Could the Arthroscopic Brostrom Procedure Be the Future of Lateral Ankle Stabilization?

James M. Cottom, DPM, FACFAS shares that the arthroscopic Brostrom repair is a simple, quick, and effective method of treating chronic lateral ankle instability. He presented his experience with this procedure, along with data from his research, to the audience at the American Society of Podiatric Surgeons’ Annual Conference, and shared some of the highlights with Podiatry Today.

“We are able to identify and treat any intra-articular pathology within the ankle joint at the same time as repairing the anterior talofibular ligament (ATFL) and reinforcing the calcaneofibular ligament (CFL),” he explains. 

He adds that this minimally invasive technique, in research he will present at the conference, yielded data suggesting that the arthroscopic Brostrom procedure is reproducible, reliable, and at a minimum of 5 years postop, demonstrates optimal and satisfactory outcomes.

Dr. Cottom explains that they used preoperative American Orthopedic Foot and Ankle (AOFAS) hindfoot scores, visual analog scale (VAS) scores, and the foot function index (FFI), and then compared them with post-operative scores. In addition, Karlsson-Peterson (KP) scores were assessed at the final follow up. Using unpaired t-tests, they set out to determine if there was a statistically significant difference in AOFAS, VAS and FFI scores. 
 
He shared that they found mean preoperative scores as follows:
·      AOFAS 51.8
·      VAS 7.36
·      FFI 83.5
 
At the 5-year mark, the postoperative scores were 88.9, 2.24, 18.4 respectively and 83.6, for the KP scores.
 
Additionally, the researchers compared patients with a BMI < 30 kg/m² to those with a BMI ≥ 30 kg/m². This comparison showed no statistically significant difference between groups at 5 years.
 
Overall, Dr. Cottom wants the audience to know that in his experience, and supported by his research, he finds the arthroscopic Brostrom procedure to be appealing from both the perspectives of the surgeon and the patient for chronic lateral ankle instability. He cites the smaller incisions, less discomfort, shorter healing time, reproducibility, and reliability as key features that could lead to its continued growing favor among surgeons.