Guillaume Cordier1,2, Johan Lebecque3,4, Jordi Vega3,5,6, Miki Dalmau-Pastor3,5,7. 1. Clinique du Sport Bordeaux-Mérignac, Institut du Sport, 2 rue negrevergne, 33700, Merignac, France. docteurcordier@yahoo.fr. 2. Groupe de Recherche et d'Etude en Chirurgie Mini-Invasive du Pied (GRECMIP), Merignac, France. docteurcordier@yahoo.fr. 3. Groupe de Recherche et d'Etude en Chirurgie Mini-Invasive du Pied (GRECMIP), Merignac, France. 4. Groupe Hospitalier Pellegrin, Bordeaux, France. 5. Department of Pathology and Experimental Therapeutics (Human Anatomy Unit), Laboratory of Arthroscopic and Surgical Anatomy, University of Barcelona, Barcelona, Spain. 6. Foot and Ankle Unit, Hospital Quirón and Clinica Tres Torres, Barcelona, Barcelona, Spain. 7. Vilamèdic, Santa Coloma de Gramanet, Barcelona, Spain.
Abstract
PURPOSE: The open "Broström-Gould" procedure has become the gold standard technique for the treatment of chronic ankle instability. Although arthroscopic techniques treating ankle instability have significantly evolved in the last years, no all arthroscopic Broström-Gould has been described. The aim of the study was to describe the all-arthroscopic Broström-Gould technique [anterior talofibular ligament (ATFL) repair with biological augmentation using the inferior extensor retinaculum (IER)], and to evaluate the clinical results in a group of patients. METHODS: Fifty-five patients with isolated lateral ankle instability were arthroscopically treated. Arthroscopic ATFL repair with biological augmentation was performed through a two-step procedure. First, the ligament is reattached through an arthroscopic procedure. Next, the ligament is augmented with the IER that is endoscopically grasped. Both the ligament repair and its augmentation with IER were performed with the help of an automatic suture passer and two soft anchors. Characteristics of the patients, and pre- and postoperatively AOFAS and Karlsson scores were recorded. RESULTS: The median preoperative AOFAS score increased from 74 (range 48-84) to 90 (range 63-100). According to the Karlsson score, the median preoperative average increased from 65 (range 42-82) to 95 (range 65-100). No major complications were reported. Only one case (1.8%) required a revision surgery at 23 months of follow-up. CONCLUSION: The arthroscopic all-inside ATFL repair with biological augmentation using the IER is a reproducible technique. Excellent clinical results were obtained. The technique has the advantage of its minimally invasive approach and the potential to treat concomitant ankle intra-articular pathology. LEVEL OF EVIDENCE: Retrospective case series, Level IV.
PURPOSE: The open "Broström-Gould" procedure has become the gold standard technique for the treatment of chronic ankle instability. Although arthroscopic techniques treating ankle instability have significantly evolved in the last years, no all arthroscopic Broström-Gould has been described. The aim of the study was to describe the all-arthroscopic Broström-Gould technique [anterior talofibular ligament (ATFL) repair with biological augmentation using the inferior extensor retinaculum (IER)], and to evaluate the clinical results in a group of patients. METHODS: Fifty-five patients with isolated lateral ankle instability were arthroscopically treated. Arthroscopic ATFL repair with biological augmentation was performed through a two-step procedure. First, the ligament is reattached through an arthroscopic procedure. Next, the ligament is augmented with the IER that is endoscopically grasped. Both the ligament repair and its augmentation with IER were performed with the help of an automatic suture passer and two soft anchors. Characteristics of the patients, and pre- and postoperatively AOFAS and Karlsson scores were recorded. RESULTS: The median preoperative AOFAS score increased from 74 (range 48-84) to 90 (range 63-100). According to the Karlsson score, the median preoperative average increased from 65 (range 42-82) to 95 (range 65-100). No major complications were reported. Only one case (1.8%) required a revision surgery at 23 months of follow-up. CONCLUSION: The arthroscopic all-inside ATFL repair with biological augmentation using the IER is a reproducible technique. Excellent clinical results were obtained. The technique has the advantage of its minimally invasive approach and the potential to treat concomitant ankle intra-articular pathology. LEVEL OF EVIDENCE: Retrospective case series, Level IV.