• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.201-207
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• 2003

Purpose: We reviewed the value of treatment for chronic lateral instability of theankle with arthroscopic procedure combined with Brostrom one. Material and Method: From May 2000 to June 2002, 18 patient with chronic lateral instability of the ankle with Modified Brostrom procedure and arthroscopic one. Mean follow-up period was 18 months. Result: Chronic lateral instability of the ankle almost had intraarticular pathology, such as osteophye, osteochondral lesion, So we could resolve intraarticular pathology by arthroscopic procedure during Brostrom one for lateral collateral ligament reconstruction. Conclusion: Modified Brostrom procedure and arthroscopic one are an excellent treating method for chronic lateral instability of the ankle which has intraarticular pathology.

• Journal of Korean Foot and Ankle Society
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• v.23 no.1
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• pp.6-11
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• 2019

As a result of the increased participation in recreational and competitive sports activity, the incidence of chronic lateral instability has risen. Because chronic ankle instability can cause significant comorbidity and increase the social cost, the interest in this issue is growing. Although there are well-documented and effective surgical treatments for managing this condition, conservative treatments are a viable first option in selected patients. Through conservative treatment, surgical treatments can be reduced or delayed without necessarily affecting the overall outcome, but the failure of conservative treatment results in the need for surgical treatment to reduce the long term complications. Appropriate postoperative rehabilitation is essential for adequate functional recovery, even when surgical treatment is required.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.19-22
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• 2009

Purpose: This retrospective study was designed to determine the type and frequency of associated lesions in patients with chronic lateral ankle instability who had modified Brostrom lateral ankle ligament reconstruction. Materials and Methods: Between 2004 and 2007, 60 cases of 60 patients were enrolled in this study. A retrospective review of the magnetic resonance images of the affected ankle was conducted by two orthopedic surgeons who did not get any information about intraoperative findings and the lesions were admitted when two doctors were coincident. Results: The overall incidence of associated lesions found in this study was about 83%. Peroneal tenosynovitis was the highest frequency (32%), followed by osteochondral lesion of talus (28%), anterolateral impingement (15%), Os subfibula (13%), Os trigonum (12%), ankle synovitis (12%), anterior tibiofibular ligament tear (15%), anterior bony spur (7%). Another findings were loose bodies (5%), flexor tendon tenosynovitis (5%), medial osteophyte (3%). Conclusion: Identifying these associated lesions will be helpful in treating chronic lateral ankle instability especially when the surgeon have a plan to operate the instability. We suggest that the better results can be obtained when the associated lesions are corrected simultaneously.

• Journal of Korean Foot and Ankle Society
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• v.23 no.1
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• pp.1-5
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• 2019

Surgical treatment to restore stability in the ankle and hindfoot and prevent further degenerative changes may be necessary in cases in which conservative treatment has failed. Anatomical direct repair using native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneus brevis tendon and applies only those with poor-quality ligaments. On the other hand, anatomic reconstruction and anatomic repair provide better functional outcomes after the surgical treatment of chronic ankle instability patients compared to a non-anatomic reconstruction. Anatomical reconstruction using an autograft or allograft applies to patients with insufficient ligament remnants to fashion direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. These procedures can provide good-to-excellent short-term outcomes. Arthroscopic ligament repair is becoming increasingly popular because it is minimally invasive. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, despite the relatively large number of complications, including nerve damage, reported following the procedure. Therefore, further investigation will be needed before widespread adoption is advocated.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.60-65
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• 2006

Purpose: This study was performed to evaluate clinical and radiographical results of treatment of chronic lateral ankle instability with modified Brostrom procedure. Materials and Methods: This is a retrospective study of 22 cases in 22 patients treated with modified $Brostr{\ddot{o}}m$ procedure under the diagnosis of chronic lateral ankle instability from May 2000 to August 2004. Average age was 32.3 years. Average follow-up period was 23 months. Preoperative and postoperative radiographs of ankle anteroposterior view, lateral view and varus stress view were analyzed. The clinical evaluation was performed according to the Americal Orthopaedic Foot and Ankle Society scales. Results: After the modified $Brostr{\ddot{o}}m$ procedure, Americal Orthopaedic Foot and Ankle Society scales score was improved by average 28 points. Among the 22 cases, 13 cases were excellent, 3 cases good, 4 cases fair, and 2 cases poor with satisfaction of 73%. Five cases had intermittent ankle pain of whom 3 cases had difficulty during competitive sports activity. Lateral tilting of talus improved by average 5.4 degrees on varus stress view. Conclusions: The modified $Brostr{\ddot{o}}m$ procedure is one of the most effective methods for treating of chronic lateral ankle instability.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.81-85
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• 2004

