Spencer M Comfort, Daniel C Marchetti, Parker P Duncan, Grant J Dornan, C Thomas Haytmanek, Thomas O Clanton
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The study purpose was to compare minimum 2-year patient-reported outcomes (PROs) following treatment of ATFL injuries with Broström repair with vs without suture tape augmentation.</p><p><strong>Methods: </strong>Between 2009 and 2018, patients >18 years old who underwent primary surgical treatment for an ATFL injury with either a Broström repair alone (BR Cohort) or Broström repair with suture tape augmentation (BR-ST Cohort) were identified. Demographic data and PROs, including Foot and Ankle Ability Measure (FAAM) with activities of daily living (ADL) and sport subscales, 12-Item Short Form Health Survey (SF-12), Tegner Activity Scale, and patient satisfaction with surgical outcome, were compared between groups, and proportional odds ordinal logistic regression was used.</p><p><strong>Results: </strong>Ninety-one of 102 eligible patients were available for follow-up at median 5 years. The BR cohort had 50 of 53 patients (94%) completed follow-up at a median of 7 years. The BR-ST cohort had 41 of 49 (84%) complete follow-up at a median of 5 years. There was no significant difference in median postoperative FAAM ADL (98% vs 98%, <i>P</i> = .67), FAAM sport (88% vs 91%, <i>P</i> = .43), SF-12 PCS (55 vs 54, <i>P</i> = .93), Tegner score (5 vs 5, <i>P</i> = .64), or patient satisfaction (9 vs 9, <i>P</i> = .82). There was significantly higher SF-12 MCS (55.7 vs 57.6, <i>P</i> = .02) in the BR-ST group. Eight patients underwent subsequent ipsilateral ankle surgery, of which one patient (BR-ST group) was revised for recurrent lateral ankle instability.</p><p><strong>Conclusion: </strong>At median 5 years, patients treated for ATFL injury of the lateral ankle with Broström repair with suture tape augmentation demonstrated similar patient-reported outcomes to those treated with Broström repair alone.</p><p><strong>Level of evidence: </strong>Level II, retrospective cohort study.</p>","PeriodicalId":12446,"journal":{"name":"Foot & Ankle International","volume":"44 8","pages":"691-701"},"PeriodicalIF":2.4000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Broström Repair With and Without Augmentation: Comparison of Outcomes at Median Follow-up of 5 Years.\",\"authors\":\"Spencer M Comfort, Daniel C Marchetti, Parker P Duncan, Grant J Dornan, C Thomas Haytmanek, Thomas O Clanton\",\"doi\":\"10.1177/10711007231176806\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>An augmented Broström repair with nonabsorbable suture tape has demonstrated strength and stiffness more similar to the native anterior talofibular ligament (ATFL) compared to Broström repair alone at the time of repair in cadaveric models for the treatment of lateral ankle instability. The study purpose was to compare minimum 2-year patient-reported outcomes (PROs) following treatment of ATFL injuries with Broström repair with vs without suture tape augmentation.</p><p><strong>Methods: </strong>Between 2009 and 2018, patients >18 years old who underwent primary surgical treatment for an ATFL injury with either a Broström repair alone (BR Cohort) or Broström repair with suture tape augmentation (BR-ST Cohort) were identified. Demographic data and PROs, including Foot and Ankle Ability Measure (FAAM) with activities of daily living (ADL) and sport subscales, 12-Item Short Form Health Survey (SF-12), Tegner Activity Scale, and patient satisfaction with surgical outcome, were compared between groups, and proportional odds ordinal logistic regression was used.</p><p><strong>Results: </strong>Ninety-one of 102 eligible patients were available for follow-up at median 5 years. The BR cohort had 50 of 53 patients (94%) completed follow-up at a median of 7 years. The BR-ST cohort had 41 of 49 (84%) complete follow-up at a median of 5 years. There was no significant difference in median postoperative FAAM ADL (98% vs 98%, <i>P</i> = .67), FAAM sport (88% vs 91%, <i>P</i> = .43), SF-12 PCS (55 vs 54, <i>P</i> = .93), Tegner score (5 vs 5, <i>P</i> = .64), or patient satisfaction (9 vs 9, <i>P</i> = .82). There was significantly higher SF-12 MCS (55.7 vs 57.6, <i>P</i> = .02) in the BR-ST group. 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引用次数: 1
