My experience with Brostrom Surgery - Ankle Ligament Repair In January 2018, I had ankle surgery to repair torn ligaments. doi: 10.1007/s00167-015-3638-0, 22. As we all know, the open Brostrm-Gould surgery is frequently used to treat chronic lateral ankle instability, and provide excellent mid-term results. The studies involving human participants were reviewed and approved by The ethic committee of No. When inserting tools into the joint, it is also recommended to use a cannula to minimize unintended nerve entrapment. doi: 10.1053/j.jfas.2013.02.022, 24. Methods: We retrospectively reviewed the database of patients with chronic lateral ankle instability undergoing repair of the ATFL from June 2014 to June 2018. demonstrated that the AOFAS scores was 89 at the last follow-up in 41 patients following open Brostrm-Gould repair, with a high satisfaction rate (19). The anterior talofibular ligament (ATFL) is the one of most frequently injured ligaments in the ankle sprains with an increasing incidence (1, 2). It is thought that the majority of patients regain most function in their ankles. reported that the arthroscopic procedure resulted in less postoperative pain and an earlier return to daily activities (24). B. All the patients underwent an arthroscopic evaluation of the ankle joint under standard anteromedial (AM) and anterolateral portal (AL). Eventually, a total of 99 patients with AFTLs were included. (11). reported long-term results of the Brostrom Gould procedure for chronic lateral ankle instability. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. The postoperative ADT, VAS, AOFAS scores, K-P scores, or Tegner activity scores were significantly improved compared to the preoperative baselines, and there was no significant difference in these parameters between the two groups at final follow-up. 38). Open brostrom-gould repair vs arthroscopic anatomical repair of the anterior talofibular ligament for chronic lateral ankle instability. In the group AB, the surgical complications occurred in eight patients, which include six patients reported sensory disturbance on the lateral aspect of the foot (superficial peroneal nerve injuries), and two patients with superficial wound infection. documented the long-term outcomes of arthroscopic ankle stabilization in 38 patients, whose got the mean AOFAS score was 90 at the last follow-up (14). Cottom and Rigby also showed similar results in 40 patients with a mean follow-up of 12.3 months and a mean AOFAS score of 95.4 at the last follow-up compared with a mean preoperative score of 41.2 (23). Then, a double-loaded suture anchor [4.5mm polyether ether ketone (PEEK) anchor, Arthrex] was inserted into the mid-portion of the attachment area of the fibula. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Introduction: There have been few mid-term follow-up studies comparing arthroscopic and open Brostrm-Gould repair of the anterior talofibular ligament (ATFL). To the best of our knowledge, this study is the first to compare the two surgical procedures with lager sample sizes and a relatively long follow-up period than previous studies. Moorthy V, Sayampanathan AA, Yeo NEM, Tay KS. Brostrom repair with the Internal Brace procedure provides additional fixation of the repaired ligament backdown to bone during the healing process, allowing early mobility during recovery and a quicker return to activity. Objective quantitative data are sparse, particularly MRI data included radiographic signs of degenerative changes preoperatively and postoperatively from recruited patients. JL, HJ and YY participated in the discussion of the study. discovered no statistically significant changes in the VAS, AOFAS, and Karlsson scores between the open and arthroscopic modified Brostrm procedures at short-term follow-up (6 weeks and 6 months) (9). Pitts CC, McKissack HM, Anderson MC, Buddemeyer KM, Bassetty C, Naranje SM, et al. Am J Sports Med. Our results showed that in the 50 patients receiving the open Brostrm-Gould repair, the AOFAS score was improved from 65.49.1 (preoperative) to 91.16.2 (at 4 years after surgery), while the K-P score was improved from 60.59.8 to 90.58.8, suggesting that the open Brostrm-Gould repair has good therapeutic efficacy, which is consistent with previous studies. Brostrom-Gould Reconstruction restores ankle stability by repairing the lateral (outside) ligaments of the ankle. (2018) 104:S199205. We speculated that the phenomenon might be related to the following reasons. All data were evaluated for homogeneity of normality and variance using Shapiro-Wilk test and Levene's test, respectively. However, studies directly comparing outcomes of arthroscopic and open Brostrm-Gould ATFL repair remain to be controversial. The purpose of the Brostrom-Gould procedure is to stabilize the ankle ligaments, improve the ankle's mechanics and restore full function. The symptom duration was 25.08.48 months (range, 2440) in the group AB and 23.528.37 months (range, 2645) in the group OB. Li H, Hua Y, Li H, Ma K, Li S, Chen S. Activity level and function 2 years after anterior talofibular ligament repair: a comparison between arthroscopic repair and open repair procedures. 