Patient Reported Outcomes Following Open Broström-Gould Procedure: Minimum 5 Year Follow Up

Abstract

Category: Hindfoot; Sports Introduction/Purpose: The purpose of this study is to demonstrate five-year patient-reported outcomes following the Broström- Gould procedure for the treatment of CAI in the general population. This is the first study utilizing PROMIS and FAAM scores at a minimum followup of five years and will provide valuable insight into the long term efficacy of the BG procedure. Additionally, our regression analysis portrays information on which individual patient factors independently influence patient reported outcome scores. Methods: Following approval from our institution’s IRB, the electronic medical record was queried for CPT code 27698 (Broström-Gould) from Jan 2010 to June 2017. Patients were included if they had a preoperative diagnosis of chronic lateral ankle instability and failed nonoperative management. Patients were excluded if they had undergone any surgeries since their BG repair (except revision BG repair), had a follow up of less than five years, were under the age of 18, or declined to answer all PROMIS and FAAM surveys. Surveys were conducted in the clinic and through phone interviews. Utilizing the EMR, patient charts were reviewed to obtain basic patient demographic information including sex, age, race, and body mass index (BMI). Comorbidities including, but not limited to, tobacco use, diabetes, hypothyroidism, rheumatoid arthritis were also recorded. Results: Our results show that the minimum 5-year patient reported PROMIS scores for patient’s following a Brostrom-Gould procedure are as follows: PROMIS PF - 50.5, PROMIS PI, 48.2, and PROMIS D - 38 2. This indicates, at a minimum, that patients 5-years removed from the procedure are within one standard deviation of the general population in regards to PROMIS physical function and pain. Our patient reported FAAM, ADL, and FAAM S scores were 59.6 and 13.0 respectively. Conclusion: This study is the first paper to report minimum five year patient reported PROMIS scores following the Broström- Gould procedure. We believe it is a valuable contribution to the literature as it provides both the treating surgeon and patient with evidence that the BG is a safe and effective procedure at the 5-year mark. Additionally, we have isolated potential factors that independently correlate with PROMIS outcomes including tobacco use, diabetes, and sports participation. We have shown the efficacy of the BG at 5-years and have provided the framework for future comparison studies hoping to utilize the PROMIS system to assess outcomes.