Clinical results of an arthroscopic modified Brostrom operation with and without an internal brace

BACKGROUND: The concept of utilizing nonabsorbable suture tape fixed directly to bone to augment Brostrom repairs of the anterior talofibular ligament (ATFL) has been proposed. However, no clinical data are currently available regarding the arthroscopic modified Brostrom operation with an internal brace. MATERIALS AND METHODS: This study involved 85 consecutive patients (22 in the with internal brace group; 63 in the without internal brace group) who could be followed up for >6 months after undergoing an arthroscopic modified Brostrom operation. The American Orthopaedic Foot & Ankle Society (AOFAS) score was administered to assess the functional status. At preoperation and at 24 weeks after surgery, the anterior drawer test was examined clinically. RESULTS: Improvement of mean AOFAS score in the internal brace group from before surgery to two weeks after surgery was statistically significant (p < 0.05). At 24-week follow-up, the anterior drawer test showed grade 0 laxity in 19 patients (86.4 %) and grade 1 in three patients (13.6 %). Improvement of AOFAS score in the group without an internal brace from before surgery to 6 weeks after surgery was not statistically significant (p = 0.001). At 24-week follow-up, the anterior drawer test showed grade 0 laxity in 54 patients (85.7 %) and grade 1 in nine patients (14.3 %). CONCLUSION: Patients in the internal brace group were able to quickly return to activity and sports. We believe this technique could be a viable option for surgically treating chronic lateral ankle instability in patients who need an early return to activity and sports. LEVEL OF EVIDENCE: III.