Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Comparison of the Modified Brostrom Repair Technique with and without Augmentation Using Suture Tape for Chronic Ankle Instability

만성 족관절 불안정성을 가진 환자군에서 변형 브로스트롬 술식과 봉합 테이프를 추가한 술식 간의 결과 비교

  • Gwak, Heui-Chul (Department of Orthopedic Surgery, Busan Paik Hospital, College of Medicine, Inje University) ;
  • Jung, Soo-Hwan (Department of Orthopedic Surgery, Busan Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Jung-Han (Department of Orthopedic Surgery, Busan Paik Hospital, College of Medicine, Inje University) ;
  • Park, Dae-Hyun (Department of Orthopedic Surgery, Busan Paik Hospital, College of Medicine, Inje University) ;
  • Choo, Hye-Jung (Department of Radiology, Busan Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Dae-Yoo (Department of Orthopedic Surgery, Busan Paik Hospital, College of Medicine, Inje University)
  • 곽희철 (인제대학교 의과대학 부산백병원 정형외과학교실) ;
  • 정수환 (인제대학교 의과대학 부산백병원 정형외과학교실) ;
  • 김정한 (인제대학교 의과대학 부산백병원 정형외과학교실) ;
  • 박대현 (인제대학교 의과대학 부산백병원 정형외과학교실) ;
  • 추혜정 (인제대학교 의과대학 부산백병원 영상의학교실) ;
  • 김대유 (인제대학교 의과대학 부산백병원 정형외과학교실)
  • Received : 2021.12.01
  • Accepted : 2022.01.27
  • Published : 2022.03.15
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Abstract

Purpose: The modified Broström repair (BR) technique has yielded good outcomes in patients with chronic ankle instability. This study compared clinical and radiological outcomes between two groups of patients who underwent modified BR or lateral ligament augmentation using suture tapes (ST). Materials and Methods: Seventy-seven patients (ST group [n=47], BR group [n=30]; body mass index <26.61 kg/m2; mean age, 30.7±11.0 years [range, 17~39 years]; mean follow-up, 34.0±12.0 months [range, 24~59 months]) were retrospectively reviewed between January 2014 and July 2017. The Foot and Ankle Outcome Score (FAOS), American Orthopedic Foot and Ankle Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS) score, and Sefton grading system were used for clinical assessment. The talar tilt angle and anterior talar translation were measured using the Telos stress device (Telos GmbH, Marburg, Germany) at 150 N for radiological evaluation. Results: FAOS, AOFAS, FAAM, and VAS scores improved in both groups at final follow-up (ST, 91.1±5.2, 93±2, 88.1±4.5, 1.5±0.7 vs. BR, 91.3±5.4, 93±3, 83.3±4.8, 1.2±0.7, respectively; p=0.854, 0.971, <0.001, 0.04, respectively). According to the FAOS, mean sports activity scores for the ST and BR groups at the final follow-up were 90.3±3.2 and 76.6±4.2, respectively, reflecting superior outcomes in the ST group (p<0.001). Sefton grading revealed satisfactory functional outcomes (ST, 91.5% vs. BR, 90.0%). There was significant improvement in the talar tilt angle and anterior talar translation in both the ST and BR groups (7.6°±1.2°, 10.5±1.8 mm vs. 4.9°±1.1°, 7.9±1.5 mm, respectively; p<0.001). Conclusion: The ST group demonstrated comparable clinical but better improvement in mechanical stability and FAOS sports scores than the BR group.

