Comparison of Outcomes in Patients With Generalized Ligamentous Laxity and Without Generalized Laxity in the Arthroscopic Modified Broström Operation for Chronic Lateral Ankle Instability

Foot Ankle Int. 2017 Dec;38(12):1318-1323. doi: 10.1177/1071100717730336. Epub 2017 Oct 14.

Abstract

Background: The arthroscopic modified Broström operation (MBO) has been frequently used to treat chronic lateral ankle instability (CLAI). However, no reports comparing the clinical outcomes between patients with or without generalized ligamentous laxity (laxity or no laxity, respectively) currently exist. The purpose of this study was to compare the clinical outcomes of the 2 groups with CLAI.

Methods: Between January 2013 and November 2015, arthroscopic MBO was performed on 99 patients with CLAI. Patients were divided into 2 groups: the laxity group (24 ankles) and no laxity group (75 ankles). Generalized ligamentous laxity was defined as a Beighton score of 4 or more points. Evaluation tools included the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot ankle score, a pain visual analog scale (VAS), and talar tilt angle.

Results: The change in talar tilt angle from preoperative to 12 months postoperative was significantly greater in the laxity group (-6.9 ± 5.2) compared with the no-laxity group (-4.2 ± 4.2) ( P = .03). The final follow-up AOFAS hindfoot ankle score and pain VAS in both groups showed improvement compared with the preoperative values.

Conclusion: All groups achieved successful clinical and radiological final follow-up outcomes. Arthroscopic MBO should be considered a reasonable method in patients who have chronic lateral ankle instability, regardless of generalized ligamentous laxity.

Level of evidence: III, comparative study.

Keywords: arthroscopic modified Broström operation; chronic lateral ankle instability; generalized laxity.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Ankle Joint / diagnostic imaging
  • Ankle Joint / physiopathology
  • Ankle Joint / surgery*
  • Arthroscopy / methods*
  • Follow-Up Studies
  • Humans
  • Joint Instability / classification
  • Joint Instability / surgery*
  • Male
  • Middle Aged
  • Pain Measurement
  • Radiography
  • Range of Motion, Articular