Clinical outcomes of the modified Broström procedure using distal fibular periosteal flap augmentation

Choi, Hongjoon; Kim, D.W.; Cho, J.H.; Park, C.H.; Chun, Dong-Il; Kang, Young Hwa

doi:10.1016/j.fas.2017.07.213

Cited by 1 publication

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“…In this study, both the L-shaped tunnel and Y-graft techniques were found to be reliable in achieving favourable outcomes at a mean follow-up of 5 years, with similar functional improvements and radiographic indings as previous studies reported at 1-3 years [2,5,9,19]. Past biomechanical and clinical studies have shown that anatomic reconstruction was better than non-anatomic reconstruction [23,31].…”

Section: Discussionsupporting

confidence: 77%

The L-shaped tunnel technique showed favourable outcomes similar to those of the Y-graft technique in anatomic lateral ankle ligament reconstruction

Jiang

Hou

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeTo compare the mid‐ to long‐term clinical and radiological outcomes of the confluent L‐shaped tunnel technique with the Y‐graft technique for anatomic lateral ankle ligament reconstruction. MethodsThis retrospective study involved 41 patients who underwent lateral ankle ligament reconstruction between 2013 and 2018. Based on the tunnel direction and tendon fixation method at the fibula side, patients were divided into two groups, with 17 patients in the L‐shaped tunnel group and 24 patients in the Y‐graft group. The American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) pain score, Tegner score, and Karlsson score were evaluated and compared preoperatively and at follow‐up. Anterior talar translation and talar tilt at stress radiographs, postoperative sprain recurrence, range of motion (ROM) restriction, sensory disturbance, etc., were also collected and compared. ResultsThe mean follow‐up times were 72 and 42 months for the L‐shaped group and Y‐graft group, respectively. The median VAS pain score, Tegner score, AOFAS score, Karlsson score significantly improved from a preoperative level in both groups (all with p < 0.01). No significant difference was found between the two groups regarding the changes from preoperatively to postoperatively except for the VAS pain score reduction (1.58 ± 1.58 in the L‐shaped group vs. 2.53 ± 1.29 in the Y‐graft group, p = 0.035). The incidence of flexion–extension ROM restriction (≥ 5°) was significantly higher in the Y‐graft group (41.2%) than in the L‐shaped group (12.5%) (p = 0.035). ConclusionsBoth the confluent L‐shaped tunnel technique and the Y‐graft technique significantly improved symptoms, ankle function, and radiographic outcomes in patients with chronic lateral ankle instability (CLAI) at mid‐ to long‐term follow‐up. The confluent L‐shaped tunnel technique resulted in lower rates of flexion–extension ROM restriction, while the Y‐graft technique showed better VAS pain reduction. This result could provide further evidence for the surgical treatment of CLAI. Level of evidenceIII.

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Section: Discussionsupporting

confidence: 77%