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A comparison of the modified Broström procedure and modified Karlsson procedure in treating chronic lateral ankle
Xinchao Deng1, Man Zou2, Hongfei Zhu3
1Department of Orthopedics, Wuhan Eighth Hospital, Wuhan, China.
Insights
The modified Karlsson procedure demonstrated superior efficacy and patient satisfaction compared to the modified Broström procedure for chronic lateral ankle instability (CLAI). Both procedures showed similar surgical complication rates.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Ankle Instability Research
Background:
- Chronic lateral ankle instability (CLAI) significantly impacts patient quality of life.
- Surgical interventions aim to restore ankle stability and function.
- The modified Broström and modified Karlsson procedures are common surgical options for CLAI.
Purpose of the Study:
- To compare the clinical efficacy of the modified Broström procedure versus the modified Karlsson procedure in treating CLAI.
- To evaluate and compare surgical complication rates between the two procedures.
Main Methods:
- A systematic review and meta-analysis of full-text publications comparing Broström and Karlsson procedures.
- Data extraction and analysis using Review Manager 5.0.
- Inclusion of nine studies with a total of 643 patients.
Main Results:
- Karlsson group showed significantly higher American Orthopedic Foot and Ankle Society (AOFAS) scores (MD = 6.31, P=0.002).
- Karlsson group reported higher patient satisfaction (MD = 0.63, P<0.00001) and shorter operation times (MD =-15.50, P<0.00001).
- No significant difference in surgery complications was found between the groups (OR = 1.71, P=0.18).
Conclusions:
- The modified Karlsson procedure appears more effective than the modified Broström procedure for CLAI treatment.
- Karlsson's procedure offers better functional outcomes and patient satisfaction with comparable safety.
- Further research may explore long-term outcomes and specific patient selection criteria.
Background:
This study sought to compare the efficacy and surgery complications of the modified Broström procedure and the modified Karlsson procedure in treating patients with chronic lateral ankle instability (CLAI).
Methods:
Full-text publications on the clinical efficacy of Broström's and Karlsson's procedures were retrieved from multiple databases. Review Manager 5.0 was adopted for the meta-analysis, sensitivity analysis, and bias analysis.
Results:
Nine studies comprising a total of 643 patients were identified. The meta-analysis suggested that the American Orthopedic Foot and Ankle Society (AOFAS) scores of patients in the Karlsson group were higher than those of patients in the Broström group [mean deviation (MD) =6.31, 95% confidence interval (CI): 2.31-10.30, P=0.002; P for heterogeneity <0.00001, I2=58%]. The Tegner scores of patients in the Karlsson group were higher than those of patients in the Broström group (MD =0.72, 95% CI: 0.48-0.95, P=0.24; P for heterogeneity <0.00001, I2=23%). Operation times in the Broström group were higher than those in the Karlsson group (MD =-15.50, 95% CI: -19.98--11.02, P<0.00001; P for heterogeneity <0.00001, I2=63%). Patients in the Karlsson group had higher levels of satisfaction than those in the Broström group (MD =0.63, 95% CI: 0.47-0.79, P<0.00001; P for heterogeneity =0.91, I2=0%). No significant difference was observed in surgery complications between the Karlsson and Broström groups [odds ratio (OR) =1.71, 95% CI: 0.79-3.71, P=0.18; P for heterogeneity =0.99, I2=0%].
Discussion:
Based on the heterogeneity analysis results, this study showed that Karlsson's procedure was more efficient and safer than Broström's treatment in the treatment of CLAI patients.
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