Does the presence of intra-articular pathology affect the outcome following modified Brostrom repair for lateral ligament instability of the ankle?

R. Kakwani, A. Higgs, S. Hepple, W. Harries, I. Winson

Introduction: Ankle sprains are one of the most common sports injuries. Around 10 -20 % of the acute ankle sprains may lead to the sequelae of chronic ankle instability. Around 15-35% of the patients have residual pain following successful lateral ligament reconstruction. One of the reasons suggested for the persistent symptoms following lateral ligament reconstruction has been the presence of intra-articular pathology.

Methods: We performed ankle arthroscopy on all patients undergoing the modified Brostrom repair and compared patients with associated intra-articular pathology to those without any intraarticular pathology.

Results: A total of 35 patients underwent the modified Brostrom procedure during the study period. 11/25 patients were found to have associated intra-articular pathology. The average age for both the groups was 33 years. The average follow-up duration was 75 months and 71 months for the intra-articular pathology group and the normal articular groups respectively. The difference in the SAFAS (Sports athlete foot and ankle score) was statistically better in the group without any intra-articular pathology (93.7 compared to 71.6, p-value < 0.05).

Conclusions: The patients who have an associated intra-articular pathology whilst undergoing the stabilisation of lateral ligament instability of the ankle have a slightly poorer outcome compared to those without any intra-articular pathology. Secondly, the SAFAS scoring system seems to overcome the ceiling effect seen in other scoring systems when used for the athletic population.