2017 ISAKOS Biennial Congress ePoster #144
All – Inside Brostrom With Gloud For Chronic Lateral Ankle Instability
Haruki Odagiri, MD, Kumamoto JAPAN
Stéphane Guillo, MD, Bordeaux-Mérignac FRANCE
Masato Takao, MD, PhD, Kisarazu, Chiba JAPAN
Hiroshi Mizuta, MD, PhD, Kumamoto City JAPAN
Centre de Chirurgie Orthopédique et Sportive, de Clinique du Sport , 2 rue Georges Negrevergne, Bordeaux-Mérignac 33700, FRANCE
FDA Status Not Applicable
The technique of all – inside Brostrom with Gloud for Chronic Lateral Ankle Instability is performed reliably and safely because of direct control and visualization by arthroscopy and lateral hindfoot endoscopy.
Ankle sprain is the most frequent sports trauma. The surgical treatment is needed in case of chronic lateral ankle instability (CLAI), after failure of the conservative treatment. Today, Brostrom with Gloud augmentation is recognized as standard surgical treatment for CLAI and it appeared recently arthroscopic technique, nevertheless, no published technique today propose a total endoscopic Brostrom technique with Gould augmentation because difficulty to visualize retinaculum by anterior ankle arthroscopy. Lateral ankle endoscopy can provide a view of this area that is superior to open surgery. The purpose of this study is to evaluate the clinical outcomes of Brostrom with Gloud augmentation by all-inside endoscopic technique for CLAI.
We retrospectively reviewed 27 ankles from 27 patients, followed up more than 2 years, who had been surgically treated for CLAI. The patient is placed into the lateral decubitus position with the pelvis slightly rotated 30° posterior. 3 portals are usually created to perform the procedure. The anteromedial portal is portal 1, the second portal is the accessory anterolateral portal (portal 2). Brostrom technique is performed by portal 1 as viewing portal and portal 2 as working portal. Then patient is changed the position, hip is internally rotated, and sinus tarsi portal (Portal 3) is made 1 cm anteriorly to the mid-distance point between the tip of the fibula and the proximal tip of the 5th metatarsal for Gloud augmentation. The portal 3 bring the solution to have a complete vision of the lateral side endoscopically with a complete vision of the retinaculum. Gloud technique is performed by portal3 as viewing portal and portal2 as working portal. The results were assessed according to recurrence of instability, the Karlsson-Peterson Ankle Score and American Orthopedics Foot and Ankle Society Ankle Hindfoot Scale (AOFAS) before and at 2 years after surgery.
Karlsson-Peterson Ankle Score and AOFAS score is significantly improved from 51.5±7.0 and 57.8±7.5 preoperatively to 86.7±12.3 and 90.9±9.9 points preoperatively (P < .01). 2 patients (7.4%) had recurrence of instability due to ankle sprain after operation.
This technique is proposing treatment which performed reliably and safely because of direct control and visualization by arthroscopy and lateral hindfoot endoscopy.