Skip to main content

Advertisement

SpringerLink
Log in

Functional outcomes and rates of return to sport activities in a non-athlete population after the open Brostrom–Gould repair: a seven-year follow-up

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

After an ankle sprain, up to 20% of patients may develop chronic lateral ankle instability (CLAI) requiring surgical treatment. The objective of this study was to investigate the functional outcomes and rates of return to sport activities in a cohort of non-athlete patients with chronic lateral ankle instability (CLAI) who underwent the opened Brostrom–Gould technique (BGT).

Materials and Methods

Seventy-nine patients (seventy-nine feet) from three different centers undergoing BGT were reviewed. For clinical and functional analysis, the AOFAS ankle–hindfoot scale was applied and rates of return to sport activities were assessed. Correlation of Δ-AOFAS and rates of return to sport activities with all variables analyzed was performed.

Results

Mean AOFAS score improved from 64.6 to 97.2 (p < 0.001). Sixty-one (77.2%) returned to preinjury activities and 18 (22.8%) changed to a lower-level modality. Symptoms of instability were related to Δ-AOFAS (p = 0.020). Change in the sport activity was related to pain and symptoms of instability (p = 0.41 and p < 0.001).

Conclusion

Recreational athlete patients who underwent the BGT demonstrated excellent functional outcomes after a mean follow-up of 7 years. Residual pain and symptoms of instability after surgery were the main complaints associated with limitations in physical activities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Waterman BR, Owens BD, Davey S et al (2010) The epidemiology of ankle sprains in the United States. J Bone Jt Surg 92:2279–2284. https://doi.org/10.2106/JBJS.I.01537

    Article  Google Scholar 

  2. Colville MR (1998) Surgical treatment of the unstable ankle. J Am Acad Orthop Surg 6:368–377. https://doi.org/10.5435/00124635-199811000-00005

    Article  CAS  PubMed  Google Scholar 

  3. Baumhauer JF, O’Brien T (2002) Surgical considerations in the treatment of ankle instability. J Athl Train 37(4):458

    PubMed  PubMed Central  Google Scholar 

  4. Kerkhoffs GM, van den Bekerom M, Elders LAM et al (2012) Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline. Br J Sports Med 46:854–860. https://doi.org/10.1136/bjsports-2011-090490

    Article  PubMed  Google Scholar 

  5. Caprio A, Oliva F, Treia F, Maffulli N (2006) Reconstruction of the lateral ankle ligaments with allograft in patients with chronic ankle instability. Foot Ankle Clin 11:597–605. https://doi.org/10.1016/j.fcl.2006.05.003

    Article  PubMed  Google Scholar 

  6. Rodriguez-Merchan EC (2012) Chronic ankle instability: diagnosis and treatment. Arch Orthop Trauma Surg 132:211–219. https://doi.org/10.1007/s00402-011-1421-3

    Article  PubMed  Google Scholar 

  7. Song Y, Li H, Sun C et al (2019) Clinical guidelines for the surgical management of chronic lateral ankle instability: a consensus reached by systematic review of the available data. Orthop J Sport Med. https://doi.org/10.1177/2325967119873852

    Article  Google Scholar 

  8. Petersen W, Rembitzki IV, Koppenburg AG et al (2013) Treatment of acute ankle ligament injuries: a systematic review. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-013-1742-5

    Article  PubMed  PubMed Central  Google Scholar 

  9. Balduini FC, Vegso JJ, Torg JS, Torg E (1987) Management and rehabilitation of ligamentous injuries to the ankle. Sport Med 4:364–380. https://doi.org/10.2165/00007256-198704050-00004

    Article  CAS  Google Scholar 

  10. Sammarco VJ (2001) Complications of lateral ankle ligament reconstruction. Clin Orthop Relat Res 391:123–132. https://doi.org/10.1097/00003086-200110000-00013

    Article  Google Scholar 

  11. Feng S-M, Sun Q-Q, Wang A-G et al (2021) Long-term functional outcomes of all-inside arthroscopic repair of anterior talofibular ligament avulsion fracture. Foot Ankle Surg 27:156–161. https://doi.org/10.1016/j.fas.2020.03.007

