Factors Associated with the Clinical Outcomes of Ankle Instability Surgery

Document Type : RESEARCH PAPER

Authors

1 Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

2 Orthopedics Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

10.22038/abjs.2024.74008.3427

Abstract

Objectives: More than 20% of patients experience chronic lateral ligamentous instability of the ankle (CLLIOTA) following the appropriate management of an ankle sprain. The modified Broström-Gould (MBG) procedure has become the standard treatment for the anatomic repair of symptomatic CLLIOTA. ‪The present study aimed to evaluate the clinical and functional outcomes of the MBG technique ‪in patients with CLLIOTA and investigate factors affecting the outcome of surgery.
Methods: This retrospective, single-group study included all patients with CLLIOTA who underwent surgery using the MBG technique in Shahid Kamyab Hospital, Mashhad, Iran, between July 2015 and August 2020. The American Orthopedic Foot and Ankle Score (AOFAS), Manchester-Oxford Foot Questionnaire (MOXFQ), and Pain Visual Analog Scale (VAS) were used to evaluate the outcome. The correlation between patient-related factors and each outcome measure was also analyzed.
Results: In total, 38 patients underwent the MBG procedure. The mean follow-up was 40.1 (18-67) months. Overall, 15 patients (39.47%) had a history of sports-related ankle sprains, and 15 (39.47%) had ankle osteochondral lesions. The AOFAS score improved significantly (51.23±13.49 to 91.92±12.077, P<0.001), while MOXFQ and VAS scores decreased significantly in the follow-up evaluation (50.28±9.33 to 27.5±13.35, P<0.001, and 6.2±1.47 to 2.18±1.86, P<0.001, respectively). No significant correlation was found between pre-operative ankle osteoarthritis, talus osteochondral lesion, duration of the follow-up, ankle sprain etiology (sports vs. non-sports), age, body mass index, gender, and the interval between the first sprain and surgery on the one hand, and post-operative outcomes, on the other hand. The more time passed after the surgery, the less painful the ankle of the patient was (P=0.038). No failure was observed among the patients.
Conclusion: This study showed that the open MBG technique for CLLIOTA can improve clinical outcomes with no major complications following surgery in the Iranian population. 
        Level of evidence: III

Keywords

Main Subjects

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            doi:10.1016/j.fastrc.2021.100106.

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The Archives of Bone and Joint Surgery
Volume 13, Issue 1
January 2025
Pages 30-38

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History

  • Receive Date: 04 August 2023
  • Revise Date: 17 October 2024
  • Accept Date: 26 March 2024

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