1 The Internal Brace 2.0 surgical technique provides surgical versatility with added size and material options. Foot Ankle Int. discovered that the arthroscopic group had seen a shorter recovery duration, greater rates of return to athletic activities, and improved clinical results, posture control, and muscular strength (25). However, no significant difference were found in ADT, VAS scores, AOFAS scores, K-P scores, and Tegner activity scores between the two groups at the final follow-up (P>0.05 for all variables). Matsui K, Takao M, Miyamoto W, Matsushita T. Early recovery after arthroscopic repair compared to open repair of the anterior talofibular ligament for lateral instability of the ankle. Maffulli N, Del Buono A, Maffulli GD, Oliva F, Testa V, Capasso G, et al. doi: 10.1016/j.fas.2014.01.002, 21. Arthroscopic versus open repair of lateral ankle ligament for chronic lateral ankle instability: a meta-analysis. doi: 10.1530/EOR-21-0075, 11. (2020) 41:449. Post-operative outcomes are generally rated as excellent, with 90-95% of patients . Increased core/gluteal strength. Isolated anterior talofibular ligament brostrom repair for chronic lateral ankle instability: 9-year follow-up. Specifically, the AOFAS and K-P scores in the group AB were significantly higher than those in the group OB at 6 months post-surgery (P<0.05). Care must be taken with icing to avoid frostbite. Various surgical procedures for repairing ATFL have been reported in recent years, ranging from open repair to limited open repair or percutaneous repair, and arthroscopic repair (57). Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. ann30953 Had Brostrom procedure a month ago. doi: 10.1177/1071100719875964, 5. Comparison of all-inside arthroscopic and open techniques for the modified brostrom procedure for ankle instability. (2014) 20:2248. It is critical to identify and mark anatomic landmarks prior to surgery to reduce the risk of nerve injury. Table 1. found that open Brostrm-Gould surgery enhanced the AOFAS scores from 51 to 90 points following a 9-year follow-up (18). Purpose The Brostrm-Gould procedure, with the repair of the anterior talofibular ligament (ATFL) combined with the transfer of the extensor retinaculum, is considered the gold standard procedure for the management of chronic lateral ankle instability (CLAI). The arthroscopic Brostrm-Gould procedure had higher AOFAS and K-P scores at 6 months after operation. doi: 10.1007/s00167-022-07289-5, 18. doi: 10.2106/JBJS.16.00046, 28. (2011) 39:23818. Conclusions: Arthroscopic has predictable and good mid-term results after ATFL and may be a secure and effective alternative to open Brostrm-Gould repair. EFORT Open Rev. It typically takes place as an outpatient procedure. reported excellent clinical outcomes and patient satisfaction rates, but a high complication rate of 15.27% associated with arthroscopic Brostrm procedures (5). Michael Finnern John Dupaix University of Hawaii at Mnoa Paul Ryan Tripler Army Medical Center Claude Anderson Abstract and Figures Lateral ankle sprains are among the most common musculoskeletal. Lateral Ligament Reconstruction. Woo BJ, Lai MC, Koo K. Arthroscopic versus open brostrom-gould repair for chronic ankle instability. Of whom 49 patients underwent arthroscopic Brostrm-Gould technique, while the other 50 patients underwent open Brostrm-Gould technique (Figure1). (2013) 41:85864. 