A Randomized Comparison Between Anterior Talofibular Ligament Repair Using Broström Operation with and without an...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Anterior talofibular ligament (ATFL) injuries are common in athletes.
• The Broström operation is a standard surgical technique for ATFL repair.
• Internal bracing may enhance stability and outcomes in ATFL reconstruction.

Purpose of the Study:

• To compare the intermediate-term clinical outcomes of arthroscopic Broström repair with and without an internal brace for ATFL injuries.
• To evaluate functional recovery and patient-reported outcomes between the two surgical techniques.

Main Methods:

• A comparative study involving 19 patients in the internal brace (IB) group and 18 in the traditional Broström (TB) group.
• Arthroscopic surgical repair of the ATFL using either technique.
• Clinical evaluation using the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM) at >24 months follow-up.
• Preoperative and postoperative stress radiography to assess ankle stability.

Main Results:

• The IB group demonstrated significantly higher FAAM scores for sports activity (90.63 ± 6.21) compared to the TB group (83.33 ± 5.66) (p = .02).
• No significant differences were observed in preoperative or postoperative stress radiographs between the groups.
• The IB group incurred significantly higher total medical expenses (p < .001).
• Functional outcomes for daily life activities showed no significant difference between the groups.

Conclusions:

• Arthroscopic Broström repair with an internal brace offers superior functional outcomes in sports activities for ATFL injuries compared to the traditional technique.
• The addition of an internal brace increases medical costs without improving stability or daily living function.
• The choice between techniques should consider the trade-off between enhanced sports function and increased cost.