Modified Broström-Gould with gracilis autograft augmentation surgery and accelerated noncasted rehabilitation in high demand patients with lateral ankle instability
Journal Publication ResearchOnline@JCUAbstract
Lateral ankle instability that has failed conservative management can be physically debilitating. Good outcomesare obtained from Brostr€om-Gould augmented repair techniques, however there are few studies evaluating theuse of a gracilis autograft augmentation coupled with an accelerated rehabilitation program in high functionaldemand patients. We believe that the modified Brostr€om-Gould technique utilizing a Gracilis autograft will pro-vide significant improvements in stability while maintaining normal ankle biomechanics in young, high demandpatients. The prospective cohort study involved 19 patients (20 ankles) who underwent surgery for chronic lateralankle instability by a single surgeon, at a single institution between October 2014 and April 2016. Patients werefollowed for 33.8§11.7 (range 12-48) months. Patients were assessed both pre- and postoperatively for talar tiltangle radiographically and with both American Orthopaedic Foot and Ankle Society Ankle and Hindfoot scoresand Karlsson-Peterson scores. A Tegner activity score was taken at the last follow-up. The mean American Ortho-paedic Foot and Ankle Society score increased from 68.85§10.57 to 91.56§5.31 points (p<.01) and mean Karls-son-Peterson score increased from 50.9§15.53 to 88.11§8.64 points (pvalue<.01) when comparedpreoperatively to mean postoperative follow-up of 33.8 months. Tegner activity score was 7.05§0.89 at last fol-low-up. The technique was found to be effective in treating chronic lateral ankle instability and in combinationwith an accelerated rehabilitation protocol, patients returned to their premorbid level of activity with improvedstability and no significant effect on donor graft site morbidity.
Journal
Journal of Foot and Ankle Surgery
Publication Name
The Journal of Foot and Ankle Surgery
Volume
60
ISBN/ISSN
1542-2224
Edition
N/A
Issue
3
Pages Count
8
Location
N/A
Publisher
Elsevier
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Date
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EISSN
N/A
DOI
10.1053/j.jfas.2020.04.020