Abstract
Research Type:
Level 2 - Prospective comparative study, Meta-analysis of Level 2 studies or Level 1 studies with inconsistent results
Introduction/Purpose:
The Arthrobrostrom with an internal brace has emerged as a promising surgical intervention for managing lateral ankle instability, a condition often resulting from recurrent ankle sprains and ligamentous laxity. This technique combines minimally invasive repair methods with the minimally invasive and innovative application of internal bracing, which aims to enhance the stability of the ankle joint during the healing process. The aim of this papar was To evaluate the effectiveness of minimally invasive arthrobrostrom with internal brace in restoring stability and function in patients with lateral ankle instability. the Secondary Objectives was To assess the postoperative recovery time and functional outcomes, including range of motion and strength, To determine the incidence of complications and recurrence of instability following the procedure.
Methods:
We conduct a prospective case series with 76 patients diagnosed with lateral ankle instability who were submitted a arthrobrostrom with an internal brace between 2019 and 2024. Inclusion Criteria: Adults aged 15-63 with a clinical diagnosis of lateral ankle instability, having failed conservative management. Preoperative Assessment: clinical evaluation, physical examination, and imaging studies (e.g., MRI or X-rays). Preoperative scoring using AOFAS and sf36 questionnaires. Detailed description of the arthrobrostrom technique with minimally invasive internal brace placement, including steps for ligament repair and brace application. Documentation of surgical time and any intraoperative and postoperative complications. Postoperative Care: Standardized rehabilitation protocol including weight-bearing status and physical therapy initiation. Regular follow-up visits at 6 weeks, 6 months and 1 year post-surgery for assessment of healing and recovery. Outcome Measures: Stability assessment via clinical examination and recurrence rates at follow-up, Functional scores (AOFAS, sf36), range of motion measurements, stability testing, and patient satisfaction.
Results:
Of the total, 39 (51.3%) patients were male. The affected ankle was the right in 43 (56.6%) cases.The average follow-up time post surgery was 2.4 years (SD 1.3 median 1.8) and the average duration of pre operative instability time was 1.9 years. 47 patients (63,2%) were also concomitantly submitted to an additional procedure in the same operation such as rotational instability, anterior impingement, osteochondral talar lesion, Dwyer osteotomy, and peroneal tendon tenoscopy. The overall AOFAS score markedly from an average of 54.6 points to 95.9 points (p < 0,001). The median postoperative AOFAS score was 41.0 points higher than the preoperative score. 3,9% patients presented complications. 35 (46%) of the patients presented some limitation of either the flexion-extension or inversion-eversion. 93.4%patients were able to resume their activities.
Conclusion:
In conclusion, the analysis of the prospective results of arthrobrostrom with minimally invasive internal brace for the treatment of lateral ankle instability highlights its effectiveness as a surgical intervention. The findings indicate that this technique significantly enhances ankle stability and promotes positive functional outcomes among patients. Throughout the follow-up period, participants demonstrated marked improvements in stability assessments, reduced rates of instability, and elevated patient satisfaction scores. More than 90 % of the patients were able to return to normal activities and 46 % of the patients presented with some degree of joint limitation.
Arthrobrostrom with minimally invasive internal brace
Technique of position and tensioning of the minimally invasive Internal Brace.