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Modified Broström procedure in patients with chronic ankle instability is superior to conservative treatment in terms of muscle endurance and postural stability

  • ANKLE
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To compare muscle strength, muscle endurance, and postural stability in both the affected and unaffected ankles between patients with chronic ankle instability (CAI) who underwent conservative treatment and those who underwent the modified Broström procedure (MBP).

Methods

A total of 67 patients (37, conservative treatment; 30, MBP) participated. Muscle strength and muscle endurance were measured using an isokinetic device, and postural stability was tested using a postural stabilometry system. We used the independent t test for continuous variables with a normal distribution and Fisher’s exact test for categorical variables.

Results

There was no difference in the muscle strengths of the affected and unaffected ankles between the groups. The muscle endurance of plantarflexion and inversion muscles was significantly lower in the affected ankles of the conservative treatment group than in those of the MBP group (plantarflexion: 209 ± 103.1 vs. 318 ± 162.2, p = 0.001; inversion: 93 ± 58.7 vs. 154 ± 65.9, p < 0.001). Static postural stability testing showed no significant differences between the affected and unaffected ankles of the two groups. In the dynamic postural stability test, the overall, anterior–posterior, and medial–lateral stability indices were all significantly higher in the affected ankles of the conservative treatment group than in those of the MBP group (p < 0.001, p = 0.004, p = 0.004, respectively), with no differences observed in the unaffected ankles.

Conclusion

The MBP may significantly improve muscle endurance and dynamic postural stability in CAI patients in whom conservative treatment has failed. Therefore, clinicians should consider using MBP instead of conservative treatment when patients show severe muscle weakness or dynamic postural instability.

Level of evidence

Case–control study, Level III.

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Funding

This research was supported by the NRF Grant funded by the Korea government (NRF-2018R1C1B6005202).

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Authors and Affiliations

  1. Department of Sports Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea

    Jin Hyuck Lee, Soon Hyuck Lee & Woo Young Jang

  2. Department of Orthopedic Surgery, College of Medicine, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea

    Soon Hyuck Lee & Woo Young Jang

  3. Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Republic of Korea

    Hae Woon Jung

Authors
  1. Jin Hyuck Lee
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Correspondence to Woo Young Jang.

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No financial biases exist for any author.

Ethical approval

The institutional review board of the Korea University Anam Hospital approved this study (No: ED17143).

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Lee, J.H., Lee, S.H., Jung, H.W. et al. Modified Broström procedure in patients with chronic ankle instability is superior to conservative treatment in terms of muscle endurance and postural stability. Knee Surg Sports Traumatol Arthrosc 28, 93–99 (2020). https://doi.org/10.1007/s00167-019-05582-4

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