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Arthro-Broström with endoscopic retinaculum augmentation using all-inside lasso-loop stitch techniques.

Yunjian Yang¹, Jing Han¹, Helin Wu²

¹Department of Orthopaedics, General Hospital of Central Theater Command, NO. 627, Wuluo Road, Wuhan, 430030, Hubei Province, People's Republic of China.

BMC Musculoskeletal Disorders

|August 20, 2022

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This study shows the arthro-Broström procedure with endoscopic retinaculum augmentation is a safe and effective treatment for chronic lateral ankle instability, improving patient outcomes and ankle function.

Area of Science:

Orthopedic Surgery
Sports Medicine
Arthroscopy

Background:

Controversy exists regarding inferior extensor retinaculum augmentation after arthroscopic anterior talofibular ligament repair.
Chronic lateral ankle instability often requires surgical intervention.
The arthro-Broström procedure is a common surgical technique for ankle instability.

Purpose of the Study:

To evaluate the efficacy and safety of a novel arthro-Broström procedure with endoscopic retinaculum augmentation using all-inside lasso-loop stitch techniques.
To assess functional outcomes and patient satisfaction after the procedure.
To compare pre-operative and post-operative patient-reported outcome scores.

Main Methods:

Retrospective assessment of 30 cases (30 ankles) with grade-2 or grade-3 chronic anterior talofibular ligament lesions.

Keywords:

Anterior talofibular ligament Arthroscopy Chronic ankle instability Endoscopy Inferior extensor retinaculum Lasso-loop stitch

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Patients underwent arthroscopic Broström procedure with endoscopic retinaculum augmentation.

Follow-up averaged 26.67 months, with assessments including Cumberland Ankle Instability Tool, Karlsson-Peterson scores, Visual Analogue Scale, and stress fluoroscopic tests.

Main Results:

Significant improvements were observed in Cumberland Ankle Instability Tool (86.63 ± 6.69), Karlsson-Peterson scores (90.17 ± 4.64), and Visual Analogue Scale (0.53 ± 0.63).
Stress fluoroscopic tests showed significant improvement post-surgery.
Complications were minimal, including mild keloid formation or knot irritation in four cases; no infections, nerve injuries, or recurrent instability were reported.

Conclusions:

The arthro-Broström procedure combined with endoscopic retinaculum augmentation is a reliable and safe surgical option.
The technique offers the advantage of direct endoscopic visualization for precise repair.
This approach leads to favorable functional outcomes and patient satisfaction in managing chronic lateral ankle instability.