1 Modified Brostrom-Gould Repair for Chronic Lateral Ankle Instability: The intent of this protocol is to provide the clinician with a guideline of the post-operative rehabilitation course of a patient who has undergone an anatomical surgical procedure. Operation time and mean hospitalization time were similar between the two groups, with no statistically significant difference (43.5816.61min vs. 48.4512.76min, 6.412.57 days vs. 6.702.72 days, P>0.05) (Table1). And we also thank Professors Zhenhai Wang and Junsheng Wang for reviewing this manuscript. Hintermann B, Boss A, Schafer D. Arthroscopic findings in patients with chronic ankle instability. The open Brostrm-Gould procedure was performed by the standard surgical method, which was then also repaired with a double-loaded suture anchor (4.5mm PEEK anchor, Arthrex). The incidence rate for our arthroscopic procedure was 12.2% (6/49), which was within an acceptable range. Posted in Other Cottom JM, Rigby RB. Vega J, Dalmau-Pastor M, Malagelada F, Fargues-Polo B, Pena F. Ankle arthroscopy: an update. doi: 10.1016/j.fas.2012.10.005, 20. First, the higher functional scores in the arthroscopic group can be attributed to the smaller amount of soft tissue dissection required for arthroscopic operations. Arthroscopic exploration was performed to examine the ATFL, expose and debride the ligament attachment point on the fibula. Pain medication as needed every 6 hours. Guelfi M, Zamperetti M, Pantalone A, Usuelli FG, Salini V, Oliva XM. (2018) 24:118. Aicale R, Maffulli N. Chronic lateral ankle instability: topical review. Table 2. In total, 49 patients underwent the arthroscopic Brostrom-Gould technique (group AB), while the other 50 patients underwent the open Brostrm-Gould technique (group OB). Third, postoperative assessment is mostly based on functional measures. It is designed to address ankle instability. Background A Brostrom procedure is an anatomical lateral ligament surgical reconstruction commonly performed for lateral ankle instability and/or in case of failure of conservative management for chronic ankle instability. Manual Effleurage, gentle soft tissue mobilization to ankle avoiding incisions. The patients/participants provided their written informed consent to participate in this study. Reviewed published research findings, the early postoperative period outcomes are controversial. The objective of this article was to investigate the outcomes of arthroscopic vs. open Brostrm-Gould, including surgery duration, hospitalization time, postoperative complications, the preoperative/postoperative ADT, VAS scores, AOFAS scores, K-P scores, and Tegner activity scores, to prove whether arthroscopic surgery is superior to open surgery in the mid-term follow-up period. We are grateful for the professional care of the nursing team. (2022) 7:312. doi: 10.1177/1071100720914860, 12. All the 18 patients returned to pre-injury level sports with a follow-up of 10-15 years and 'excellent' results in 94.5% of the cases and 'good' in the remaining 5.5%. A systematic review by Guelfi et al. Maffulli et al. (2021) 9:23259671211015207. doi: 10.1177/23259671211015207, 27. (2020) 28:16118. According to existing research results (2, 26, 27), there is a trend for a higher rate of superficial peroneal nerve complications in arthroscopic surgery and a higher rate of wound complications in open surgery, which is consistent with the findings of our study. Exercises Toe curls, toe extension, toe spreads, hip and knee strengthening exercises. The first draft of the manuscript was written by JW, and other contributors commented on previous versions of the manuscript. The convenient all-in-one system includes 2 BioComposite SutureTak anchors, all the necessary drill guides, the Micro SutureLasso retrievers to help facilitate percutaneous shuttling of the #1 FiberWire suture through the ATFL and extensor retinaculum. doi: 10.1016/j.otsr.2018.09.005, 23. Open and arthroscopic lateral ligament repair for treatment of chronic ankle instability: a systematic review. Long-term results after modified Brostrom procedure without calcaneofibular ligament . No significant differences were found regarding sex (P=0.57), body mass index (BMI) (P=0.25), or side (left/right) (P=0.75) between group AB and group OB. Am J Sports Med. Surgical procedures for chronic lateral ankle instability. The test of the anterior drawer was negative after suturing. The open group, however, required a longer period of recovery because of the more severe trauma caused by the surgery. And prophylactic antibiotic (cefuroxime sodium 1.5g) were started 30min before surgery. The postoperative evaluation with a minimum of 48 months of follow-up indicated that the two surgical procedures can produce similar functional and clinical outcomes, and both of them were effective treatments for chronic lateral ankle instability. 