Modified Broström operation with absorbable sutures only: are suture anchors and nonabsorbable materials necessary?

The modified Broström operation is the gold standard surgical approach for chronic lateral ankle instability. The aim of surgical treatment for chronic lateral ankle instability is to shorten and repair the lax lateral ligaments, once the healing process is complete, the sutures will no longer be necessary. While non-absorbable sutures are commonly used, they may cause complications, such as inflammation and foreign body reactions. The purpose of this study was to evaluate the clinical outcomes of the modified Broström operation using absorbable sutures, which we expected to yield favorable results.

From 2019 to 2023, 157 cases of mechanical chronic lateral ankle instability treated with the modified Broström operation using absorbable sutures were analyzed retrospectively Functional outcomes were assessed using preoperative and postoperative AOFAS Ankle-Hindfoot scores and Karlsson-Peterson scores.

The mean AOFAS score improved from 66.84 (range: 36-98) preoperatively to 88.20 (range: 55-100) postoperatively, and the mean Karlsson score improved from 53.67 (range: 25-95) to 82.29 (range: 35-100). Recurrence of instability or sprains occurred in 6.3% of cases, with only two patients (1.2%) requiring reoperation. Complications other than recurrence were rare, limited to a single case of superficial peroneal nerve injury and one deep infection. Multivariate analysis revealed that younger age was associated with a higher risk of recurrence.

The modified Broström operation using absorbable sutures demonstrated favorable functional improvement with low recurrence and complication rates, suggesting that it may represent a safe and effective surgical option.