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Traditional Modified Broström vs Suture Tape Ligament Augmentation
Robert Kulwin1, Troy S Watson2, Ryan Rigby3
1Illinois Bone and Joint Institute, Libertyville, IL, USA.
Foot & Ankle International
|January 25, 2021
Summary
Suture tape (ST) augmentation in the modified Broström (MB) procedure for chronic lateral ankle instability (CLAI) significantly speeds return to preinjury activity levels. This approach may also support accelerated rehabilitation without increasing complications.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomaterials in Surgery
Background:
- Chronic lateral ankle instability (CLAI) is commonly treated with the modified Broström (MB) procedure.
- Suture tape (ST) augmentation is a newer technique for MB repair, but its clinical benefit requires further investigation.
Purpose of the Study:
- To compare the efficacy of the modified Broström (MB) procedure with suture tape (ST) augmentation versus the traditional MB procedure alone for treating CLAI.
Main Methods:
- A prospective, randomized comparative study (Level II evidence) involving 119 adult patients with CLAI.
- Patients were randomized to undergo either MB or ST-augmented MB.
- Primary outcome was time to return to preinjury level of activity (RTPAL); secondary outcomes included complications, accelerated rehabilitation protocol (ARP) completion, patient-reported outcomes, and pain scores.
Main Results:
- Average RTPAL was significantly shorter with ST augmentation (13.3 weeks) compared to MB alone (17.5 weeks) (P < .001).
- The ST group showed a trend towards fewer patients not achieving RTPAL by 26 weeks (3.6% vs 12.5%).
- Complication rates (1.7% vs 8.5%) and ARP completion failures (1 vs 4) were lower in the ST group, though not statistically significant.
Conclusions:
- Suture tape augmentation in the modified Broström procedure facilitates an earlier return to preinjury activity levels for CLAI patients.
- ST augmentation appears to support accelerated rehabilitation and does not increase complications or morbidity compared to the traditional MB procedure.