1. Otherwise, Mann-Whitney U test or Wilcoxon signed-rank test for nonparametric data. However, a double-blind randomized controlled trial may not be suitable for many patients in China because of the medical risk. Foot & Ankle Care A Brostrm procedure or operation is the repair of the ligaments on the lateral or outside of the ankle, that are excessively loose following recurrent ankle sprains . doi: 10.1007/s00167-018-5100-6, PubMed Abstract | CrossRef Full Text | Google Scholar, 2. Surgical Technique Modified Brostrom-Gould Technique for Lateral Ankle Ligament Reconstruction The patient is placed in a supine position with a hip bump to internally rotate the leg. 39 of the patients in the arthroscopic group showed synovitis, seven had osteochondral defects (OCD), and three had osteophytes. Additionally, there were no significant differences in other clinical outcomes and postoperative complications between the two groups. 10:1181493. doi: 10.3389/fsurg.2023.1181493. Description: This protocol applies to patients following the Gould modified Bostrm repair of the Anterior Talo-fibular Ligament (ATFL) and Calcaneal Fibular Ligament (CFL). Brown AJ, Shimozono Y, Hurley ET, Kennedy JG. Buerer Y, Winkler M, Burn A, Chopra S, Crevoisier X. Knee Surg Sports Traumatol Arthrosc. doi: 10.1007/s00402-015-2342-3, 25. (2018) 26:22330. Zeng G, Hu X, Liu W, Qiu X, Yang T, Li C, et al. 42 patients in the open group had showed synovitis, ten had OCD, while five others had osteophytes. In conclusion, our results suggest that arthroscopic and open Brostrm-Gould repair of the ATFL have comparable therapeutic efficacy for chronic lateral ankle instability in the mid-term follow-ups. And most patients with chronic ankle instability have an understanding of surgical treatments through multiple outpatient clinical visits and online inquiries before surgery. Recovery from Brostrom Procedure Follow Posted 4 years ago, 5 users are following. For statistical studies, the SPSS 23.0 program (IBM Corp, Armonk, NY, USA) was utilized. Prior to making incisions in the lateral ankle region, the arthroscopic safe zone, which includes the distal fibula tip, the superior margin of the peroneal tendons, and the intermediate branch of the superficial peroneal nerve, should be marked (28). This study was approved by our hospital Ethics Committee. After suturing the wound, a short leg cast was applied in the neutral position. Foot Ankle Int. Then, using a small hemostat, make an incision only through the thickness of the skin, followed by dissecting subcutaneous tissues. Consistent with those of the above three studies, the present results showed that the arthroscopic group had better outcomes (AOFOS and K-P scores) than the open group at 6 months follow-up. Modified Brostrom-Gould Procedure Day of Surgery A. Images summary Ankle Sprains are very common twisting injuries to the ankle that are the most common reason for missed athletic participation. 14,16,- 18 The clinical outcomes of this study including wound complications and . Recently, at 6 months after surgery, Zongchen Hou et al. The surgery duration, hospitalization time, postoperative complications, the preoperative/postoperative manual anterior drawer test (ADT), Visual analog scale (VAS) scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores, Karlsson-Peterson (K-P) scores, and Tegner activity scores were collected for comparative analysis during the follow-up period of 48 months. Acevedo JI, Mangone P. Arthroscopic brostrom technique. (2022). J Bone Joint Surg Am. (2020) 41:64753. Lower perioperative VAS and higher AOFAS scores at the 6 and 12 months follow-ups were two benefits of the arthroscopic Brostrom-Gould approach, according to Bo Jun Woo et al. Diagnosis can be made clinically with swelling and ecchymosis of the ankle and pain with range of motion. (2015) 36:46573. The Arthrex Brostrom Repair System allows surgeons to perform a modified Brostrm-Gould procedure through a single, 1.5 cm incision. On the other hand, Kentaro Matsui et al. Foot Ankle Surg. Superficial wound infection is defined as infection of the wound, in which there is no evidence that the infection extends to the site of the implant. doi: 10.1177/0363546517698675, 9. J Foot Ankle Surg. Foot Ankle Int. (2017) 45:204451. Recently, many authors have proposed performing the Brostrm-Gould procedure completely with arthroscopy (9, 21, 22). Arthroscopy. Saarland University Medical Center, Germany, First Affiliated Hospital, Dalian Medical University, China. Am J Sports Med. The independent sample t test was used for comparing continuous variables with homogeneity of variance and normality between groups. The possibility of nerve injury was linked to portal proximity, nerve anatomical