Comparison of arthroscopic and open Brostrom-Gould surgery for chronic ankle instability: a systematic review and meta-analysis

Abstract Background Approximately 20% of acute ankle sprains progress to chronic lateral ankle instability (CLAI) requiring surgical intervention. There has been growing interest among surgeons regarding whether arthroscopic techniques can replace open Brostrom-Gould surgery in treating CLAI. The pu...

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Main Authors: Binzhi Zhao, Qingnan Sun, Xiaopei Xu, Yang Liu, Yanrui Zhao, Yulin Gao, Junlin Zhou
Format: Article
Language:English
Published: BMC 2023-11-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-023-04292-5
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author Binzhi Zhao
Qingnan Sun
Xiaopei Xu
Yang Liu
Yanrui Zhao
Yulin Gao
Junlin Zhou
author_facet Binzhi Zhao
Qingnan Sun
Xiaopei Xu
Yang Liu
Yanrui Zhao
Yulin Gao
Junlin Zhou
author_sort Binzhi Zhao
collection DOAJ
description Abstract Background Approximately 20% of acute ankle sprains progress to chronic lateral ankle instability (CLAI) requiring surgical intervention. There has been growing interest among surgeons regarding whether arthroscopic techniques can replace open Brostrom-Gould surgery in treating CLAI. The purpose of this study was to pool the results of multiple studies comparing the treatment effects of these two fixation approaches. Methods Our study involved thorough searches across multiple electronic databases, including PubMed, Cochrane, Embase, and Web of Science, to identify all relevant publications on CLAI that were repaired using the arthroscopic or open Broström-Gould technique. Through a comprehensive meta-analysis, we evaluated several outcomes, including post-operative function, radiological measurements, complications, and time efficiency. Result A total of 686 patients from 11 studies were included in the analysis. Among them, 351 patients underwent open repair, and 335 underwent arthroscopic Brostrom-Gould surgery. The present study revealed that arthroscopic and open Brostrom-Gould techniques demonstrated no significant differences in talar tilt, talar anterior translation, complication rate, and time to return to previous level of activity. Furthermore, no significant differences were observed in AOFAS, K–P, VAS, and Tegner scores at the 2-year follow-up. However, significant differences were noted between the two surgical approaches in terms of early weight-bearing (WMD = − 1.33 weeks, 95% CI = [− 1.91, − 0.76], P = 0.17, I2 = 40%), as well as AOFAS scores (WMD = 1.00, 95% CI = [0.05, 1.95], P = 0.73, I2 = 0%), K–P scores (WMD = 1.57, 95% CI = [0.49, 2.64], P = 0.15, I2 = 47%), and VAS scores (WMD = − 0.15, 95% CI = [− 0.60, 0.29], P < 0.08, I2 = 61%) within the first postoperative year. Conclusions Our findings support that arthroscopic repair yields comparable outcomes to open surgery. Consequently, we advocate for adopting arthroscopic repair as a preferred alternative to the conventional open Broström-Gould procedure for treating chronic lateral ankle instability.
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spelling doaj.art-6d5a0b3a4a5a40a5a94c1dddfce891dd2023-11-20T10:20:21ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-11-0118111310.1186/s13018-023-04292-5Comparison of arthroscopic and open Brostrom-Gould surgery for chronic ankle instability: a systematic review and meta-analysisBinzhi Zhao0Qingnan Sun1Xiaopei Xu2Yang Liu3Yanrui Zhao4Yulin Gao5Junlin Zhou6Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical UniversityAbstract Background Approximately 20% of acute ankle sprains progress to chronic lateral ankle instability (CLAI) requiring surgical intervention. There has been growing interest among surgeons regarding whether arthroscopic techniques can replace open Brostrom-Gould surgery in treating CLAI. The purpose of this study was to pool the results of multiple studies comparing the treatment effects of these two fixation approaches. Methods Our study involved thorough searches across multiple electronic databases, including PubMed, Cochrane, Embase, and Web of Science, to identify all relevant publications on CLAI that were repaired using the arthroscopic or open Broström-Gould technique. Through a comprehensive meta-analysis, we evaluated several outcomes, including post-operative function, radiological measurements, complications, and time efficiency. Result A total of 686 patients from 11 studies were included in the analysis. Among them, 351 patients underwent open repair, and 335 underwent arthroscopic Brostrom-Gould surgery. The present study revealed that arthroscopic and open Brostrom-Gould techniques demonstrated no significant differences in talar tilt, talar anterior translation, complication rate, and time to return to previous level of activity. Furthermore, no significant differences were observed in AOFAS, K–P, VAS, and Tegner scores at the 2-year follow-up. However, significant differences were noted between the two surgical approaches in terms of early weight-bearing (WMD = − 1.33 weeks, 95% CI = [− 1.91, − 0.76], P = 0.17, I2 = 40%), as well as AOFAS scores (WMD = 1.00, 95% CI = [0.05, 1.95], P = 0.73, I2 = 0%), K–P scores (WMD = 1.57, 95% CI = [0.49, 2.64], P = 0.15, I2 = 47%), and VAS scores (WMD = − 0.15, 95% CI = [− 0.60, 0.29], P < 0.08, I2 = 61%) within the first postoperative year. Conclusions Our findings support that arthroscopic repair yields comparable outcomes to open surgery. Consequently, we advocate for adopting arthroscopic repair as a preferred alternative to the conventional open Broström-Gould procedure for treating chronic lateral ankle instability.https://doi.org/10.1186/s13018-023-04292-5Chronic lateral ankle instabilityOpenArthroscopicBrostrom-GouldRepairMeta-analysis
spellingShingle Binzhi Zhao
Qingnan Sun
Xiaopei Xu
Yang Liu
Yanrui Zhao
Yulin Gao
Junlin Zhou
Comparison of arthroscopic and open Brostrom-Gould surgery for chronic ankle instability: a systematic review and meta-analysis
Journal of Orthopaedic Surgery and Research
Chronic lateral ankle instability
Open
Arthroscopic
Brostrom-Gould
Repair
Meta-analysis
title Comparison of arthroscopic and open Brostrom-Gould surgery for chronic ankle instability: a systematic review and meta-analysis
title_full Comparison of arthroscopic and open Brostrom-Gould surgery for chronic ankle instability: a systematic review and meta-analysis
title_fullStr Comparison of arthroscopic and open Brostrom-Gould surgery for chronic ankle instability: a systematic review and meta-analysis
title_full_unstemmed Comparison of arthroscopic and open Brostrom-Gould surgery for chronic ankle instability: a systematic review and meta-analysis
title_short Comparison of arthroscopic and open Brostrom-Gould surgery for chronic ankle instability: a systematic review and meta-analysis
title_sort comparison of arthroscopic and open brostrom gould surgery for chronic ankle instability a systematic review and meta analysis
topic Chronic lateral ankle instability
Open
Arthroscopic
Brostrom-Gould
Repair
Meta-analysis
url https://doi.org/10.1186/s13018-023-04292-5
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