Modified Broström With and Without Suture Tape Augmentation: A Systematic Review

• Published in: The Journal of foot and ankle surgery Vol. 61; no. 2; pp. 390 - 395
• Main Authors: Piscoya, Andres S., Bedrin, Michael D., Lundy, Alexander E., Eckel, Tobin T.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2022
• Subjects: Ankle Joint - surgery; Humans; Joint Instability - surgery; lateral ankle instability; Lateral Ligament, Ankle - surgery; modified Broström; Retrospective Studies; Suture Anchors; suture tape augmentation; Sutures; Treatment Outcome; lateral ankle instability; modified Broström; suture tape augmentation; 4
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2021.09.027

The Modified Broström has become the gold standard for operative management of chronic lateral ankle instability. Despite overall good clinical outcomes with this procedure, recent biomechanical data have called into question the strength and durability of this technique. Accordingly, the addition of suture tape to the Modified Broström construct has been described in an attempt to more closely recreate the natural biomechanical properties of the ankle lateral ligament complex. We performed a systematic review of the literature was using PubMed, Embase, and CINAHL to identify English-language articles from 2009 to present discussing outcomes with the augmented Modified Broström technique. A total of 4 studies (2 retrospective cohort studies, 2 case series) involving 156 patients with Modified Broström with augmentation met inclusion criteria. Average follow-up time was 13.8 months. Of the 3 studies reporting patient-reported outcome measures both pre- and postoperatively, there was a significant improvement in all measures (p < .05). Two studies compared the Modified Broström directly with and without augmentation, one of which found a statistically significant difference in the Foot and Ankle Ability Measure in favor of the augmentation group (93.1 vs 90.5, p = .027), while American Orthopaedic Foot and Ankle Society score was not significantly different (p > .05) between the 2 procedures across studies. There were no significant differences in complications between techniques. Modified Broström with suture tape augmentation for chronic lateral ankle instability can produce good short-term clinical outcomes with few complications, comparable to the Modified Broström alone.