• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.69-77
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• 2011

Purpose: This study was retrospectively performed to compare the clinical outcomes of modified Brostrom procedures using the single suture anchor and the double suture anchor for chronic lateral ankle instability. Materials and Methods: Thirty-seven patients were followed up for more than 1 year after the modified Brostrom procedures using suture anchor. Single surgeon treated seventeen cases with single suture anchor and 20 cases with double suture anchor. The clinical evaluation was performed according to the Karlsson scale and Sefton grading system. Radiologic measurement of the talar tilt and anterior talar translation was performed through anterior and varus stress radiographs using Telos device. Results: The Karlsson scale had improved significantly from preoperative average of 45.2 points to 89.4 points in single suture anchor group, and from 46.4 points to 90.5 points in double suture anchor group. According to the Sefton grading system, 15 cases (88.2%) in single suture anchor group and 18 cases (90%) in double suture anchor group achieved satisfactory results. The talar tilt angle and anterior talar translation had improved significantly from preoperative average of $13.6^{\circ}$ and 8.6 mm to $5.4^{\circ}$ and 4.1 mm in single suture anchor group, from $14.1^{\circ}$ and 8.4mm to $3.9^{\circ}$ and 4 mm in double suture anchor group. Double suture anchor technique was significantly superior in postoperative talar tilt. Conclusion: Single and double suture anchor techniques produced similar clinical and functional outcomes except for talar tilt, which was significantly superior in double suture anchor group. Both modified Brostrom procedures using the single and double suture anchor appear to be effective treatment methods for chronic lateral ankle instability. Further evaluation of clinical outcomes and biomechanical studies in athletes are needed.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.201-207
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• 2003

Purpose: We reviewed the value of treatment for chronic lateral instability of theankle with arthroscopic procedure combined with Brostrom one. Material and Method: From May 2000 to June 2002, 18 patient with chronic lateral instability of the ankle with Modified Brostrom procedure and arthroscopic one. Mean follow-up period was 18 months. Result: Chronic lateral instability of the ankle almost had intraarticular pathology, such as osteophye, osteochondral lesion, So we could resolve intraarticular pathology by arthroscopic procedure during Brostrom one for lateral collateral ligament reconstruction. Conclusion: Modified Brostrom procedure and arthroscopic one are an excellent treating method for chronic lateral instability of the ankle which has intraarticular pathology.

• 대한족부족관절학회:학술대회논문집
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• 2008.11a
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• pp.16-16
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• 2008

• Journal of Korean Foot and Ankle Society
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• v.17 no.4
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• pp.283-287
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• 2013

Purpose: To evaluate the result of arthroscopic modified Brostrom procedure with suture anchor for chronic lateral ankle instability. Materials and Methods: Fifty-two patients with chronic lateral ankle instability were analyzed, who underwent arthroscopic modified Brostrom procedure between December 2010 and May 2012. Clinical evaluation was performed using AOFAS scroring and Sefton grading system. Results: The average AOFAS hind foot score increased from preoperative 61.9 to 88.8 at the last follow up. There were 35 excellent, 9 good, 4 fair, 4 poor results according to Sefton grading system. For one patient, lateral ankle instability recurred. Conclusion: Arthroscopic modified Brostrom procedure is considered to be an effective and satisfactory technique.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.149-152
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• 2004

Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.

• Journal of Korean Foot and Ankle Society
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• v.16 no.4
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• pp.241-246
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• 2012

Purpose: The purpose of our study was to perform a comparison of the outcomes of the modified Brostrom procedure using only a suture anchor compared with using a suture anchor with a pushlock anchor. Materials and Methods: This was a retrospective study of chronic lateral ankle instability that underwent a modified Brostrom procedure using a bioabsorbable suture anchor & a pushlock anchor, performed by a single surgeon. A total of 88 patients were enrolled in the study. The function of the patient's ankles were scored using the American Orthopaedic Foot and Ankle Society (AOFAS), visual analogue scale (VAS) both preoperatively and postoperatively. Results: The difference in the overall means between the group A and group B was not statistically significant. But, the patient's satisfaction was better in the group B, and there were more complications in the group A. Conclusion: The technique presented here uses the modified Brostrom procedure with pushlock anchors to prevent the problems associated with subcutaneous knot irritation.

• Journal of Korean Foot and Ankle Society
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• v.11 no.1
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• pp.62-66
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• 2007

Purpose: We try to retrospectively analyze the clinical results of the modified Chrisman-Snook procedure for chronic ankle instability. Materials and Methods: From November 1997 to April 2006, thirty-one patients who underwent modified Chrisman-Snook procedure for chronic ankle instability were analyzed. All patients were male and the mean age was 31 years. The follow-up period averaged 48 months. We evaluated the clinical results measured by Hasegawa method. Results: Among them, there were soldiers in 11, socker players in 6, patients who weigh more 80 kg in 5. And there were 9 patients who previously underwent modified Brostrom procedure for chronic ankle instability. The clinical results were rated as excellent in 29, fair in 2 who did not cooperate with postoperative rehabilitation program. There were complications of 2 cases of irritation of the sural nerve and recurrence respectively, 1 case of wound problem. Conclusion: Our results show that the modified Chrisman-Snook procedure is effective treatment method for patients with high-performance athlete/soldier or failed modified Brostrom procedure.

