Arthroscopic modified Broström may improve function while anatomic reconstructions could enhance stability for...

Area of Science:

• Orthopedics
• Sports Medicine
• Surgical Innovation

Background:

• Chronic lateral ankle instability (CLAI) significantly impacts patient function and quality of life.
• Various surgical techniques exist for CLAI, including modified Broström procedures (MB), anatomical reconstructions, and suture tape augmentations (STA).
• Comparative efficacy data for these diverse surgical options remain crucial for clinical decision-making.

Purpose of the Study:

• To systematically review and network meta-analyze the efficacy of surgical treatments for CLAI.
• To compare open and arthroscopic modified Broström procedures (MB), anatomical reconstructions (autografts/allografts), and suture tape augmentations (STA).
• To rank treatments based on functional outcomes, stability improvements, and complication rates.

Main Methods:

• Systematic search of comparative studies on adult patients with CLAI.
• Inclusion of open MB, arthroscopic MB, anatomical reconstructions, and STA.
• Random-effects model network meta-analysis (NMA) with Surface Under the Cumulative Ranking Curve (SUCRA) for treatment ranking.

Main Results:

• Arthroscopic MB demonstrated the highest likelihood of improving functional outcomes (AOFAS scores).
• Anatomical graft reconstructions showed superior reduction in anterior talar translation (ATT) and talar tilt angle (TTA).
• Arthroscopic MB and STA were associated with lower complication rates compared to other methods.

Conclusions:

• Arthroscopic MB may offer better functional recovery for CLAI patients.
• Anatomical reconstructions provide enhanced joint stability.
• Arthroscopic approaches generally carry lower risks of complications, informing surgical strategy for CLAI.