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References

  1. Cho BK, Kim YM, Kim DS, Choi ES, Shon HC, Park KJ. Comparison between suture anchor and transosseous suture for the modified-Brostrom procedure. Foot Ankle Int. 2012;33:462-8. doi: 10.3113/FAI.2012.0462.
  2. Karlsson J, Bergsten T, Lansinger O, Peterson L. Reconstruction of the lateral ligaments of the ankle for chronic lateral instability. J Bone Joint Surg Am. 1988;70:581-8. https://doi.org/10.2106/00004623-198870040-00015
  3. Li X, Killie H, Guerrero P, Busconi BD. Anatomical reconstruction for chronic lateral ankle instability in the high-demand athlete: functional outcomes after the modified Brostrom repair using suture anchors. Am J Sports Med. 2009;37:488-94. doi: 10.1177/0363546508327541.
  4. Sefton GK, George J, Fitton JM, McMullen H. Reconstruction of the anterior talofibular ligament for the treatment of the unstable ankle. J Bone Joint Surg Br. 1979;61:352-4. doi: 10.1302/0301-620X.61B3.113415.
  5. Cho BK, Kim YM, Kim DS, Choi ES, Shon HC, Park KJ. Outcomes of the modified Brostrom procedure using suture anchors for chronic lateral ankle instability: a prospective, randomized comparison between single and double suture anchors. J Foot Ankle Surg. 2013;52:9-15. doi: 10.1053/j.jfas.2012.10.004.
  6. Clanton TO, Viens NA, Campbell KJ, LaPrade RF, Wijdicks CA. Anterior talofibular ligament ruptures, part 2: biomechanical comparison of anterior talofibular ligament reconstruction using semitendinosus allografts with the intact ligament. Am J Sports Med. 2014;42:412-6. doi: 10.1177/0363546513509963.
  7. Giza E, Shin EC, Wong SE, Acevedo JI, Mangone PG, Olson K, et al. Arthroscopic suture anchor repair of the lateral ligament ankle complex: a cadaveric study. Am J Sports Med. 2013;41:2567-72. doi: 10.1177/0363546513500639.
  8. Viens NA, Wijdicks CA, Campbell KJ, LaPrade RF, Clanton TO. Anterior talofibular ligament ruptures, part 1: biomechanical comparison of augmented Brostrom repair techniques with the intact anterior talofibular ligament. Am J Sports Med. 2014;42:405-11. doi: 10.1177/0363546513510141.
  9. Hu CY, Lee KB, Song EK, Kim MS, Park KS. Comparison of bone tunnel and suture anchor techniques in the modified Brostrom procedure for chronic lateral ankle instability. Am J Sports Med. 2013;41:1877-84. doi: 10.1177/0363546513490647.
  10. Roos EM, Brandsson S, Karlsson J. Validation of the foot and ankle outcome score for ankle ligament reconstruction. Foot Ankle Int. 2001;22:788-94. doi: 10.1177/107110070102201004.
  11. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15:349-53. doi: 10.1177/107110079401500701.
  12. Ibrahim T, Beiri A, Azzabi M, Best AJ, Taylor GJ, Menon DK. Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales. J Foot Ankle Surg. 2007;46:65-74. doi: 10.1053/j.jfas.2006.12.002.
  13. Martin RL, Irrgang JJ, Burdett RG, Conti SF, Van Swearingen JM. Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int. 2005;26:968-83. doi: 10.1177/107110070502601113.
  14. Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990;13:227-36. doi: 10.1002/nur.4770130405.
  15. Karlsson J, Lansinger O. Chronic lateral instability of the ankle in athletes. Sports Med. 1993;16:355-65. doi: 10.2165/00007256-199316050-00006.
  16. Huang B, Kim YT, Kim JU, Shin JH, Park YW, Kim HN. Modified Brostrom procedure for chronic ankle instability with generalized joint hypermobility. Am J Sports Med. 2016;44:1011-6. doi: 10.1177/0363546515623029.
  17. Hassan S, Thurston D, Sian T, Shah R, Aziz A, Kothari P. Clinical outcomes of the modified Brostrom technique in the management of chronic ankle instability after early, intermediate, and delayed presentation. J Foot Ankle Surg. 2018;57:685-8. doi: 10.1053/j.jfas.2017.12.003.
  18. Coetzee JC, Ellington JK, Ronan JA, Stone RM. Functional results of open Brostrom ankle ligament repair augmented with a suture tape. Foot Ankle Int. 2018;39:304-10. doi: 10.1177/1071100717742363.
  19. Xu DL, Gan KF, Li HJ, Zhou SY, Lou ZQ, Wang Y, et al. Modified Brostrom repair with and without augmentation using suture tape for chronic lateral ankle instability. Orthop Surg. 2019;11:671-8. doi: 10.1111/os.12516.
  20. Cho BK, Park JK, Choi SM, SooHoo NF. A randomized comparison between lateral ligaments augmentation using suture-tape and modified Brostrom repair in young female patients with chronic ankle instability. Foot Ankle Surg. 2019;25:137-42. doi: 10.1016/j.fas.2017.09.008.
  21. Li H, Zhao Y, Chen W, Li H, Hua Y. No differences in clinical outcomes of suture tape augmented repair versus Brostrom repair surgery for chronic lateral ankle instability. Orthop J Sports Med. 2020;8:2325967120948491. doi: 10.1177/2325967120948491.
  22. Schuh R, Benca E, Willegger M, Hirtler L, Zandieh S, Holinka J, et al. Comparison of Brostrom technique, suture anchor repair, and tape augmentation for reconstruction of the anterior talofibular ligament. Knee Surg Sports Traumatol Arthrosc. 2016;24:1101-7. doi: 10.1007/s00167-015-3631-7.
  23. Girard P, Anderson RB, Davis WH, Isear JA, Kiebzak GM. Clinical evaluation of the modified Brostrom-Evans procedure to restore ankle stability. Foot Ankle Int. 1999;20:246-52. doi: 10.1177/107110079902000407.
  24. Sammarco GJ, Idusuyi OB. Reconstruction of the lateral ankle ligaments using a split peroneus brevis tendon graft. Foot Ankle Int. 1999;20:97-103. doi: 10.1177/107110079902000205.
  25. Cho BK, Park KJ, Kim SW, Lee HJ, Choi SM. Minimal invasive suture-tape augmentation for chronic ankle instability. Foot Ankle Int. 2015;36:1330-8. doi: 10.1177/1071100715592217.
  26. Kirk KL, Campbell JT, Guyton GP, Parks BG, Schon LC. ATFL elongation after Brostrom procedure: a biomechanical investigation. Foot Ankle Int. 2008;29:1126-30. doi: 10.3113/FAI.2008.1126.