• Journal of Korean Foot and Ankle Society
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• v.18 no.3
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• pp.108-114
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• 2014

Purpose: Ligament reattachment technique using a suture anchor appears to show satisfactory functional outcomes and mechanical stability compared with conventional bone tunnel technique. This study was prospectively conducted in order to evaluate functional outcomes of modified Brostrom procedures using the suture bridge technique for chronic ankle instability in athletes. Materials and Methods: Twenty eight athletes under 30 years of age were followed for more than two years after undergoing the modified Brostrom procedure using the suture bridge technique. Functional evaluation consisted of the foot and ankle outcome score (FAOS), foot and ankle ability measure (FAAM) score. Range of motion and time to return to exercise were evaluated using a periodic questionnaire. Talar tilt angle and anterior talar translation were measured through stress radiographs for evaluation of mechanical stability. Results: FAOS improved significantly from preoperative mean 59.4 points to 91.4 points (p<0.001). Daily living and sport activity scores of FAAM improved significantly from preoperative mean 50.5, 32.5 points to 94.8, 87.3 points, respectively (p<0.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean $16.8^{\circ}$, 13.5 mm to $4.2^{\circ}$, 4.1 mm at final follow-up (p<0.001). Times to return to exercise were as follows: mean 10.2 weeks in jogging, 15.4 weeks in spurt running, 13.1 weeks in jumping, 11.5 weeks in walking on uneven ground, 9.1 weeks in standing on one leg, 7.2 weeks in tip-toeing gait, 8.4 weeks in squatting, and 10.6 weeks in descending stairs. Conclusion: Modified Brostrom procedure using the suture bridge technique showed satisfactory functional outcomes for chronic ankle instability in athletes. Optimal indication and cost-effectiveness of the suture bridge technique will be studied in the future.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.60-65
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• 2006

Purpose: This study was performed to evaluate clinical and radiographical results of treatment of chronic lateral ankle instability with modified Brostrom procedure. Materials and Methods: This is a retrospective study of 22 cases in 22 patients treated with modified $Brostr{\ddot{o}}m$ procedure under the diagnosis of chronic lateral ankle instability from May 2000 to August 2004. Average age was 32.3 years. Average follow-up period was 23 months. Preoperative and postoperative radiographs of ankle anteroposterior view, lateral view and varus stress view were analyzed. The clinical evaluation was performed according to the Americal Orthopaedic Foot and Ankle Society scales. Results: After the modified $Brostr{\ddot{o}}m$ procedure, Americal Orthopaedic Foot and Ankle Society scales score was improved by average 28 points. Among the 22 cases, 13 cases were excellent, 3 cases good, 4 cases fair, and 2 cases poor with satisfaction of 73%. Five cases had intermittent ankle pain of whom 3 cases had difficulty during competitive sports activity. Lateral tilting of talus improved by average 5.4 degrees on varus stress view. Conclusions: The modified $Brostr{\ddot{o}}m$ procedure is one of the most effective methods for treating of chronic lateral ankle instability.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.40-47
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• 2022

Purpose: The modified Broström repair (BR) technique has yielded good outcomes in patients with chronic ankle instability. This study compared clinical and radiological outcomes between two groups of patients who underwent modified BR or lateral ligament augmentation using suture tapes (ST). Materials and Methods: Seventy-seven patients (ST group [n=47], BR group [n=30]; body mass index <26.61 kg/m²; mean age, 30.7±11.0 years [range, 17~39 years]; mean follow-up, 34.0±12.0 months [range, 24~59 months]) were retrospectively reviewed between January 2014 and July 2017. The Foot and Ankle Outcome Score (FAOS), American Orthopedic Foot and Ankle Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS) score, and Sefton grading system were used for clinical assessment. The talar tilt angle and anterior talar translation were measured using the Telos stress device (Telos GmbH, Marburg, Germany) at 150 N for radiological evaluation. Results: FAOS, AOFAS, FAAM, and VAS scores improved in both groups at final follow-up (ST, 91.1±5.2, 93±2, 88.1±4.5, 1.5±0.7 vs. BR, 91.3±5.4, 93±3, 83.3±4.8, 1.2±0.7, respectively; p=0.854, 0.971, <0.001, 0.04, respectively). According to the FAOS, mean sports activity scores for the ST and BR groups at the final follow-up were 90.3±3.2 and 76.6±4.2, respectively, reflecting superior outcomes in the ST group (p<0.001). Sefton grading revealed satisfactory functional outcomes (ST, 91.5% vs. BR, 90.0%). There was significant improvement in the talar tilt angle and anterior talar translation in both the ST and BR groups (7.6°±1.2°, 10.5±1.8 mm vs. 4.9°±1.1°, 7.9±1.5 mm, respectively; p<0.001). Conclusion: The ST group demonstrated comparable clinical but better improvement in mechanical stability and FAOS sports scores than the BR group.