2015 ISAKOS Biennial Congress ePoster #134

Accelerated Rehabilitation After Augmented Arthroscopic Brostrom Procedure

James Robert McWilliam, MD, Harrison, NY UNITED STATES
Montefiore New Rochelle Hospital, New Rochelle, NY, USA

FDA Status Not Applicable

Summary: An “augmented” arthroscopic Brostrom procedure safely allows for immediate weight bearing and accelerated rehabilitation and results in a high rate of patient satisfaction with a low incidence of complications

Abstract:

Introduction

The detrimental effects of cast immobilization on injured joints has been well documented as have the benefits of early mobilization on repaired soft tissues. Bench studies suggest that current techniques for lateral ligament repair may not have the strength necessary to support early, unrestricted mobilization. As such, existing techniques involve varying periods of cast immobilization and non-weight bearing. An augmented repair may allow for early weight bearing and mobilization, possibly enhancing quality of healing and improving patient outcomes.

Methods

After failure of conservative management for ankle instability 41 patients underwent arthroscopic Brostrom repair augmented by a polyethylene suture tape arthroscopically fixed to the insertion sites of the anterior talofibular ligament using interference screw fixation. An accelerated physical therapy program was begun 3-5 days post operatively and continued for 12-16 weeks. VAS and Foot and Ankle Ability Measure were taken. IRB approval was obtained.

Results

Average follow up was 17 months (range 12-23 months). Average VAS was 1.6 (range 0-5). Average FAAM ADL subscale was 95 (range 91-100). Average FAAM Sports subscale was 92 (range 88-100). Average time to desired level of physical activity was 17 weeks (range 13-26 weeks). There were no incidents of recurrent instability. There were no wound or nerve complications. All patients were satisfied with their surgery without reservations.

Conclusions

An “augmented” arthroscopic Brostrom procedure safely allows for immediate weight bearing and accelerated rehabilitation and results in a high rate of patient satisfaction with a low incidence of complications.