All-Inside Endoscopic Classic Bröstrom-Gould Technique: Medium-term Results

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Ankle Instability Research

Background:

• Short-term outcomes of arthroscopic/endoscopic lateral ligament repair for chronic lateral ankle instability are satisfactory.
• Medium- to longer-term results for these procedures are currently lacking in scientific literature.

Purpose of the Study:

• To report the medium-term outcomes (5 years) of an all-inside endoscopic classic Bröstrom-Gould procedure.
• To evaluate the sustainability of good outcomes using this minimally invasive technique for lateral ankle instability.
• Hypothesized that the procedure would yield lasting positive results at a medium-term follow-up.

Main Methods:

• A prospective case series (Level of evidence, 4) of 43 patients undergoing the all-inside endoscopic classic Bröstrom-Gould repair.
• Included repair of the anterior talofibular ligament and calcaneofibular ligament with inferior extensor retinaculum augmentation.
• Collected data on patient demographics, American Orthopaedic Foot & Ankle Society (AOFAS) scores, Karlsson scores, ankle activity scores (AAS), and patient satisfaction.

Main Results:

• Significant improvements were observed in AOFAS scores (69.6 to 93.7) and Karlsson scores (59.7 to 91.5) at a mean follow-up of 63.1 months.
• 32 patients (74.4%) maintained or improved their AAS, with a high mean satisfaction rate of 9.1/10.
• 11 patients experienced a reduced AAS but reported a mean satisfaction rate of 7.4/10; 7% failure rate due to recurrent instability.

Conclusions:

• The all-inside endoscopic classic Bröstrom-Gould procedure demonstrates good medium-term functional outcomes in 93% of patients.
• While overall satisfaction remains high, approximately 25% of patients experienced decreased ankle activity levels at 5 years.
• This study is the first to report medium-term results for this specific endoscopic technique, highlighting its efficacy and potential limitations.