Anatomical reconstruction for chronic lateral ankle instability in the high-demand athlete: functional outcomes after the modified Brostrom repair using suture anchors
Department of Orthopedics and Physical Rehabilitation
Medical Subject Headings
Adolescent; Ankle Injuries; Ankle Joint; Athletic Injuries; Female; Follow-Up Studies; Humans; Joint Instability; Lateral Ligament, Ankle; Magnetic Resonance Imaging; Male; Questionnaires; Range of Motion, Articular; Recovery of Function; *Suture Anchors; Treatment Outcome; Young Adult
Orthopedics | Rehabilitation and Therapy
BACKGROUND: Modification of the Brostrom repair with suture anchors has been used to address chronic lateral ankle instability. However, there are few studies in the literature reporting the functional outcomes after this particular procedure in the high-demand athlete.
HYPOTHESIS: Anatomical reconstruction of the lateral ankle ligaments for chronic instability will return the high-demand athlete functionally to his or her previous level of activity.
STUDY DESIGN: Case series; Level of evidence, 4.
METHODS: Sixty-two patients who had grade III ankle sprain that failed at least a 6-month course of supervised conservative management with a preinjury Tegner score of > or = 6 underwent a variant of the Gould-modified Brostrom procedure with suture anchors for lateral ankle instability. Each patient was given the Tegner and Karlsson questionnaire at the 6-month, 1-year, and 2-year time points. Range of motion of the operative ankle was also assessed. The mean age was 19.6 years (range, 16-26 years), and 10 patients were lost to follow-up.
RESULTS: The mean follow-up was 29 months (minimum, 24 months) in the remaining 52 patients (84%). Mean Tegner scores at the 1- and 2-year time points were 8.2 (range, 5-9) and 8.6 (range, 5-9), respectively. The mean Karlsson scores were 92 +/- 5.2 and 95 +/- 3.1 at the 1- and 2-year time points, respectively. Range of motion was equal to the contralateral ankle in all but 3 patients at the 2-year follow up. A 6% major complication rate included 3 reruptures.
CONCLUSION: Anatomical ligament reconstruction for chronic lateral ankle instability using a variant of the Gould-modified Brostrom procedure with suture anchors was effective in returning high-demand athletes to their preinjury functional level.
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Citation: Am J Sports Med. 2009 Mar;37(3):488-94. Link to article on publisher's site