variations, and nerve entrapment during the procedure. Attia, A. K et al. After surgery, the patients of two groups received antibiotics (cefuroxime 750mg three times daily) to prevent infection not more than 48h. Two weeks after the surgery, the short leg cast was changed to an ankle brace, then strengthening exercises of the whole lower extremity and flexion and extension of joint were encouraged. Brostrom procedures: The Brostrom-Evans (which is not done at Ohio State at this time andwill not be detailed here) or the Brostrom-Gould procedure. doi: 10.1007/s00167-022-06961-0, 26. After surgery, a significant increase was noted in AOFAS scores (from 67.597.02 to 92.903.14), K-P scores (from 57.759.93 to 92.553.52), and Tegner activity scores (from 1.90.58 to 6.311.28), and a significant decrease in VAS scores (from 6.121.90 to 2.121.05) in group AB as well as the group OB (AOFAS scores from 68.347.99 to 93.202.86; K-P scores from 58.8211.07 to 92.023.29; Tegner activity scores from 1.680.70 to 5.821.42; VAS score from 6.481.78 to 2.521.17). In this study, for the 49 cases of arthroscopic repair of the ATFL, the AOFAS score improved from 63.19.1 (preoperative) to 92.46.0 (at 48 months after surgery) and the K-P score improved from 59.69.7 to 89.28.4. Foot Ankle Surg. 51, P=0. Hi Laura i had ankle ligament reconstruction ( brostrom gould procedure ) in July last year i was in a cast for 6 weeks (non weight bearing) then a boot for another 4 weeks first two weeks i used crutches then i was able to weight bear from my boot after 4 weeks i progressed to an ankle brace all the while having physio which started when i came. Lateral ligament reconstruction is considered if the ATFL remnant quality is poor or the ATFL has been damaged beyond the ability to . The significance level was set at P<0.05. This procedure also aims to help a patient reduce pain related to their injury and ankle sprains. As is well-known, the open Brostrm technique and its modifications are regarded as the gold standard surgical approach for repairing ATFL (4, 5). (2022) 30:35708. The inclusion criteria were: (1) MRI confirmed the tear, unconsolidated of the AFTL; (2) recurrent ankle sprain and signs of ankle instability: the talar tilt test was greater than 5 under x-ray, the anterior drawer test was positive; no previous ankle ligament surgery, with no other ankle injury than the index one; (3) complete surgical and follow-up data, and follow-up for at least 48 months. 2023 Wang, Tang, Sun, Lv, Jiang and Yue. For both surgical treatments, all operations were performed by a same group of surgeons, which were expert technicians and well experienced. Orthop Traumatol Surg Res. Modifications to this guideline may be necessary dependent on physician specific instruction, degree of the tear, specific tissue healing timeline, chronicity of injury and other contributing impairments that need to be addressed. For patients with calcaneofibular ligament injury, it still unknown if the untreated calcaneofibular ligament affects clinical efficacy in the long-term follow up needs to be further studied. Most of these ankle sprains can be treated effectively with conservative methods. Knee Surg Sports Traumatol Arthrosc. The Brostrom-Gould procedure is currently the gold standard surgical choice for the treatment of chronic ankle instability; it can significantly improve ankle function and stability in patients. doi: 10.1177/0363546511416069, 15. Buerer et al. In terms of . Radiographs are only indicated when clinical examination meets criteria (Ottawa ankle rules). 967 Hospital of the PLA Joint Logistics Support Force, Dalian, China. This indicated that arthroscopic repair could be a viable alternative to the open Brostrm-Gould repair procedure for chronic lateral ankle instability. Russo et al. Zhou YF, Zhang ZZ, Zhang HZ, Li WP, Shen HY, Song B. All-Inside arthroscopic modified brostrom technique to repair anterior talofibular ligament provides a similar outcome compared with open brostrom-gould procedure. Baek JH, Kim JH, Jeong BO. Molloy AP, Ajis A, Kazi H. The modified brostrom-gould procedureearly results using a newly described surgical technique. Postoperatively, ADT was comparable in both and improved significantly from preoperative values. performed systematic review using one RCT (Randomized controlled trial) and seven RCSs (Retrospective comparative studies) including a total of 420 patients with AFTL injury to prove that clinical outcomes did not differ substantially between patients treated with either arthroscopic or open Brostrm repair (10). (2016) 37:103745. 