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Updated: Jun 14, 2026
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Combination of modified Broström procedure with ankle arthroscopy for chronic ankle instability accompanied by
Yinghui Hua1, Shiyi Chen, Yunxia Li
1Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Fudan University, Shanghai, China.
Purpose:
To evaluate the effectiveness of the modified Broström procedure combined with ankle arthroscopy for chronic ankle instability (CAI) accompanied by intra-articular symptoms.
Methods:
We identified 85 consecutive patients with CAI (87 ankles). There were 58 male patients (58 ankles) and 27 female patients (29 ankles) with a mean age of 24.4 years (range, 14 to 36 years). All the patients had intra-articular symptoms. Ankle arthroscopic surgery was performed initially to manage any intra-articular lesions. This was followed by the modified Broström procedure, including shortening of the anterior talofibular ligament and/or calcaneofibular ligament, as well as extensor retinaculum augmentation. All the intra-articular lesions found during surgery were recorded. American Orthopaedic Foot & Ankle Society (AOFAS) scores were obtained before surgery and at follow-up.
Results:
Intra-articular lesions were found in 79 ankles (90.8%), including 75 with synovitis and soft-tissue impingement, 33 with chondral injuries, 23 with anterior tibial osteophytes, 7 with loose bodies, and 6 with distal tibiofibular syndesmosis injuries. A total of 79 patients (92.9%) (81 ankles) were followed up for a mean of 29 months (range, 12 to 47 months). The mean AOFAS score improved from 46.6 +/- 8.1 preoperatively to 86.5 +/- 7.6 postoperatively (P < .05). Mean postoperative AOFAS scores were significantly higher in patients without chondral lesions than in those with chondral lesions (89.76 +/- 5.88 and 81.35 +/- 7.18, respectively; P < .05). Improvements in AOFAS scores after surgery were significantly greater in patients without chondral lesions than in those with chondral lesions (42.28 +/- 9.04 and 36.06 +/- 11.85, respectively; P < .05).
Conclusions:
The modified Broström procedure combined with ankle arthroscopy produced satisfactory surgical outcomes in patients with CAI and intra-articular symptoms. Accompanying chondral injuries were associated with poorer surgical outcomes.
Level Of Evidence:
Level IV, therapeutic case series.
