Clinical Outcomes After Arthroscopic Broström-Gould Procedure for Chronic Lateral Ankle Instability

TL;DR

This study shows that arthroscopic Broström-Gould surgery significantly improves ankle function and reduces pain in patients with chronic lateral ankle instability.

Contribution

The study provides new clinical evidence supporting the effectiveness of arthroscopic Broström-Gould for treating chronic lateral ankle instability.

Findings

All three functional scores (VAS, K-P, AOFAS) showed significant improvement post-surgery.

Postoperative VAS scores dropped from 5.87 to 2.0, indicating reduced pain.

K-P and AOFAS scores increased significantly, showing improved ankle function.

Abstract

Background

Chronic lateral ankle sprains are common injuries that are largely sequelae of inversion injuries of the ankle. These injuries are amenable to surgical intervention, namely, Broström-Gould reconstruction, which is commonly performed for the above injury. Many open and arthroscopic variations of the technique have been described. Arthroscopic Broström-Gould has been shown to have comparable outcomes to the open technique.

Analysis of 39 patients who underwent arthroscopic Broström-Gould at a tertiary institution showed excellent outcomes from all three functional scores.

Methods

Thirty-nine patients underwent arthroscopic Broström-Gould in 2021 at a tertiary institution and were followed up for up to one year postoperatively. All patients had failed conservative treatment and reported pain and chronic instability prior to surgical intervention. Outcomes were measured with functional scores, namely, the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS), and Karlsson and Peterson Scoring System (K-P). Other demographics such as age, gender, laterality, and body mass index were also recorded.

Statistical analysis was performed with GraphPad Prism (GraphPad Software, San Diego, CA). Outcomes were analysed by paired t-test and statistical significance was set at p < 0.05.

Results

A total of 39 patients with chronic lateral ankle instability (CLAI) who underwent arthroscopic Broström-Gould were followed up for up to one year postoperatively. Demographics were as follows: 22 males and 17 females, 20 right ankles and 19 left ankles, average age of 36.2 years (19.6-64.8 years), and BMI of 27.4 (19.2-40).

At follow-up, functional scores were measured as described in the methods section above. Preoperative VAS scores were 5.87 ± 1.92 (1-10) while postoperative VAS scores were 2.0 ± 2.16 (0-7). Preoperative K-P scores were 43.68 ± 13.2 (7-70) while postoperative K-P scores were 69.21 ± 17.86 (37-100). Preoperative AOFAS scores were 62.53 ± 16.05 (29-83) while postoperative AOFAS scores were 83.8 ± 11.49 (59-100).

Conclusions

Significant improvement of all three functional scores (VAS, K-P, and AOFAS scores) following arthroscopic Broström-Gould was noted. This shows that the arthroscopic Broström-Gould is an effective method to treat CLAI with good outcomes.