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Absence of ATFL remnant does not affect the clinical outcomes of the modified broström operation for chronic ankle instability

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

Abstract

Purpose

The modified Broström operation for chronic ankle instability has demonstrated good clinical results. Absence of ligamentous tissue is a risk factor for recurrence of ankle instability after surgery. This study evaluated the effect of quality of ligament tissue (anterior talofibular ligament, ATFL) on prognosis, in a cohort of patients with chronic ankle instability after the modified Broström operation.

Methods

This was a retrospective case series. Overall, 60 patients underwent the modified Broström operation for chronic ankle instability (mean follow-up, 30.1 [range, 24–47] months). Presence of ATFL remnant was assessed on ultrasound, magnetic resonance imaging, and arthroscopy in all patients. Foot and ankle outcome score (FAOS) was used to evaluate functional outcomes. Clinical outcomes were compared by the condition of the ligament remnant. Association with other risk factors was evaluated using multiple linear regression analysis.

Results

ATFL was visible in 51/60 cases on ultrasound. Thirty, 22, and eight patients had thin or absent; normal thickness; and thick ATFL on magnetic resonance imaging, respectively. ATFL was visible in 15 patients on arthroscopy and nonvisible or not clear in 45. No significant differences occurred in FAOS with the presence of ATFL remnant on ultrasound, arthroscopy, and the grade of ATFL thickness on magnetic resonance imaging. No correlation was found between FAOS and the thickness of ATFL.

Conclusion

The results suggest that the modified Broström operation for patients with chronic ankle instability was good, regardless of the presence or absence of ATFL remnant.

Level of evidence

III, Retrospective cohort study.

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Funding

No funds were received in support of this study.

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Authors and Affiliations

  1. Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, 164, World Cup Road, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea

    Sunghoon Park

  2. Department of Orthopedic Surgery, Ajou University Hospital, Ajou University School of Medicine, 164, World Cup Road, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea

    Taehun Kim, Myungsub Lee & Younguk Park

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  1. Sunghoon Park
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  2. Taehun Kim
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Correspondence to Younguk Park.

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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Ethical approval

This study was approved by the institutional review board of the Ajou University Hospital. (AJIRB-MED-MDB-16-476).

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Informed consent was waived because of the retrospective nature of the study and the analysis used anonymous clinical data.

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Park, S., Kim, T., Lee, M. et al. Absence of ATFL remnant does not affect the clinical outcomes of the modified broström operation for chronic ankle instability. Knee Surg Sports Traumatol Arthrosc 28, 213–220 (2020). https://doi.org/10.1007/s00167-019-05464-9

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  • DOI: https://doi.org/10.1007/s00167-019-05464-9

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