title: The effect of modified Broström-Gould repair for lateral ankle instability on in vivo tibiotalar kinematics.
abstract: BACKGROUND
  Lateral ankle instability leads to an increased risk of tibiotalar joint osteoarthritis. Previous studies have found abnormal tibiotalar joint motions with lateral ankle instability that may contribute to this increased incidence of osteoarthritis, including increased anterior translation and internal rotation of the talus under weightbearing loading. Surgical repairs for lateral ankle instability have shown good clinical results, but the effects of repair on in vivo ankle motion are not well understood.
  
  
  OBJECTIVE
  The modified Broström-Gould lateral ligament reconstruction decreases anterior translation and internal rotation of the talus under in vivo weightbearing loading conditions.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  Seven patients underwent modified Broström-Gould repair for unilateral lateral ankle instability. Ankle joint kinematics as a function of increasing body weight was studied with magnetic resonance imaging and biplanar fluoroscopy. Tibiotalar kinematics was measured in unstable ankles preoperatively and postoperatively at a mean follow-up of 12 months as well as in the uninjured contralateral ankles of the same patients.
  
  
  RESULTS
  Surgical repair resulted in statistically significant decreases (expressed as mean ± standard error of the mean) in anterior translation of the talus (0.9 ± 0.3 mm; P = .018) at 100% body weight and internal rotation of the talus at 75% (2.6° ± 0.8°; P = .019) and 100% (2.7° ± 0.8°; P = .013) body weight compared with ankle kinematics measured before repair. No statistically significant differences were detected between repaired ankles and contralateral normal ankles.
  
  
  CONCLUSIONS
  The modified Broström-Gould repair improved the abnormal joint motion observed in patients with lateral ankle instability, decreasing anterior translation and internal rotation of the talus.
  
  
  CONCLUSIONS
  Altered kinematics may contribute to the tibiotalar joint degeneration that occurs with chronic lateral ankle instability. The findings of the current study support the efficacy of this repair in improving the abnormal ankle motion observed in these patients.
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Wainright
authors.forename: Charles E
authors.initials: CE
authors.lastname: Spritzer
authors.forename: Jun Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Mark E
authors.initials: ME
authors.lastname: Easley
authors.forename: James K
authors.initials: JK
authors.lastname: DeOrio
authors.forename: James A
authors.initials: JA
authors.lastname: Nunley
authors.forename: Louis E
authors.initials: LE
authors.lastname: DeFrate
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000503:physiopathology* / Q000601:surgery*; D000843:Ankle Joint; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures; D012399:Rotation; D013628:Talus / Q000503:physiopathology*; D013977:Tibia / Q000503:physiopathology*; D016474:Weight-Bearing