Presence of Subfibular Ossicle Does Not Affect the Outcome of Arthroscopic Modified Broström Procedure for Chronic Lateral Ankle Instability

Kim, Woo Jong; Lee, Hong Seop; Moon, Sang Il; Kim, Hak Soo; Yeo, Eui Dong; Kim, Young Hwan; Park, Eun Seok; Lee, Young Koo

doi:10.1016/j.arthro.2018.10.148

Cited by 18 publications

(8 citation statements)

References 30 publications

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“…Partial defects of the ATFL with subfibular ossicle excision afforded clinical and radiographical outcomes comparable to those in the traditional modified Broström procedure. Kim et al [ 11 ] compared the results of 26 CLAI ankles with subfibular ossicles to those of 99 ankles without subfibular ossicles. The ossicle to the lateral ligament was resected, the ATFL remnants were not repairable, and augmentation of the lateral capsule and inferior extensor retinaculum was performed using the all-inside arthroscopic modified Broström procedure.…”

Section: Discussionmentioning

confidence: 99%

All-inside arthroscopic modified Broström-Gould procedure for chronic lateral ankle instability with and without anterior talofibular ligament remnant repair produced similar functional results

Feng

Maffulli

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose The Broström-Gould procedure, with the repair of the anterior talofibular ligament (ATFL) combined with the transfer of the extensor retinaculum, is considered the gold standard procedure for the management of chronic lateral ankle instability (CLAI). Lateral ligament reconstruction is considered if the ATFL remnant quality is poor or the ATFL has been damaged beyond the ability to suture it. It remains unclear whether not repairing the ATFL remnant produces comparable functional outcomes to the classical Broström-Gould procedure. Methods This retrospective cohort study included 84 patients with CLAI undergoing either repair or non-repair of the ATFL remnant using an all-inside arthroscopic Broström-Gould procedure from 2015 to 2018. The Visual Analogue Scale (VAS) scores, American Orthopedic Foot and Ankle Society (AOFAS) scores, Karlsson Ankle Functional Score (KAFS), Anterior Talar Translation (ATT), Active Joint Position Sense (AJPS), and the rate of return to sports were compared in both groups. Results All the functional scores (VAS, AOFAS, KAFS, ATT, AJPS) significantly improved in both groups at 1 and 2 years after surgery. At all the follow-up time points, the VAS, AOFAS, KAFS, ATT, AJPS, and the rate of return to sport scores were comparable between the repair and non-repair group. Conclusion There are no statistically significant differences in postoperative outcomes between ATFL remnant repair and non-repair for the management of CLAI using the all-inside arthroscopic Broström-Gould procedure. From the clinical viewpoint, the present study shows that the potential differences in clinical outcomes between ATFL remnant repair and non-repair are likely not relevant when performing an all-inside arthroscopic Broström-Gould procedure for CLAI. Level of evidence III.

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Section: Discussionmentioning

confidence: 99%

All-inside arthroscopic modified Broström-Gould procedure for chronic lateral ankle instability with and without anterior talofibular ligament remnant repair produced similar functional results

Feng

Maffulli

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…performed open Broström–Gould procedures with two suture anchors in free‐edge suture fashion on 12 fresh cadaveric specimens. The maximum load to failure reached 156.43 (range 83.69 to 192.00) N. Kim and coworkers 23 examined 99 CLAI patients treated with the all‐inside arthroscopic Broström–Gould procedure; at 12 months after surgery, they found that AOFAS increased from 65.0 to 87.0, and the talar tilt decreased from 7.3º to 3.2º.…”

Section: Discussionmentioning

confidence: 99%

Functional Comparison of Horizontal Mattress Suture VersusFree‐Edge Suture in the All‐Inside Arthroscopic Broström–Gould Procedure for Chronic Lateral Ankle Instability