    Article  PubMed  Google Scholar 

  12. Ajis A, Maffulli N (2006) Conservative management of chronic ankle instability. Foot Ankle Clin 11:531–537. https://doi.org/10.1016/j.fcl.2006.07.004

    Article  PubMed  Google Scholar 

  13. Ulucakoy C, Kaptan AY, Eren TK et al (2021) Is arthroscopic surgery as successful as open approach in the treatment of lateral ankle instability? Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-021-03799-y

    Article  PubMed  Google Scholar 

  14. Karlsson J, Bergsten T, Lansinger O, Peterson L (1988) Reconstruction of the lateral ligaments of the ankle for chronic lateral instability. J Bone Jt Surg Am 70:581–588

    Article  CAS  Google Scholar 

  15. Gould N, Seligson D, Gassman J (1980) Early and late repair of lateral ligament of the ankle. Foot Ankle 1:84–89. https://doi.org/10.1177/107110078000100206

    Article  CAS  PubMed  Google Scholar 

  16. Hamilton WG, Thompson FM, Snow SW (1993) The modified brostrom procedure for lateral ankle instability. Foot Ankle 14:1–7. https://doi.org/10.1177/107110079301400101

    Article  CAS  PubMed  Google Scholar 

  17. Karlsson J, Bergsten T, Lansinger O, Peterson L (1989) Surgical treatment of chronic lateral instability of the ankle joint. Am J Sports Med 17:268–274. https://doi.org/10.1177/036354658901700220

    Article  CAS  PubMed  Google Scholar 

  18. Harrington KD (1979) Degenerative arthritis of the ankle secondary to long-standing lateral ligament instability. J Bone Jt Surg Am 61:354–361

    Article  CAS  Google Scholar 

  19. Valderrabano V, Hintermann B, Horisberger M, Fung TS (2006) Ligamentous posttraumatic ankle osteoarthritis. Am J Sports Med 34:612–620. https://doi.org/10.1177/0363546505281813

    Article  PubMed  Google Scholar 

  20. Valderrabano V, Horisberger M, Russell I et al (2009) Etiology of ankle osteoarthritis. Clin Orthop Relat Res 467:1800–1806. https://doi.org/10.1007/s11999-008-0543-6

    Article  PubMed  Google Scholar 

  21. Cox JS (1985) Surgical and nonsurgical treatment of acute ankle sprains. Clin Orthop Relat Res 198:118–126

    Article  Google Scholar 

  22. Bell SJ, Mologne TS, Sitler DF, Cox JS (2006) Twenty-six-year results after broström procedure for chronic lateral ankle instability. Am J Sports Med 34:975–978. https://doi.org/10.1177/0363546505282616

    Article  PubMed  Google Scholar 

  23. Tourné Y, Mabit C, Moroney PJ et al (2012) Long-term follow-up of lateral reconstruction with extensor retinaculum flap for chronic ankle instability. Foot Ankle Int 33:1079–1086. https://doi.org/10.3113/FAI.2012.1079

    Article  PubMed  Google Scholar 

  24. Dias S, Lewis TL, Alkhalfan Y et al (2022) Current concepts in the surgical management of chronic ankle lateral ligament instability. J Orthop 33:87–94. https://doi.org/10.1016/j.jor.2022.07.006

    Article  PubMed  PubMed Central  Google Scholar 

  25. Buerer Y, Winkler M, Burn A et al (2013) Evaluation of a modified Broström–Gould procedure for treatment of chronic lateral ankle instability: a retrospective study with critical analysis of outcome scoring. Foot Ankle Surg 19:36–41. https://doi.org/10.1016/j.fas.2012.10.005

    Article  PubMed  Google Scholar 

  26. Dallman J, Wolf MR, Campbell T et al (2023) Current definitions of failure in lateral ankle instability surgery: a systematic review. Am J Sports Med. https://doi.org/10.1177/03635465231153165

    Article  PubMed  Google Scholar 

  27. Hunt KJ, Fuld RS, Sutphin BS et al (2017) Return to sport following lateral ankle ligament repair is under-reported: a systematic review. J ISAKOS 2:234–240. https://doi.org/10.1136/jisakos-2016-000064

