Arthroscopic-Assisted Versus All-Arthroscopic Ankle Stabilization Technique

  • Matteo Guelfi
    Casa di Cura Villa Montallegro, Genoa, Italy
  • Gustavo Araujo Nunes
    Hospital Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
  • Francesc Malagelada
    Department of Trauma and Orthopaedic Surgery, Royal London Hospital, Barts Health NHS Trust, London, UK
  • Guillaume Cordier
    GRECMIP (Groupe de Recherche et d’Etude en Chirurgie Mini-Invasive du Pied) Soon MIFAS (Minimally Invasive Foot and Ankle Society), Merignac, France
  • Miki Dalmau-Pastor
    Human Anatomy and Embryology Unit, Department of Pathology and Experimental Therapeutics, University of Barcelona, Barcelona, Spain
  • Jordi Vega
    Human Anatomy and Embryology Unit, Department of Pathology and Experimental Therapeutics, University of Barcelona, Barcelona, Spain

Abstract

<jats:sec><jats:title>Background:</jats:title><jats:p>Both the percutaneous technique with arthroscopic assistance, also known as arthroscopic Broström (AB), and the arthroscopic all-inside ligament repair (AI) are widely used to treat chronic lateral ankle instability. The aim of this study was to compare the clinical outcomes of these 2 arthroscopic stabilizing techniques.</jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p>Thirty-nine consecutive patients were arthroscopically treated for chronic ankle instability by 2 different surgeons. The AB group comprised 20 patients with a mean age of 30.2 (range, 18-42) years and a mean follow-up of 19.6 (range, 12-28) months. The AI group comprised 19 patients with a mean age of 30.9 (range, 18-46) years and mean follow-up of 20.7 (range, 13-32) months. Functional outcomes using the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score and visual analog pain scale (VAS) were assessed pre- and postoperatively. Range of motion (ROM) and complications were recorded.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>In both groups the AOFAS and VAS scores significantly improved compared with preoperative values ( P < .001) with no difference ( P > .1) between groups. In the AB group the mean AOFAS score improved from 67 (range, 44-87) to 92 (range, 76-100) and the mean VAS score from 6.4 (range, 3-10) to 1.2 (range, 0-3). In the AI group the mean AOFAS score changed from 60 (range, 32-87) to 93 (range, 76-100) and the mean VAS score from 6.1 (range, 4-10) to 0.8 (range, 0-3). At the final follow-up 8 complications (40%) were recorded in the AB group. In the AI group 1 complication (5.3%) was observed ( P < .05).</jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p>Both the AB and AI techniques are suitable surgical options to treat chronic ankle instability providing excellent clinical results. However, the AB had a higher overall complication rate than the AI group, particularly involving a painful restriction of ankle plantarflexion and neuritis of the superficial peroneal nerve.</jats:p></jats:sec><jats:sec><jats:title>Level of Evidence:</jats:title><jats:p>Level III, retrospective comparative study.</jats:p></jats:sec>

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