Comparison of the period of return to practice in All-Inside Arthroscopic and Open Techniques for the Modified Broström Procedure for Ankle Instability

Abstract

Category: Arthroscopy Introduction/Purpose: Lateral ankle instability (LAI) is common injury in general population and open modified Broström operation (OMBO) is standard treatment of lateral ankle instability. Recently arthroscopic modified Broström operation (AMBO) is performed and many studies show that there are no difference in clinical & radiologic outcomes between open and arthroscopic operation. But not previously reported, comparison between OMBO and AMBO with the period of return to practice. The purpose of this study is to evaluate the time of return to practice in patients with clinical functional outcomes. Methods: From January 2012. to July 2014. 60 patients were included. They were divided into 2 groups: AMBO (30 patients) and OMBO (30 patients.). All patients followed a standardized treatment and rehabilitation program. We measured the period of return to practice by 7 Questions asked in each groups to compare period of return to practice. Survey is consisted of about time of walking, running, jumping, squatting, climbing stairs, rising up heels and toes without pain. And we also compared the time from the symptom of instability onset to date of operation. And for clinical outcome, evaluations were performed preoperatively, postoperatively, and 6months postoperatively using the AOFAS ankle-hindfoot score, pain VAS score and subjective satisfaction for rehabilitation, activity level of patients. Results: For comparison of the dates of operation, the average period of AMBO was faster (6.37±3.378 weeks) than OMBO (14.47±5.794 weeks). And for return to practice, AMBO showed faster return to practice (7.07±2.96 weeks) in walking without pain than OMBO (11.03±8.58 weeks). And other survey showed no difference in period of return to practice between OMBO and AMBO. There were no difference in postoperatively 6 month AOFAS and VAS score, but postoperatively VAS score showed significantly lower in AMBO than OMBO. AMBO was found to be faster return to practice in 2 out of 7 questions in high physical activity group, and also subjective satisfaction rate for rehabilitation of AMBO was higher than OMBO. Conclusion: For general population, except walking, there was no difference in the period of return to practice and clinical outcomes between the AMBO and OMBO for the treatment of lateral ankle instability. However, this study showed that AMBO was able to receive the surgery more quickly than OMBO. and AMBO can be a treatment option and should be considered carefully in atheletes who have lateral ankle instability that AMBO showed good results in higher activity level group for period of return to practice, subjective satisfaction, lower postoperatively pain.