Effects of Broström Versus Allograft Reconstruction Surgery on the Kinematic and Kinetic Gait Parameters in Chronic Ankle Instability.

Abstract

Background: Chronic ankle instability (CAI) commonly follows ankle sprains and significantly affects walking patterns and daily activities. Two main surgical treatments exist: Broström repair and anatomic allograft reconstruction. It remains unclear which technique better restores normal ankle movement. This study compared how these 2 surgeries affect ankle function during walking.

Methods: We conducted a prospective study with 30 CAI patients. Fifteen received Broström repair and 15 received anatomic allograft reconstruction. We also included 16 healthy controls. We analyzed ankle joint kinematics (range of motion in dorsi/plantar flexion and inversion/eversion), and kinetics (joint moments, power, and ground reaction force [GRF]) during the gait cycle using 3D motion capture and force plate measurements. Assessments were performed before and 8 months after surgery.

Results: Both surgical techniques altered ankle biomechanics compared with controls. However, the Broström repair group demonstrated gait patterns more similar to healthy controls in most parameters. The reconstruction group showed greater deviation from normal, with increased plantarflexion and eversion throughout the gait cycle. Kinetic analysis revealed that Broström repair better preserved normal ankle moment patterns, while reconstruction resulted in significant alterations in ankle power generation.

Conclusion: Both surgical techniques alter ankle mechanics, but Broström repair more effectively restores normal ankle biomechanics compared with allograft reconstruction in CAI patients during walking. These findings can guide surgeons in selecting the most appropriate surgical technique for restoring natural gait patterns.

Level of evidence: II.