    Article  Google Scholar 

  28. May NR, Driscoll M, Nguyen S, Ferkel RD (2022) Analysis of return to play after modified broström lateral ankle ligament reconstruction. Orthop J Sport Med 10:232596712110685. https://doi.org/10.1177/23259671211068541

    Article  Google Scholar 

  29. Goru P, Talha S, Majeed H (2022) Outcomes and return to sports following the ankle lateral ligament reconstruction in professional athletes: a systematic review of the literature. Indian J Orthop 56:208–215. https://doi.org/10.1007/s43465-021-00532-0

    Article  PubMed  Google Scholar 

  30. White WJ, McCollum GA, Calder JDF (2016) Return to sport following acute lateral ligament repair of the ankle in professional athletes. Knee Surg Sport Traumatol Arthrosc 24:1124–1129. https://doi.org/10.1007/s00167-015-3815-1

    Article  Google Scholar 

  31. Hong CC, Calder J (2022) Ability to return to sports after early lateral ligament repair of the ankle in 147 elite athletes. Knee Surg Sport Traumatol Arthrosc. https://doi.org/10.1007/s00167-022-07270-2

    Article  Google Scholar 

  32. Gregush RV, Ferkel RD (2010) Treatment of the unstable ankle with an osteochondral lesion. Am J Sports Med 38:782–790. https://doi.org/10.1177/0363546509351556

    Article  PubMed  Google Scholar 

Download references

Funding

The authors did not receive any financial benefit in the preparation of this work. This study did not receive any grant from academic, industry or charitable organizations.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital Alemão Oswaldo Cruz, 94, São Joaquim Street, Liberdade, São Paulo, SP, CEP: 01508-000, Brazil

    Danilo Ryuko Cândido Nishikawa

  2. Department of Orthopaedic Surgery, Hospital Sírio-Libanês, 91, Dona Adma Jafet Street, Bela Vista, São Paulo, SP, CEP:01308-050, Brazil

    Guilherme Honda Saito

  3. Department of Orthopaedic Surgery, Hospital Israelita Albert Einstein, 627, Albert Einstein Avenue, Jardim Leonor, São Paulo, SP, CEP: 05652-900, Brazil

    Alberto Abussamra Moreira Mendes, Adilson Sanches de Oliveira Junior & Marcelo Pires Prado

  4. Department of Orthopaedic Surgery, Clinica San Francesco, 21/B, Monte Ortigara Street, 37127, Verona, VR, Italy

    Alberto Marangon

  5. Department of Orthopaedic Surgery, Instituto Prata de Ortopedia, 161, Paineiras Street, Jardim, Santo André, SP, CEP 09090-521, Brazil

    Carlos Henrique Tardini

  6. Department of Orthopaedic Surgery, Foot and Ankle Surgery, Clínica de Ortopedia e Traumatologia Ortocity, 526, Brigadeiro Gavião Peixoto Street, Lapa, São Paulo, SP, CEP: 05078-000, Brazil

    Fernando Aires Duarte

Authors
  1. Danilo Ryuko Cândido Nishikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guilherme Honda Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alberto Abussamra Moreira Mendes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alberto Marangon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carlos Henrique Tardini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Adilson Sanches de Oliveira Junior
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Fernando Aires Duarte
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marcelo Pires Prado
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AM, AAMM, CHT and MPP performed the operations. DRCN, GHS, ASOJ and FAD collected data. Material preparation was performed by all authors. First draft of the manuscript was written by DRCN and GHS, and all authors commented for adequate changes of its final version. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Danilo Ryuko Cândido Nishikawa.

Ethics declarations

Conflict of interest

The authors have no conflict of interest in the preparation of this work..

Ethical approval

This study was approved by our institution Ethical Committee with CAAE number 53649221.5.0000.0071.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nishikawa, D.R.C., Saito, G.H., Mendes, A.A.M. et al. Functional outcomes and rates of return to sport activities in a non-athlete population after the open Brostrom–Gould repair: a seven-year follow-up. Eur J Orthop Surg Traumatol 34, 1957–1962 (2024). https://doi.org/10.1007/s00590-024-03882-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-024-03882-1

Keywords

Search

Navigation