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Outcomes of Internal Brace Augmentation Alone vs Broström Repair With Internal Brace for Chronic Lateral Ankle
Clayton Maschhoff1, Vu Bui2, Stephen Gauta2
1Division of Orthopedic Surgery, Albany Medical College, Albany, NY, USA.
Background:
The Broström procedure and its modifications remain the gold standard for surgical treatment of chronic lateral ankle instability (CLAI). Internal brace augmentation has gained popularity because of its enhanced mechanical stability and potential to facilitate earlier rehabilitation. However, the effectiveness of internal brace augmentation without formal ligament repair remains unclear. This study compared 1-year postoperative outcomes between standalone internal brace augmentation and modified Broström repair with internal brace augmentation.
Methods:
We retrospectively reviewed all lateral ankle stabilization procedures performed at a single academic center between January 2017 and December 2020. Patients were grouped by surgical technique: (1) Internal Brace Alone, defined as suture-tape augmentation without formal ligament repair (ST), and (2) Broström + Internal Brace. Outcomes assessed at a minimum follow-up of 1 year included satisfaction, persistent pain, recurrent instability, and revision surgery.
Results:
A total of 80 patients met inclusion criteria, including 58 (72.5%) in the ST cohort and 22 (27.5%) in the combined cohort. Baseline demographic and comorbidity profiles were similar between groups (all P > .05). At a minimum follow-up of 12 months, both cohorts demonstrated high satisfaction rates, with no significant difference between the ST and combined groups (87.5% vs 90.9%, P = .67). Persistent ankle pain was reported in 32.7% of ST patients vs 22.7% of combined-group patients (P = .38). Recurrent instability occurred in 6.9% and 4.5% of patients, respectively (P = .70). Revision surgery was required in 12.1% of ST patients compared with 4.5% of combined-group patients (P = .32).
Conclusion:
With the sample size available, no statistically significant differences in measured 1-year outcomes could be detected between standalone internal brace augmentation and modified Broström repair with internal brace augmentation. These findings should be considered preliminary and require confirmation in adequately powered prospective studies.
Level Of Evidence:
Level III, retrospective comparative study.