摘要
背景:在治疗踝关节外侧不稳定的尸体模型中，与Broström修复相比，使用不可吸收缝合带进行增强Broström修复，其强度和刚度更接近天然距腓骨前韧带(ATFL)。研究的目的是比较Broström修复与不缝合带增强治疗ATFL损伤后至少2年的患者报告结果(PROs)。方法:在2009年至2018年期间，对>18岁的患者进行了ATFL损伤的初级手术治疗，无论是单独Broström修复(BR队列)还是Broström缝合带增强修复(BR- st队列)。比较两组间的人口统计数据和PROs，包括足踝能力测量(FAAM)和日常生活活动(ADL)和运动分量表、12项简短健康调查(SF-12)、Tegner活动量表和患者对手术结果的满意度，并采用比例odds有序逻辑回归。结果:102例符合条件的患者中有91例接受了中位5年的随访。BR队列中53例患者中有50例(94%)完成了中位7年的随访。BR-ST队列49例患者中有41例(84%)完成了中位5年的随访。术后FAAM ADL中位数(98% vs 98%， P = 0.67)、FAAM运动(88% vs 91%， P = 0.43)、sf - 12pcs (55 vs 54, P = 0.93)、Tegner评分(5 vs 5, P = 0.64)或患者满意度(9 vs 9, P = 0.82)均无显著差异。BR-ST组SF-12 MCS显著升高(55.7 vs 57.6, P = 0.02)。8名患者随后接受了同侧踝关节手术，其中1名患者(BR-ST组)因复发性踝关节外侧不稳定而进行了翻修。结论:中位5年，采用Broström缝合带增强修复术治疗外侧踝关节ATFL损伤的患者与单独采用Broström修复术治疗的患者报告的结果相似。证据等级:II级，回顾性队列研究。
Broström Repair With and Without Augmentation: Comparison of Outcomes at Median Follow-up of 5 Years.
Background: An augmented Broström repair with nonabsorbable suture tape has demonstrated strength and stiffness more similar to the native anterior talofibular ligament (ATFL) compared to Broström repair alone at the time of repair in cadaveric models for the treatment of lateral ankle instability. The study purpose was to compare minimum 2-year patient-reported outcomes (PROs) following treatment of ATFL injuries with Broström repair with vs without suture tape augmentation.
Methods: Between 2009 and 2018, patients >18 years old who underwent primary surgical treatment for an ATFL injury with either a Broström repair alone (BR Cohort) or Broström repair with suture tape augmentation (BR-ST Cohort) were identified. Demographic data and PROs, including Foot and Ankle Ability Measure (FAAM) with activities of daily living (ADL) and sport subscales, 12-Item Short Form Health Survey (SF-12), Tegner Activity Scale, and patient satisfaction with surgical outcome, were compared between groups, and proportional odds ordinal logistic regression was used.
Results: Ninety-one of 102 eligible patients were available for follow-up at median 5 years. The BR cohort had 50 of 53 patients (94%) completed follow-up at a median of 7 years. The BR-ST cohort had 41 of 49 (84%) complete follow-up at a median of 5 years. There was no significant difference in median postoperative FAAM ADL (98% vs 98%, P = .67), FAAM sport (88% vs 91%, P = .43), SF-12 PCS (55 vs 54, P = .93), Tegner score (5 vs 5, P = .64), or patient satisfaction (9 vs 9, P = .82). There was significantly higher SF-12 MCS (55.7 vs 57.6, P = .02) in the BR-ST group. Eight patients underwent subsequent ipsilateral ankle surgery, of which one patient (BR-ST group) was revised for recurrent lateral ankle instability.
Conclusion: At median 5 years, patients treated for ATFL injury of the lateral ankle with Broström repair with suture tape augmentation demonstrated similar patient-reported outcomes to those treated with Broström repair alone.
Level of evidence: Level II, retrospective cohort study.
期刊介绍：
Foot & Ankle International (FAI), in publication since 1980, is the official journal of the American Orthopaedic Foot & Ankle Society (AOFAS). This monthly medical journal emphasizes surgical and medical management as it relates to the foot and ankle with a specific focus on reconstructive, trauma, and sports-related conditions utilizing the latest technological advances. FAI offers original, clinically oriented, peer-reviewed research articles presenting new approaches to foot and ankle pathology and treatment, current case reviews, and technique tips addressing the management of complex problems. This journal is an ideal resource for highly-trained orthopaedic foot and ankle specialists and allied health care providers.
The journal’s Founding Editor, Melvin H. Jahss, MD (deceased), served from 1980-1988. He was followed by Kenneth A. Johnson, MD (deceased) from 1988-1993; Lowell D. Lutter, MD (deceased) from 1993-2004; and E. Greer Richardson, MD from 2005-2007. David B. Thordarson, MD, assumed the role of Editor-in-Chief in 2008.
The journal focuses on the following areas of interest:
• Surgery
• Wound care
• Bone healing
• Pain management
• In-office orthotic systems
• Diabetes
• Sports medicine
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