Arthroscopic Brostrom Technique

Acevedo, Jorge I.; Mangone, Peter G.

doi:10.1177/1071100715576107

Cited by 102 publications

(118 citation statements)

References 28 publications

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“…Acevedo and Mangone (19) described their technique for the arthroscopic Brostr€ om procedure and their experience with this technique. They used a similar technique to that used in group 1 of the present study.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Two Different Arthroscopic Broström Repair Constructs for Treatment of Chronic Lateral Ankle Instability in 110 Patients: A Retrospective Cohort Study

Cottom

Baker

Plemmons

2018

The Journal of Foot and Ankle Surgery

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Chronic lateral ankle instability is a common condition treated by most foot and ankle surgeons. Once conservative treatment has failed, patients often undergo surgical reconstruction, either anatomic or nonanatomic. The present retrospective cohort study compared the clinical outcomes of 2 different arthroscopic Broström procedures. A total of 110 patients (83 females [75.5%] and 27 males [24.5%]) were treated with 1 of the 2 lateral ankle stabilization techniques from October 1, 2014 to December 31, 2015. Of the 110 patients, 75 were included in the arthroscopic lateral ankle stabilization group with an additional suture anchor used proximally and 35 were included in the arthroscopic lateral ankle stabilization group using the knotless design. The age of the cohort was 46.05 ± 17.89 (range 12 to 83) years. The body mass index was 30.03 ± 7.42 (range 18.3 to 52.5) kg/m. Of the 110 patients, 25 (22.7%) had undergone concomitant procedures during lateral ankle stabilization. Overall, postoperative complications occurred in 14 patients (12.7%). No statistically significant differences were found between the 2 groups regarding the complication rates, use of concomitant procedures, and the presence of diabetes and workers compensation claims. No statistically significant differences were found in the mean age, body mass index, or gender distribution between the 2 groups. The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores were 50.85 ± 13.56 (range 18 to 76) and 51.26 ± 13.32 (range 18 to 69) in groups 1 and 2, respectively. The postoperative AOFAS Ankle-Hindfoot scores were 88.19 ± 10.72 (range 54 to 100) and 84 ± 15.41 (range 16 to 100) in groups 1 and 2, respectively. No statistically significant difference was found between these 2 groups. The preoperative visual analog scale score was 7.45 ± 1.39 (range 3 to 10) and 6.97 ± 1.25 (range 5 to 10), which had improved to 1.12 ± 1.38 (range 0 to 5) and 1.8 ± 1.98 (range 1 to 9) postoperatively for groups 1 and 2, respectively. The difference in the postoperative visual analog scale score between the 2 groups was statistically significant. The preoperative and postoperative AOFAS scale, Foot Function Index, and Karlsson-Peterson scores showed no statistically significant differences between the 2 groups. From our experience, either procedure is an acceptable treatment option for chronic lateral ankle instability, with the knotless technique showing a trend toward more complications.

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Section: Discussionmentioning

confidence: 99%

Analysis of Two Different Arthroscopic Broström Repair Constructs for Treatment of Chronic Lateral Ankle Instability in 110 Patients: A Retrospective Cohort Study

Cottom

Baker

Plemmons

2018

The Journal of Foot and Ankle Surgery

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“…A number of techniques have been described for arthroscopic lateral ankle-ligament repair. [56][57][58] These procedures are similar to the modified Broström procedure, except that the surgeon places the anchors while viewing the distal fibula through an arthroscope rather than through an open exposure of the distal fibula. The technical details of the arthroscopic Broström are beyond the scope of this review.…”

Section: Ankle Arthroscopic and Arthroscopic Ligament Repairmentioning

confidence: 99%

“…The technical details of the arthroscopic Broström are beyond the scope of this review. Arthroscopic repair has been shown to restore equivalent function as open repair but with the advantages of smaller scars, less pain, less swelling, less disturbance of cutaneous sensation, 56 and possibly faster recovery. 57 Despite these reported advantages, arthroscopic repair has not yet gained widespread acceptance, perhaps because of the simplicity, reliability, and rapidity of the standard open-repair techniques.…”

Section: Ankle Arthroscopic and Arthroscopic Ligament Repairmentioning

confidence: 99%

“…For example, in 1 protocol, an athlete may be cleared to return to play simply by performing a full-speed figure of 8. 56 Other protocols deem an athlete ready to return to sport if he or she can perform both cutting exercises and drills pertaining to the desired sport-for example, karaoke drills in soccer, double jumps in basketball, or burpees in football. 60 Furthermore, some researchers 40 who used casts for 6 weeks as their postoperative immobilization protocol suggested that an athlete may return to play 3 months after cast removal without mention of passing any functional tests.…”

