title: Anatomical reconstruction for chronic lateral ankle instability in the high-demand athlete: functional outcomes after the modified Broström repair using suture anchors.
abstract: BACKGROUND
  Modification of the Bröstrom repair with suture anchors has been used to address chronic lateral ankle instability. However, there are few studies in the literature reporting the functional outcomes after this particular procedure in the high-demand athlete.
  
  
  OBJECTIVE
  Anatomical reconstruction of the lateral ankle ligaments for chronic instability will return the high-demand athlete functionally to his or her previous level of activity.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Sixty-two patients who had grade III ankle sprain that failed at least a 6-month course of supervised conservative management with a preinjury Tegner score of > or = 6 underwent a variant of the Gould-modified Broström procedure with suture anchors for lateral ankle instability. Each patient was given the Tegner and Karlsson questionnaire at the 6-month, 1-year, and 2-year time points. Range of motion of the operative ankle was also assessed. The mean age was 19.6 years (range, 16-26 years), and 10 patients were lost to follow-up.
  
  
  RESULTS
  The mean follow-up was 29 months (minimum, 24 months) in the remaining 52 patients (84%). Mean Tegner scores at the 1- and 2-year time points were 8.2 (range, 5-9) and 8.6 (range, 5-9), respectively. The mean Karlsson scores were 92 +/- 5.2 and 95 +/- 3.1 at the 1- and 2-year time points, respectively. Range of motion was equal to the contralateral ankle in all but 3 patients at the 2-year follow up. A 6% major complication rate included 3 reruptures.
  
  
  CONCLUSIONS
  Anatomical ligament reconstruction for chronic lateral ankle instability using a variant of the Gould-modified Broström procedure with suture anchors was effective in returning high-demand athletes to their preinjury functional level.
authors.affiliation: University of Massachusetts Medical Center, Division of Sports Medicine, Department of Orthopaedic Surgery, Room S4-827, 55 Lake Avenue North, Worcester, MA 01655, USA. xinning.li@gmail.com
authors.forename: Xinning
authors.initials: X
authors.lastname: Li
authors.forename: Heather
authors.initials: H
authors.lastname: Killie
authors.forename: Patrick
authors.initials: P
authors.lastname: Guerrero
authors.forename: Brian D
authors.initials: BD
authors.lastname: Busconi
mesh_terms: D000293:Adolescent; D016512:Ankle Injuries / Q000503:physiopathology / Q000601:surgery*; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D001265:Athletic Injuries / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D017844:Lateral Ligament, Ankle / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D016059:Range of Motion, Articular; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D053441:Suture Anchors; D016896:Treatment Outcome; D055815:Young Adult