Outcome following a modified Broström procedure and arthroscopic debridement of medial gutter osteoarthritis combined with chronic ankle instability

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Created On: 17/01/2020

Outcome following a modified Broström procedure and arthroscopic debridement of medial gutter osteoarthritis combined with chronic ankle instability

Due to the availability of limited data regarding the results of operative therapy used to treat ankle instability with coincident arthritic changes in the medial gutter, this investigation was carried out to assess the intermediate-term radiological and clinical results after a modified Broström operation and arthroscopic debridement among middle-aged patients suffering from chronic ankle instability and medial gutter osteoarthritis.

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Key take away

Knee is one of the crucial affected weight-bearing joints by osteoarthritis along with ankle instability. As per this study, the Modified Broström procedure combined with arthroscopic debridement found to be an effective operative option for medial gutter osteoarthritis secondary to chronic ankle instability. Moreover, it was also confirmed to reduce pain and eliminate instability.

Background

Method

A total of 22 patients with medial gutter osteoarthritis related to chronic lateral ankle, instability was followed for more than three years after operative treatment. All the participants exhibited the medial joint space narrowing of Takakura stage II during surgery. The visual analogue scale (VAS), Foot and Ankle Ability Measure (FAAM), and the American Orthopaedic Foot & Ankle Society (AOFAS) score were used for the clinical evaluation.

Result

A significant improvement from 51.2 and 45.7 points to 80.3 and 78.4 points was seen in the mean AOFAS and FAAM scores at final follow-up, respectively. The pain-VAS scores improved from 6.8 points to 3.5 points. In spite of improved VAS score, eight participants complained of gait discomfort along with the severe pain of 4 or more points. Six patients exhibited a progression of arthritis stage and only one with recurrent ankle instability.

Conclusion

Modified Broström operation combined with arthroscopic debridement emerges as an effective operative choice for medial gutter osteoarthritis secondary to chronic ankle instability. Regardless of the outbreak of arthritis, most subjects were able to obtain remarkable improvement in decreasing pain while terminating instability.