Section: Postoperative Management and Return To Sportmentioning

confidence: 99%

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Surgical Management of Lateral Ankle Instability in Athletes

Camacho

Roward

Deng

et al. 2019

Journal of Athletic Training

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Ankle sprains are common injuries involving the lateral ankle ligaments and affect athletes of all levels. Most patients heal uneventfully, but those with symptoms persisting past 3 months should be evaluated for chronic ankle instability and its associated conditions as well as for the presence of varus malalignment. Chronic ankle instability is initially treated nonoperatively, with surgical management reserved for those who have failed to improve after 3 to 6 months of bracing and functional rehabilitation. Anatomic repair using a modification of the Broström procedure is the preferred technique for initial surgery. Anatomic reconstruction with tendon graft should be considered when repair is not possible, as it maintains physiological joint kinematics. Nonanatomic reconstructions are seldom indicated. Arthroscopic repair or reconstruction of the lateral ankle ligaments is a promising new technique with results similar to those of open surgery.

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“…Pereira et al 22 also described a knotless suture anchor repair technique. The knotless suture anchor has the following advantages: (1) it avoids the need for classic knot-tying methods, diminishing the chance of knot migration caused by pendulum movements; (2) it avoids some complications that have been related to the use of metallic anchors and some currently available biomaterials; (3) and it prevents prominent knots, which have been described as a possible cause of secondary complaints.…”

mentioning

confidence: 99%

Anatomic Knot Suture Anchor Versus Knotless Suture Anchor Technique for Anterior Talofibular Ligament Repair: A Biomechanical Comparison

Hua

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: To date, there are few biomechanical studies comparing the strength between knot repair and knotless repair procedures for anterior talofibular ligament (ATFL) injury. Purpose: To perform a biomechanical comparison of the strength of the arthroscopic ATFL repair technique with knot or knotless suture anchors in a cadaveric model with partial or complete ATFL injuries. Study Design: Controlled laboratory study. Methods: A total of 24 fresh-frozen cadaveric ankles were used. Arthroscopy was used to identify, section, and repair the ATFL on the fibular insertion site. The specimens were then randomly placed into 1 of 4 groups: group A received complete ATFL section and 1–suture anchor repair with knot, group B received complete ATFL section and 1-anchor knotless repair, group C received partial ATFL section and 1–suture anchor repair with knot, and group D received partial ATFL section and 1-anchor knotless repair. After repair, the ATFL tension was measured first with a digitalized tensiometer. Specimens were then mounted on a materials testing system to determine the ultimate load to failure and stiffness. Results: The mean ± SD ligament tension measured during the arthroscopic procedure was 8.6 ± 0.6 N for group A, 9.2 ± 0.5 N for group B, 9.4 ± 1.1 N for group C, and 9.6 ± 0.9 N for group D. No significant difference in tension was detected among groups. In load-to-failure testing, the mean ultimate failure load was 27.9 ± 4.1 N for group A, 26.2 ± 9.3 N for group B, 81.9 ± 26.5 N for group C, and 88.1 ± 41.6 N for group D. The mean ultimate failure loads of the partial repair groups were significantly higher than those of the complete repair groups (C vs A, P = .008; D vs B, P = .002), while there was no significant difference between groups A and B ( P > .05) or between groups C and D ( P > .05). Conclusion: The results of the present study showed that there was no significant difference in biomechanical properties between knot repair and knotless repair techniques. Clinical Relevance: Biomechanically, the results showed that knot suture anchor and knotless suture repair provide similar biomechanical strength for ATFL injury. Unfortunately, these methods in the complete ATFL section models provided less than half the strength and stiffness in the partial ATFL section models at time zero after surgery. As a result, 1–suture anchor repair is not suitable for complete ATFL injury regardless of the repair method.

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Arthroscopic Brostrom Technique

Abstract: Level V, expert opinion.

Cited by 102 publications

References 28 publications

Analysis of Two Different Arthroscopic Broström Repair Constructs for Treatment of Chronic Lateral Ankle Instability in 110 Patients: A Retrospective Cohort Study

Analysis of Two Different Arthroscopic Broström Repair Constructs for Treatment of Chronic Lateral Ankle Instability in 110 Patients: A Retrospective Cohort Study

Surgical Management of Lateral Ankle Instability in Athletes

Anatomic Knot Suture Anchor Versus Knotless Suture Anchor Technique for Anterior Talofibular Ligament Repair: A Biomechanical Comparison

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