title: Comparison of bone tunnel and suture anchor techniques in the modified Broström procedure for chronic lateral ankle instability.
abstract: BACKGROUND
  The modified Broström procedure is frequently used to treat chronic lateral ankle instability. There are 2 common methods of the modified Broström procedure, which are the bone tunnel and suture anchor techniques.
  
  
  OBJECTIVE
  To compare the clinical outcomes of the modified Broström procedure using the bone tunnel and suture anchor techniques.
  
  
  METHODS
  Cohort study; Level of evidence, 2.
  
  
  METHODS
  Eighty-one patients (81 ankles) treated with the modified Broström procedure for chronic lateral ankle instability constituted the study cohort. The 81 ankles were divided into 2 groups, namely, a bone tunnel technique (BT group; 40 ankles) and a suture anchor technique (SA group; 41 ankles). The Karlsson score, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, anterior talar translation, and talar tilt angle were used to evaluate clinical and radiographic outcomes. The BT group consisted of 32 men and 8 women with a mean age of 34.8 years at surgery and a mean follow-up duration of 34.2 months. The SA group consisted of 33 men and 8 women with a mean age of 33.3 years at surgery and a mean follow-up duration of 32.8 months.
  
  
  RESULTS
  Mean Karlsson scores improved significantly from 57.0 points preoperatively to 94.9 points at final follow-up in the BT group and from 59.9 points preoperatively to 96.4 points at final follow-up in the SA group. Mean AOFAS scores also improved from 64.2 points preoperatively to 97.8 points at final follow-up in the BT group and from 70.3 points preoperatively to 97.4 points at final follow-up in the SA group. Mean anterior talar translations in the BT group and SA group improved from 9.0 mm and 9.2 mm preoperatively to 6.5 mm and 6.8 mm at final follow-up, respectively. Mean talar tilt angles were 12.0° in the BT group and 12.5° in the SA group preoperatively and 8.8° at final follow-up for both groups. No significant differences were found between the 2 groups in terms of the Karlsson score, AOFAS score, anterior talar translation, and talar tilt angle.
  
  
  CONCLUSIONS
  The bone tunnel and suture anchor techniques of the modified Broström procedure showed similar good functional and radiographic outcomes. Both techniques appear to be effective and reliable methods for the treatment of chronic lateral ankle instability.
authors.affiliation: Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, 42 Jebongro, Donggu, Gwangju, 501-757, Korea.
authors.forename: Chang-Yong
authors.initials: CY
authors.lastname: Hu
authors.forename: Keun-Bae
authors.initials: KB
authors.lastname: Lee
authors.forename: Eun-Kyoo
authors.initials: EK
authors.lastname: Song
authors.forename: Myung-Sun
authors.initials: MS
authors.lastname: Kim
authors.forename: Kyung-Soon
authors.initials: KS
authors.lastname: Park
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D011859:Radiography; D012720:Severity of Illness Index; D053441:Suture Anchors; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: ankle; bone tunnel technique; chronic lateral instability; modified Broström procedure; suture anchor technique