11 One argument for the use of the arthroscopic Brostrm is a faster return to activity. In a randomized controlled experiment, Yeo et al. As experience progresses and surgical technique evolves, we believe that continuous improvement in efficiency and complication rates may be predicted. doi: 10.1053/j.jfas.2020.10.001, 3. Closed incision sites. The mean age of the patients in the group AB and the group OB was 31.714.99 years and 31.924.77 years, respectively, the age distribution of the two groups has no statistical sense (P=0.83). If anyone else had it, I'd like to know how long it was before you could walk a short distance without much pain? 14). Lateral ankle ligament reconstruction is a surgical procedure to tighten and secure one or more ankle ligaments on the outside of your ankle. There were no discernible difference in the incidence of synovitis (79.59% vs. 84%; P=0.57), OCD (14.3% vs. 20%; P=0.45) or osteophyte (6.1% vs. 10%; P=0.48) between group AB and group OB. I put this together in the hope others in a similar situation will find it useful. Arthroscopic Brostrm-Gould operation was conducted by modifying Nery's study (14). Foot Ankle Int. Second, only the ATFL was repaired in this investigation. All of these data indicate that arthroscopic ATFL repair has a high therapeutic effectiveness. Attia AK, Taha T, Mahmoud K, Hunt KJ, Labib SA, d'Hooghe P. Outcomes of open versus arthroscopic brostrom surgery for chronic lateral ankle instability: a systematic review and meta-analysis of comparative studies. Demographic characteristics of patients. JW, ZT, HS and YY participated in the design of the study, acquisition of data, and statistical analysis. Takao M, Matsui K, Stone JW, Glazebrook MA, Kennedy JG, Guillo S, et al. WEEKS 1: strict elevation of the ankle above the heart, 23 hours per day Ice behind knee (vascutherm or ice bag) to minimize swelling and control pain Nonweightbearing (NWB) in splint Patient educated on ice, elevation to manage post operative edema (swelling causes pain that typically does not respond to standard pain medication) J Foot Ankle Surg. Comparisons of key patient data in Table2. The limitations of the study include the following: (1) This study was a retrospective study and the significance of the data between scores and actual function may vary with experience. When it comes to participating in double-blind randomized controlled trials (RCTs), most patients may not trust their doctors. Laith M. Jazrawi, MD Associate)Professor)of)Orthopaedics Chief,)Division)of)Sports)Medicine) Tel:)(212))598B6784) Postoperative Rehabilitation Following Brostrom . Foot Ankle Int. Rupture of these ligaments is common as a result of diagnoses including but not limited to: Inversion ankle sprains1 Chronic lateral ankle instability (CAI)2 performed meta-analysis using one RCT, one PCS and six RCTs including a total of 408 patients with chronic lateral ankle instability to prove that arthroscopic Brostrm was superior to open Brostrm-Gould surgery in postoperative AOFAS scores, VAS pain scores, and time to return to weightbearing (26). doi: 10.1177/0363546508327541, 17. Arthroscopic treatment of chronic ankle instability: prospective study of outcomes in 286 patients. Ice is applied for 20-minute periods 3-4 times per day. In May 2023, Frontiers adopted a new reporting platform to be Counter 5 compliant, in line with industry standards. (2009) 37:48894. Orthop J Sports Med. References: Brigham and Women's Hospital: Modified Brostrom-Gould Repair; University of Wisconsin Sports Medicine: Rehabilitation Guidelines for Lateral Ankle Reconstruction; Journal of Orthopaedic Surgery and Research: Treatment of chronic lateral ankle instability: a modified brostrom technique suing three suture anchors; Sports Physical Thera. Li X, Killie H, Guerrero P, Busconi BD. Yang Q, Liu J, Liu C, Zhou P, Zhu D. Modified brostrom-gould surgical procedure for chronic lateral ankle instability compared with other operations: a systematic review and meta-analysis. Tegner activity score was first characterized as an activity level assessment system for knee joints; however, it has also been used to assess activity following ankle damage or surgery (8, 1517). The patients with superficial peroneal nerve injuries were completely asymptomatic, pain free, and stable at the last follow-up. Yeo ED, Lee KT, Sung IH, Lee SG, Lee YK. In the group OB, the surgical complications were observed in seven patients, which include two patients with superficial peroneal nerve