Fear of Reinjury Limits Patient Functional Outcomes as Measured by PROMIS Following Augmented Broström Procedure.

Background: Fear of reinjury (FORI) can hinder recovery in several orthopaedic conditions, but its impact after augmented Broström repair is unknown. We sought to determine the prevalence of FORI and its association with functional outcomes in this setting. This study aims to determine whether patients experience FORI following augmented Broström repair and whether FORI impacts functional outcomes.

Methods: 80 patients who underwent Broström repair with InternalBrace augmentation were contacted to complete surveys containing questionnaires with Patient Reported Outcome Measurement Information System (PROMIS) measures of physical function (PF) and pain interference (PI), Cumberland Ankle Instability Tool (CAIT), and whether patients experienced current (at time of survey completion) activity limitations due to FORI.

Results: 64% (51/80) of patients reported postoperative FORI. Average follow-up was 3.9 years. Fear was associated with worse PF (49.9 ± 7.4 vs 54.9 ± 8.4, P = .01) and worse CAIT (19.1 ± 8.0 vs 23.2 ± 8.1, P = .04), and both differences exceeded the minimal clinically important difference (MCID). There was no significant difference in PI (49.8 ± 8.7 vs 46.5 ± 6.9, P = .06). There were no significant differences in the proportion of patients who reported FORI by age, sex, or BMI.

Conclusion: FORI affected nearly two-thirds of patients and was linked to clinically meaningful functional deficits. Although PROMIS scores reached population means overall, addressing psychological barriers may further optimize outcomes after augmented Broström repair.

Level of evidence: Level IV, retrospective case series study.