Postural stability after operative reconstruction of the AFTL in chronic ankle instability comparing three different surgical techniques.

Background: Chronic lateral ankle instability is a relatively frequent consequence after acute ankle sprain. In case of unsuccessful conservative treatment, surgical therapy is recommended to prevent osteoarthritis of the ankle joint. To date, different surgical methods have evolved. Yet, it remains unclear which approach reveals the best results. We hypothesized that the modified Broström-Gould procedure with suture anchor ligament fixation leads to superior postoperative results compared to the Broström-Gould procedure or the periosteal flap technique.

Material and methods: In a prospective study, we examined the three surgical techniques. For this purpose, we performed a matched-pair analysis with four groups according to age, sex, and body mass index: periosteal flap technique (G1), Broström-Gould procedure (G2), modified Broström-Gould procedure with suture anchor ligament fixation (G3), and a control group (G4). Results were compared with the American Orthopaedic Foot & Ankle Society (AOFAS) score, a functional analysis as well as measuring postural stability with the Biodex balance system.

Results: No significant differences were found between all four groups concerning AOFAS score, functional results, as well as postural stability.

Conclusion: All three surgical methods revealed satisfactory results. No significant differences could be detected in clinical and functional categories. The Broström-Gould method as well as the modified procedure with anchor can be recommended as surgical therapy for chronic lateral ankle instability. Additional anchors do not seem to have a significant positive impact on the results.