Factors Associated with the Clinical Outcomes of Ankle Instability Surgery

Objectives: More than ۲۰% of patients experience chronic lateral ligamentous instability of the ankle (CLLIOTA) following the appropriate management of an ankle sprain. The modified Broström-Gould (MBG) procedure has become the standard treatment for the anatomic repair of symptomatic CLLIOTA. ‪The present study aimed to evaluate the clinical and functional outcomes of the MBG technique ‪in patients with CLLIOTA and investigate factors affecting the outcome of surgery.Methods: This retrospective, single-group study included all patients with CLLIOTA who underwent surgery using the MBG technique in Shahid Kamyab Hospital, Mashhad, Iran, between July ۲۰۱۵ and August ۲۰۲۰. The American Orthopedic Foot and Ankle Score (AOFAS), Manchester-Oxford Foot Questionnaire (MOXFQ), and Pain Visual Analog Scale (VAS) were used to evaluate the outcome. The correlation between patient-related factors and each outcome measure was also analyzed.Results: In total, ۳۸ patients underwent the MBG procedure. The mean follow-up was ۴۰.۱ (۱۸-۶۷) months. Overall, ۱۵ patients (۳۹.۴۷%) had a history of sports-related ankle sprains, and ۱۵ (۳۹.۴۷%) had ankle osteochondral lesions. The AOFAS score improved significantly (۵۱.۲۳±۱۳.۴۹ to ۹۱.۹۲±۱۲.۰۷۷, P<۰.۰۰۱), while MOXFQ and VAS scores decreased significantly in the follow-up evaluation (۵۰.۲۸±۹.۳۳ to ۲۷.۵±۱۳.۳۵, P<۰.۰۰۱, and ۶.۲±۱.۴۷ to ۲.۱۸±۱.۸۶, P<۰.۰۰۱, respectively). No significant correlation was found between pre-operative ankle osteoarthritis, talus osteochondral lesion, duration of the follow-up, ankle sprain etiology (sports vs. non-sports), age, body mass index, gender, and the interval between the first sprain and surgery on the one hand, and post-operative outcomes, on the other hand. The more time passed after the surgery, the less painful the ankle of the patient was (P=۰.۰۳۸). No failure was observed among the patients.Conclusion: This study showed that the open MBG technique for CLLIOTA can improve clinical outcomes with no major complications following surgery in the Iranian population.         Level of evidence: III

کلیدواژه ها:

Ankle ، clinical outcomes ، Lateral Ligamentous Instability ، Orthopedics ، Reconstruction