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Arthroscopic modified Broström procedure achieves faster return to sports than open procedure for chronic ankle instability

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

Abstract

Purpose

To compare the clinical outcomes, rate of return to sports, postural control, and muscle strength between the arthroscopic and open modified Broström procedure for chronic lateral ankle instability (CLAI) patients.

Methods

From September 2018 to April 2019, 70 patients diagnosed with CLAI were prospectively included with arthroscopic modified Broström procedure (n = 36) and open modified Broström procedure (n = 34). They were evaluated at five time points (preoperation and 3 months, 6 months, 1 year and 2 years postoperatively). The main results examined the rate of return to sports, American Orthopaedic Foot and Ankle Society Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS), centre of pressure (COP) excursion velocity, time to boundary (TTB), plantar pressure, isokinetic muscle strength and complications.

Results

Compared with the open group, the arthroscopic group demonstrated a significantly shorter period of return to the preinjury sport (13.2 ± 2.4 weeks vs. 18.7 ± 3.1 weeks, P = 0.023) and a higher early sport ratio (80.6 vs. 61.8%, P = 0.011) combined with better FAAM sports and AOFAS at 3 months and 6 months postoperatively and VAS at 3 months postoperatively. In addition, better anterior–posterior postural control stability, less time to peak force under lateral hindfoot and better dorsiflexion strength were shown in the arthroscopic group at 6 months postoperatively. No significant difference was found in clinical scores, posture control or muscle strength at the 1- or 2-year follow-up between the two groups.

Conclusions

Shorter period and higher rates of return to sport activities and better clinical scores, posture control and muscle strength were achieved in the arthroscopic group at 6 months postoperatively, and no clinical differences were found between arthroscopic and open modified Broström procedure 1 year or 2 years postoperatively. Arthroscopic modified Broström procedure is a reliable procedure for CLAI injuries with the demand for fast exercise recovery.

Clinical registration

ChiCTR1900023999.

Level of evidence

II.

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Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors report funding from National Key Research and Development Program of China (2019YFB1706905, 2018YFF0301100), and National Natural Science Foundation of China (82072428).

Author information

Author notes

  1. Zong-chen Hou and Tong Su contributed equally to this study.

Authors and Affiliations

  1. Department of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, No.49 North Garden Road, Haidian, Beijing, 100191, China

    Zong-chen Hou, Tong Su, Ying-fang Ao, Yue-lin Hu, Chen Jiao, Qin-wei Guo, Shuang Ren & Dong Jiang

  2. Research Center of Clinical Epidemiology, Peking University Third Hospital, No.49 North Garden Road, Haidian, Beijing, 100191, China

    Nan Li

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  1. Zong-chen Hou
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  2. Tong Su
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  9. Dong Jiang
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Contributions

DJ and ZCH designed the study. ZCH, TS, LN and YFA analysed and interpreted the patient data regarding the mechanical ankle instability. QWG and CJ and DJ substantively revised it. CH and TS were major contributors in writing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Dong Jiang.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The research was approved by the IRB Medical Committee (IRB00006761-M2019164), and written informed consents were obtained from the subjects.

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Hou, Zc., Su, T., Ao, Yf. et al. Arthroscopic modified Broström procedure achieves faster return to sports than open procedure for chronic ankle instability. Knee Surg Sports Traumatol Arthrosc 30, 3570–3578 (2022). https://doi.org/10.1007/s00167-022-06961-0

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  • DOI: https://doi.org/10.1007/s00167-022-06961-0

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