title: Minimal Invasive Suture-Tape Augmentation for Chronic Ankle Instability.
abstract: BACKGROUND
  Although the modified Brostrom procedure has had excellent clinical results, postoperative complications such as skin irritation by suture material and problematic scar formation occur. This prospective study was performed to evaluate the clinical outcomes of mini-open ligament augmentation (internal brace technique) using suture tape for chronic ankle instability in a select cohort of patients.
  
  
  METHODS
  Thirty-four young female patients with less than 70 kg of body weight were followed for more than 2 years after suture tape augmentation for lateral ankle instability. The clinical evaluation consisted of the Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAM) score, Sefton grading system, and the period to return to various activities. Measurement of talar tilt angle and anterior talar translation was obtained from stress radiographs to evaluate the longevity of mechanical ankle stability.
  
  
  RESULTS
  FAOS and FAAM scores had significantly improved to 92.5 points at final follow-up (P < .001). According to the Sefton grading, 31 cases (91.2%) achieved satisfactory functional results. The period to return to exercise was on average 10.2 weeks for jogging and 9.6 weeks for walking on uneven ground. The average subjective satisfaction score of patients was 93.8 points, and satisfaction with the scar was 98.5 points. Talar tilt angle and anterior talar translation had significantly improved to an average of 4.5 degrees and 4.1 mm, respectively, at final follow-up (P < .001). There were no complications such as skin irritation and wound infection, except for 1 case of chronic inflammation.
  
  
  CONCLUSIONS
  Minimally invasive suture tape augmentation seems to be an effective alternative for young women with chronic ankle instability. Because there is a possibility of progressive elongation over time, the longevity of mechanical ankle stability and the proper indication for using the internal brace technique should be addressed in future studies.
  
  
  METHODS
  Level IV, case series study.
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea titanick25@naver.com.
authors.forename: Byung-Ki
authors.initials: BK
authors.lastname: Cho
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
authors.forename: Kyoung-Jin
authors.initials: KJ
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
authors.forename: Seok-Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
authors.forename: Hyung-Joon
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
authors.forename: Seung-Myung
authors.initials: SM
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000328:Adult; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D001182:Arthroscopy; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D011446:Prospective Studies; D011859:Radiography; D020127:Recovery of Function; D053441:Suture Anchors; D016896:Treatment Outcome
keywords: chronic ankle instability; ligament augmentation; minimally invasive; suture tape