mean follow-up was 12.13 ± 4.27 (range 6 to 21) months. The mean preoperative VAS pain score was 8.2 (range 4 to 10). The mean postoperative VAS pain score was 1.1 (range 0 to 5). The mean postoperative Karlsson–Peterson score
Discussion
Those patients whose injury is unresponsive to conservative modalities might require some form of stabilization of the lateral ankle ligament complex to alleviate their symptoms and resume activity. The Broström-Gould procedure has become a well-accepted standard in addressing primary stabilization for the typical patient (8). However, other pathologic features are frequently involved within the ankle joint itself that might not be addressed by an isolated Broström-Gould procedure.
In a recent
References (27)
- et al.
Thermal-assisted capsular modification for functional ankle instability
Foot Ankle Clin North Am
(2002) - et al.
The use of arthroscopic thermal shrinkage to treat chronic lateral ankle instability in young athletes
Arthroscopy
(2005) Arthroscopic stapling repair for chronic lateral instability
Clin Podiatr Med Surg
(1987)- et al.
Arthroscopic stabilization of the ankle
Clin Podiatr Med Surg
(1997) - et al.
Evaluation of ankle joint function: the use of a scoring scale
Foot
(1991) Surgical treatment of the unstable ankle
J Am Acad Orthop Surg
(1998)The frequency of injury, mechanism of injury, and epidemiology of ankle sprains
Am J Sports Med
(1977)Sprained ankles, VI: surgical treatment of “chronic” ligament ruptures
Acta Chir Scand
(1966)- et al.
Early and late repair of the lateral ligaments of the ankle
Foot Ankle
(1980) - et al.
Arthroscopic lateral ankle ligament reconstruction
Tech Foot Ankle Surg
(2011)
Arthroscopic repair of chronic lateral ankle instability
Foot Ankle Int
Anatomical reconstruction for chronic lateral ankle instability in the high-demand athlete: functional outcomes after the modified Broström repair using suture anchors
Am J Sports Med
A radiographic investigation to determine the safety of suture anchor systems for pediatric modified Broström ankle ligament reconstruction
Am J Sports Med
Cited by (123)
Accuracy of Cutaneous Landmarks Compared to Ultrasound to Locate the Calcaneal Footprint of the CFL
2024, Journal of Foot and Ankle SurgeryArthroscopic Lateral Stabilization
2023, Clinics in Podiatric Medicine and SurgeryDetermining the Feasibility of Arthroscopic Anterior Talofibular Ligament Repair Utilizing a Novel Classification System
2023, Journal of Foot and Ankle SurgeryReturn to sports: Rate and time after arthroscopic surgery for chronic lateral ankle instability
2022, Revue de Chirurgie Orthopedique et TraumatologiqueReturn to sports: Rate and time after arthroscopic surgery for chronic lateral ankle instability
2022, Orthopaedics and Traumatology: Surgery and Research
Financial Disclosure: None reported.
Conflict of Interest: Dr. Cottom is a paid consultant for Arthrex, Inc., Naples, FL. Arthrex had no role in the design, data collection, or writing of this paper.