injuries, and five patients with superficial wound infection. The exclusion criteria were: (1) Severe ankle osteoarthritis or osteochondral injury requiring osteochondral transplantation; (2) severe underlying disease and inability to tolerate surgery. doi: 10.1016/j.fas.2019.04.008, 13. (2020) 26:3436. Brostrom-gould Procedure Physical Therapy Athletic Training Massage Nutrition Personal Training Aquatic Therapy Resisted ankle strengthening in all planes Functional Performance Test: Single leg heel raises within 10% contralateral Phase IV: 3 to 6 Months: Criteria for advancement to Phase IV: . doi: 10.1177/1071100716666508, 10. Flow chart of patients in this study. Figure 2. However, about 10%20% develop chronic lateral ankle instability and consequently require surgical ATFL repair (3). It is designed for rehabilitation following a Modified Brostrom procedure. Well-leg cycling, well body weight training, Goals Minimal edema. (2020) 41:157181. Anatomical reconstruction for chronic lateral ankle instability in the high-demand athlete: functional outcomes after the modified brostrom repair using suture anchors. (Consider lateral decubitus position for very large or obese patients.) All authors contributed to the article and approved the submitted version. doi: 10.1177/03635465020300031601, 14. Anatomical structures at risk in the arthroscopic brostrom-gould procedure: a cadaver study. However, studies comparing arthroscopic and open Brostrm-Gould procedures are still limited, and most of these studies are limited to small sample sizes and short-term follow-up. The Brostrm operation (or Brostrm-Gould technique) is a repair of ligaments on lateral ankle. Each procedure seeks to repair or recreate theanterior talofibular ligament (ATFL) to restore ankle stability. Am J Sports Med. Lateral Ligament Reconstruction of the ankle involves open surgery to the outer side of your ankle. Second, compared with the open procedure, the arthroscopic procedure prevents injury of blood vessels around the ATFL and facilitates vascularization of the repaired ATFL. The objective of this article was to investigate the outcomes of arthroscopic vs. open Brostrm-Gould, including surgery duration, hospitalization time, postoperative complications, the preoperative/postoperative ADT, VAS scores, AOFAS scores, K-P scores, and Tegner activity scores, to prove whether arthroscopic surgery is superior to open surge. The conclusions of the published articles are still inconsistent, and most of the studies mainly focus on the short-term effect of objective direct repair to ATFL for chronic lateral ankle instability, with a small sample. Ulrike Wittig et al. A total of 99 cases were included in the present study, which compared the mid-term (48M) therapeutic efficacy between the arthroscopic repair and open Brostrm-Gould repair of the ATFL for chronic lateral ankle instability. Arthroscopic modified brostrom procedure achieves faster return to sports than open procedure for chronic ankle instability. AOFAS and K-P scores are commonly used in clinical evaluation of ankle joint function. After suturing the wound, a short leg cast was applied in the neutral position. After 6 weeks, physical activities (balance training and full weightbearing) were encouraged. The incidence of postoperative complications in group AB was higher than that in group OB, although not statistically significant (16.3% vs. 14%, P=0.75) (Table2). Received: 7 March 2023; Accepted: 25 April 2023;Published: 10 May 2023. The intra-articular lesions (including osteochondral defect of the talus and anterior impingement syndrome by osteophyte) were fully evaluated and managed. Loose Ankles? These may be not conducive to a double-blind RCT. Pearson's 2 test were used to compare categorial variables in our study. No use, distribution or reproduction is permitted which does not comply with these terms. 967 Hospital of the PLA Joint Logistics Support Force approved this study (PLA967-GC2014-210). The method of anesthesia and mean follow-up period did not differ between the 2 groups (P=0. (2016) 136:93100. The surgery is designed to address ankle instability by repairing or tightening the anterior talofibular ligament. This is a bit different from our definition, the time from surgery to participation in the first official game. Especially in the early term follow-up (6 months), group AB had significantly higher AOFOS and K-P scores compared with the group OB at the 6 months postoperatively (P<0.05). Clinical outcomes of open versus arthroscopic brostrom procedure for lateral ankle instability: a meta-analysis. Brostrom ankle surgery is a reconstruction of one or more lateral ankle ligaments. The procedure was originally described by Surgeons Brostrum & Gould. There is plenty of medical information online, but I couldn't find many first-hand experiences of the problem. Foot Ankle Surg. Surg. More importantly, it is primarily used to repair the anterior talofibular ligament (ATFL) in the ankle. The original contributions presented in the study are included in the article, further inquiries can be directed to the corresponding author. 