Effect of Arthroscopically Confirmed Syndesmotic Widening on Outcome Following Isolated Broström Operation for Chronic Lateral Ankle Instability

Author:

Su Tong1,Du Ming-Ze1,Parekh Selene G.2,Jiang Yan-fang1,Jiao Chen1ORCID,Hu Yue-lin1,Guo Qin-wei1ORCID,Jiang Dong1ORCID

Affiliation:

1. Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, China

2. Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA

Abstract

Background: Tibiofibular syndesmosis (TFS) widening sometimes is not evident on radiography but can be found under arthroscopy in chronic lateral ankle instability (CLAI). This study aimed to evaluate the effect of TFS widening severity on clinical outcomes and return to activities after isolated Broström operation in CLAI patients and to propose an indication for its surgical intervention. Methods: A total of 118 CLAI patients undergoing diagnostic ankle arthroscopy and open Broström-Gould operation were included. Based on the middle width of TFS measured under arthroscopy, patients were divided into the TFS-2 group (≤2 mm, n = 44), the TFS-3 group (2-4 mm, n = 42), and the TFS-4 group (≥4 mm, n = 32). The time to return to recreational sport and work, Tegner activity score, and proportion of returning to preinjury sports at the final follow-up were evaluated and compared. Other subjective evaluations included the American Orthopaedic Foot & Ankle Society score, visual analog scale, and Karlsson-Peterson score. Results: Among the 3 groups, the TFS-4 group demonstrated the longest mean time to return to work and recreational sports, with the lowest proportion returning to preinjury sports. The TFS-4 group showed a significantly higher rate of sprain recurrence (12.5%) than the other 2 groups ( P =.021). All the other subjective scores significantly improved after the operation without differences among the 3 groups. Conclusion: Concomitant severe syndesmotic widening adversely affects the return to activities after Broström operation in CLAI cases. The CLAI patients with a middle TFS width ≥4 mm were associated with delayed return to work and sports, a lower proportion of returning to preinjury sports, and more sprain recurrence, which might require further surgical intervention for syndesmosis in addition to Broström surgery. Level of Evidence: Level III, retrospective cohort study.

Funder

National Natural Science Foundation of China

Peking University Third Hospital

National Key R&D Program of China

Natural Science Foundation of Beijing Municipality

Publisher

SAGE Publications

Subject

Orthopedics and Sports Medicine,Surgery

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Subtle Syndesmotic Instability;Journal of the American Academy of Orthopaedic Surgeons;2024-01-30

2. Foot & Ankle International Commentary;Foot & Ankle International;2023-03-10

3. Myth, Lore, and Reality in the Syndesmosis: Moving Toward What Matters;Foot & Ankle International;2023-03-10

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