Summary

All-inside arthroscopic modified Broström operation with single double loaded suture anchor yield good clinical and radiographic results for the treatment of chronic lateral ankle instability

Abstract

The modified Brostrom-Gould operation is considered the gold standard procedure for the treatment of chronic lateral ankle instability . Originally, this procedure was done by the open method, but recently, the all-inside arthroscopic Broström-Gould operation has become more popular and also shown good clinical results. The aim of the study was to determine the mid-term functional, image outcomes and complication rate among patients who underwent the all-inside arthroscopic modified Broström operation with a single double loaded suture anchor for chronic lateral ankle instability.
From 2021.01 to 2023.07, 36 consecutive patients with chronic lateral ankle instability underwent all-inside arthroscopic modified Broström operation by a single surgeon. Of these, 6 patients were lost to follow-up, and 30 patients were followed up for at least 12 months. At the post-op 1 year follow-up, all patients were evaluated clinically using the Visual Analogue Scale (VAS) scores and the American Orthopedic Foot and Ankle Society (AOFAS) score. Radiological evaluation was performed using anterior drawer and varus stress radiographs with a standard Telos device in 150 N. Talar tilt angles and anterior talar translation were measured both preoperatively and 1 year postoperatively.
All the functional scores (AOFAS and VAS) significantly improved after one year of surgery. Preoperatively, the mean AOFAS score was 68.8 ± 8.5, while postoperatively, the score was 90.6 ±  4.6, and the mean VAS score was 5.2 ± 1.5 preoperatively and improved to 0 postoperatively. Talar tilt angle and anterior talar translation measured by the stress radiographs also significantly improved after the operation at 1 year follow up. Talar tilt angle (°) improved from 12.4 ± 7.8 to 5.2 ± 4.8, and the anterior talar translation (mm) improved from 11.4 ± 4.7 to 4.2 ± 3.3. There was no complication observed one year post-surgery.
The all-inside arthroscopic modified Broström operation with a single suture anchor technique showed excellent functional and radiographic outcomes after one year of follow-up without any complications, which provides a good treatment option for chronic lateral ankle instability patients who had failed conservative treatment.