Purpose: The purpose of this study is to evaluate the surgical results of modified $Brostr{\ddot{o}}m$ procedure for chronic lateral ankle instability and to assess whether or not associated injuries may affect postoperative satisfaction. Materials and Methods: Twenty- four patients with chronic lateral ankle instability were evaluated retrospectively from August 1998 to March 2002. Average age was 29.3 years. All patients were performed pre & postoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device, MRI and intraoperative arthroscopic evaluations before ligament reconstruction. Results: Of the 24 cases, 23 cases was improved more than average 12 points on AOFAS scales. On modified scales of Hamilton, 3 excellent, 20 good, 1 fair results. On stress view, average 2.2 mm difference was improved on anterior drawer test and average 1.7 degree on varus test. Associated injuries were 8 osteochondral defects, 4 anterior impingements, 2 loose bodies, 2 os subfibulare, 2 os submalleolare and 2 partial ruptures of peroneus brevis. 8 cases with no associated injuries rated excellent or good. Conclusion: The modified $Brostr{\ddot{o}}m$ procedure is believed to be an effective and successful method for chronic lateral ankle instability that didn't respond to conservative treatment. Because associated injuries in chronic lateral ankle instability may affect postoperative satisfaction, appropriate detection and treatment may need for postoperative satisfaction.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.198-203
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• 2007

Purpose: To assess the arthroscopic findings in chronic lateral ankle instability and to evaluate the results of modified $Brostr{\ddot{o}}m$ operation and arthroscopic procedures. Materials and Methods: Twenty-nine cases with chronic lateral ankle instability were treated with modified $Brostr{\ddot{o}}m$ operation and ankle arthroscopy from May 2004 to January 2007. There were 19 male and 10 female with the mean age of 29.7 years. Mean follow up period was 15.8 months. All patients were checked preoperative stress anterior drawer and varus test with X-ray. Results: Associated injuries were 28 fat impingement projected into the joint between distal tibio-fibular space, 20 anterior impingement of soft tissue, 19 osteochondral defects and 13 loose body. Preoperative AOFAS score of pain, function and alignment were 28.9, 34.1 and 7.9 each other. They were improved into 38.7, 40.8 and 9.8 postoperatively. Conclusions: Modified $Brostr{\ddot{o}}m$ operation with ankle arthroscopy for chronic lateral ankle instability is believed to be a reliable option to obtain satisfactory results. Careful attention to the associated injuries such as distal fat impingement, anterior impingement, osteochondral defect and loose body is needed during the arthroscopy.

• Journal of Korean Foot and Ankle Society
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• v.21 no.1
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• pp.12-16
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• 2017

Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.

• Journal of Korean Foot and Ankle Society
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• v.26 no.4
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• pp.171-176
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• 2022

Purpose: This study reports on a series of patients with chronic lateral ankle instability that underwent the Brostrom procedure with suture tape augmentation and allowed early unrestricted weight-bearing in a simple stirrup brace. Materials and Methods: This retrospective study was conducted on 36 patients (22 males and 14 females of mean age 34 years [range 23~48 years]) with chronic lateral ankle instability treated using the Brostrom procedure using suture tape augmentation and inferior extensor retinaculum reinforcement with a fiber-wire connected to a SwiveLock screw inserted into the talus. When possible, patients started unrestricted weight-bearing in a stirrup brace from the third postoperative day. Demographics and functional outcomes, including American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, visual analogue scale (VAS), and satisfaction scores, were recorded. In addition, varus stress radiographs obtained before and 24 months after surgery were compared. Patients were followed for a mean 29 months (range 25~40 months). Results: Mean AOFAS ankle-hindfoot scores increased from 51 points preoperatively to 92 points at final follow-up, and mean VAS decreased from 6.8 to 1.2 points. Mean patient satisfaction scores were 8.7 at 12 months and 9.6 at 24 months. Stress radiographs demonstrated that talar tilt decreased from a mean 18 degrees preoperatively to 7 degrees at 24 months. Conclusion: Early unrestricted weight-bearing in a stirrup brace following the Brostrom procedure with suture tape augmentation is a successful protocol for treating chronic lateral ankle instability.

• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.66-72
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• 2002

Purpose: To evaluate the overall results and its major affecting factors(athlete/associated injury) of modified Brostrom procedure for chronic ankle lateral instability. Materials and Methods: Fifty-one patients (51 ankles) with chronic ankle lateral instability were sub-grouped athletes and non-athletes and again sub-grouped with associated injury and without associated injury. Associated injuries were osteochondral defect(6), peroneal tendon abnormality(10), os subfibularae(4), os subtibialae(4), anterior impingement(5) and loose body(2). The overall surgical results were evaluated and also see whether or not athletes and associated injury affect the result. Result: Of the 51 operations performed, there were 39 excellent, 8 good and 4 fair as a whole. Of the 24 athletes operated, there were 19 excellent, 3 good, and 2 fair. Among the 27 non-athletes, there were 20 excellent, 5 good and 2 fair results. The average time to ordinary life in the non-athlete group was 2.5 months and average time to sports activity in the athlete was 4.5 months postoperatively. Those who didn't have any associated injury had all excellent result, on the contrary, those who had associated injuries, 14 excellent, 8 good and 4 fair results. All the fair results were associated with osteochondral lesion of talus. Whether or not the patient is athlete does not affect the surgical results, but whether or not there were associated injuries does affect the surgical results. Conclusion: Modified Brostrom procedure for chronic ankle lateral instability itself is an excellent to good operation. This procedure can be used in athletic populations who need high demand of sports activity. But chronic ankle lateral instability with associated injury group showed variable, less satisfactory results than those without associated injury. Careful preoperative and intraoperative examination should be done to find out the associated injury with chronic ankle lateral instability.