Feng

Han

Wang

et al. 2020

Orthopaedic Surgery

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Objective: To compare the clinical outcomes of horizontal mattress suture vs free-edge suture in the all-inside arthroscopic Broström-Gould procedure. Methods: This retrospective cohort study included 68 chronic lateral ankle instability (CLAI) patients who underwent either a horizontal mattress suture or a free-edge suture all-inside arthroscopic Broström-Gould procedure from January 2014 to January 2017. Patients were divided into two groups based on the suture fashion during the all-inside arthroscopic Broström-Gould procedure. In the horizontal mattress suture group (n = 31), anchor sutures were used to suture the ATFL, capsule, and inferior extensor retinaculum in horizontal mattress suture fashion. In the free-edge suture group (n = 37), anchor sutures were used to suture the ATFL, capsule, and inferior extensor retinaculum in free-edge suture fashion. The Visual Analogue Scale (VAS) score, the American Orthopaedic Foot and Ankle Society (AOFAS) score, Karlsson Ankle Functional Score (KAFS), Anterior Talar Translation (ATT), the rate of return to sports, and ankle proprioceptive recovery were compared in both groups. Results: The operative times and duration of hospitalization between the two groups were comparable (all P > 0.05). The VAS, AOFAS, ATT, the rate of return to sports, and ankle proprioceptive recovery were comparable between the horizontal mattress suture and free-edge suture groups at 1 and 2 years after surgery. Patients of the free-edge suture group achieved better KAFS 1 and 2 years after the surgery compared with those of the horizontal mattress suture group. In both groups, incisions were healed by first intention, and complications such as infection, implant reactions, tendon injury, and nervous or vascular injuries were not observed. The ankle proprioceptive recovery in horizontal mattress suture and free-edge suture groups showed no significant differences at 1 and 2 years after surgery. The mean time of the return to full activity for patients in the horizontal mattress suture group was 10.38 AE 2.02 (range 8 to 12) weeks vs 8.63 AE 2.31 (range 8 to 12) weeks for those in the free-edge suture group (P = 0.001, power = 0.907). The exercise participation rates were comparable between groups (P > 0.05). At the 2-year follow-up, all patients regained normal activities and ankle stability, and no recurrence of CLAI or revision surgery was recorded. Conclusion: All-inside arthroscopic Broström-Gould surgery for the treatment of CLAI ensures a better functional effect (KAFS) and better recovery time when free-edge suture is used instead of horizontal mattress suture.

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“…Moreover, repetitive trauma can degenerate joint cartilage, leading to early onset of post-traumatic osteoarthritis (Lee et al, 2015), which lacks effective treatment (Yeo et al, 2021). Nowadays, conservative rehabilitation and surgery after ineffectual conservative management are the primary treatment for CAI (Yeo et al, 2016;Kim et al, 2019). However, some patients fail to recover or return to sports as usual (Doherty et al, 2017;Aicale and Maffulli, 2020).…”

Section: Introductionmentioning

confidence: 99%

Not Only in Sensorimotor Network: Local and Distant Cerebral Inherent Activity of Chronic Ankle Instability—A Resting-State fMRI Study

Shen

Wang

et al. 2022

Front. Neurosci.

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BackgroundIncreasing evidence has proved that chronic ankle instability (CAI) is highly related to the central nervous system (CNS). However, it is still unclear about the inherent cerebral activity among the CAI patients.PurposeTo investigate the differences of intrinsic functional cerebral activity between the CAI patients and healthy controls (HCs) and further explore its correlation with clinical measurement in CAI patients.Materials and MethodsA total of 25 CAI patients and 39 HCs were enrolled in this study. Resting-state functional magnetic resonance imaging (rs-fMRI) was used to detect spontaneous cerebral activity. The metrics of amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) of the two groups were compared by two-sample t-test. The brain regions that demonstrated altered functional metrics were selected as the regions of interest (ROIs). The functional connectivity (FC) was analyzed based on the ROIs. The Spearman correlation was calculated between rs-fMRI metrics and clinical scale scores.ResultsCompared with HCs, CAI patients showed higher ALFF and ReHo values in the right postcentral gyrus, the right precentral gyrus, and the right middle frontal gyrus, while lower fALFF values in the orbital-frontal cortex (OFC, p < 0.01 after correction). Increasing FC between the right precentral gyrus and the right postcentral gyrus while decreasing FC between the right precentral gyrus and the anterior cingulum cortex (ACC), the right middle frontal gyrus and the left middle temporal gyrus, and the OFC and left inferior parietal lobule (IPL) was observed. In addition, in the CAI group, the ReHo value negatively correlated with the Cumberland Ankle Instability Tool score in the right middle frontal gyrus (r = −0.52, p = 0.007).ConclusionThe CAI patients exhibited enhanced and more coherent regional inherent neuronal activity within the sensorimotor network while lower regional inherent activity in pain/emotion modulation related region. In addition, the information exchanges were stronger within the sensorimotor network while weaker between distant interhemispheric regions. Besides, the increased inherent activity in the right middle frontal gyrus was related to clinical severity. These findings may provide insights into the pathophysiological alteration in CNS among CAI patients.

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Presence of Subfibular Ossicle Does Not Affect the Outcome of Arthroscopic Modified Broström Procedure for Chronic Lateral Ankle Instability

Cited by 18 publications

References 30 publications

All-inside arthroscopic modified Broström-Gould procedure for chronic lateral ankle instability with and without anterior talofibular ligament remnant repair produced similar functional results

All-inside arthroscopic modified Broström-Gould procedure for chronic lateral ankle instability with and without anterior talofibular ligament remnant repair produced similar functional results

Functional Comparison of Horizontal Mattress Suture VersusFree‐Edge Suture in the All‐Inside Arthroscopic Broström–Gould Procedure for Chronic Lateral Ankle Instability

Not Only in Sensorimotor Network: Local and Distant Cerebral Inherent Activity of Chronic Ankle Instability—A Resting-State fMRI Study

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