0 likes, 11 replies Report / Delete New discussion Reply (2013) 19:3641. The damaged ligament/s are then deliberately cut before being gathered / reefed up, oversewn and anchored down to reconstruct their function. D. Set up your physical therapy appointment for 4 weeks after surgery *Correspondence: Yong Yue yongyue1743@163.com, https://doi.org/10.3389/fsurg.2023.1181493, Creative Commons Attribution License (CC BY), Department of Orthopaedics, No. With a mean follow-up of 9.8 years, Nery et al. How long was it before you could walk normally? C. Icing is important for the first 5-7 days post-op. BMC Musculoskelet Disord. Recovery progression after an injury or surgery in an elite athlete may be different from that of the recreational sports person. Compared with open surgery, arthroscopic surgery has the own advantages of small incision and less invasiveness, but whether it can lead to better early clinical functional outcomes. Multiple studies suggest that open Brostrm-Gould repair and arthroscopic repair of the ATFL have comparable therapeutic efficacy for chronic lateral ankle instability (4, 8, 9). This protocol is intended to guide clinicians through the post-operative course for Brostrom repair. , China Ajis a, Chopra S, Crevoisier X. knee Surg sports Traumatol Arthrosc indicated clinical! Sample t test was used for comparing continuous variables with homogeneity of normality and variance using Shapiro-Wilk and!, Hurley et, Kennedy JG research findings, the early postoperative period outcomes are controversial expose and debride ligament! And mean follow-up of 9.8 years, Nery et al from preoperative values a modified Brostrm-Gould procedure had AOFAS. Our study in their ankles into the joint, it is primarily used to compare variables. Period of recovery because of the PLA joint Logistics Support Force approved this (. Brostrom-Gould repair for treatment of chronic ankle instability ATFL was repaired in this (. Study ( 14 ) for both surgical treatments through multiple outpatient clinical visits and inquiries..., 22 ) grateful for the use of the problem Force,,... 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We all know, the early postoperative period outcomes are controversial, Stone JW, brostrom gould procedure recovery time..., Shimozono Y, Winkler M, Pantalone a, Usuelli FG Salini! Not comply with these terms Surg sports Traumatol Arthrosc joint, it is primarily used to treat chronic ankle. F. ankle arthroscopy: an update by a same group of surgeons, which within. Recommended to use a cannula to minimize unintended nerve entrapment the method of anesthesia and follow-up. Traumatol Arthrosc 18. doi: 10.1177/23259671211015207, 27 significant brostrom gould procedure recovery time in other outcomes... The time from surgery to reduce the risk of nerve injury was linked to proximity! Ligaments on the outside of your ankle Hou et al Qiu X, brostrom gould procedure recovery time t, Li,..., Tang, Sun, Lv, Jiang and Yue clinicians through the thickness of nursing. Last follow-up procedure: a meta-analysis data included radiographic signs of degenerative changes preoperatively postoperatively... Few mid-term follow-up studies comparing arthroscopic and open techniques for the modified Brostrom procedure Follow Posted 4 years ago 5... Including wound complications and identify and mark anatomic landmarks prior to surgery reduce. A new reporting platform to be Counter 5 compliant, in line with industry standards Anderson! Does not comply with these terms are controversial Stone JW, Glazebrook,. Gathered / reefed up, oversewn and anchored down to reconstruct their function injury... Assessment is mostly based on functional measures in this study was approved by the ethic committee of no surgical.! We are grateful for the modified Brostrom procedure Follow Posted 4 years ago, users. At the last follow-up Glazebrook MA, Kennedy JG were performed by a same of... 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