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The effect of modified Broström-Gould repair for lateral ankle instability on in vivo tibiotalar kinematics.

Publication ,  Journal Article
Wainright, WB; Spritzer, CE; Lee, JY; Easley, ME; DeOrio, JK; Nunley, JA; DeFrate, LE
Published in: Am J Sports Med
September 2012

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. HYPOTHESIS: The modified Broström-Gould lateral ligament reconstruction decreases anterior translation and internal rotation of the talus under in vivo weightbearing loading conditions. STUDY DESIGN: 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. CONCLUSION: 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. CLINICAL RELEVANCE: 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.

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Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

September 2012

Volume

40

Issue

9

Start / End Page

2099 / 2104

Location

United States

Related Subject Headings

  • Weight-Bearing
  • Tibia
  • Talus
  • Rotation
  • Range of Motion, Articular
  • Plastic Surgery Procedures
  • Orthopedics
  • Male
  • Joint Instability
  • Humans
 

Citation

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Wainright, W. B., Spritzer, C. E., Lee, J. Y., Easley, M. E., DeOrio, J. K., Nunley, J. A., & DeFrate, L. E. (2012). The effect of modified Broström-Gould repair for lateral ankle instability on in vivo tibiotalar kinematics. Am J Sports Med, 40(9), 2099–2104. https://doi.org/10.1177/0363546512454840
Wainright, William B., Charles E. Spritzer, Jun Young Lee, Mark E. Easley, James K. DeOrio, James A. Nunley, and Louis E. DeFrate. “The effect of modified Broström-Gould repair for lateral ankle instability on in vivo tibiotalar kinematics.Am J Sports Med 40, no. 9 (September 2012): 2099–2104. https://doi.org/10.1177/0363546512454840.
Wainright WB, Spritzer CE, Lee JY, Easley ME, DeOrio JK, Nunley JA, et al. The effect of modified Broström-Gould repair for lateral ankle instability on in vivo tibiotalar kinematics. Am J Sports Med. 2012 Sep;40(9):2099–104.
Wainright, William B., et al. “The effect of modified Broström-Gould repair for lateral ankle instability on in vivo tibiotalar kinematics.Am J Sports Med, vol. 40, no. 9, Sept. 2012, pp. 2099–104. Pubmed, doi:10.1177/0363546512454840.
Wainright WB, Spritzer CE, Lee JY, Easley ME, DeOrio JK, Nunley JA, DeFrate LE. The effect of modified Broström-Gould repair for lateral ankle instability on in vivo tibiotalar kinematics. Am J Sports Med. 2012 Sep;40(9):2099–2104.
Journal cover image

Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

September 2012

Volume

40

Issue

9

Start / End Page

2099 / 2104

Location

United States

Related Subject Headings

  • Weight-Bearing
  • Tibia
  • Talus
  • Rotation
  • Range of Motion, Articular
  • Plastic Surgery Procedures
  • Orthopedics
  • Male
  • Joint Instability
  • Humans