Revision anatomical reconstruction of the lateral ligaments of the ankle augmented with suture tape for patients with a failed Broström procedure

Bone Joint J. 2017 Sep;99-B(9):1183-1189. doi: 10.1302/0301-620X.99B9.BJJ-2017-0144.R1.


Aims: The aim of this prospective study was to evaluate the intermediate-term outcomes after revision anatomical ankle ligament reconstruction augmented with suture tape for a failed modified Broström procedure.

Patients and methods: A total of 30 patients with persistent instability of the ankle after a Broström procedure underwent revision augmented with suture tape. Of these, 24 patients who were followed up for more than two years were included in the study. There were 13 men and 11 women. Their mean age was 31.8 years (23 to 44). The mean follow-up was 38.5 months (24 to 56) The clinical outcome was assessed using the Foot and Ankle Outcome Score (FAOS) and the Foot and Ankle Ability Measure (FAAM) score. The stability of the ankle was assessed using stress radiographs.

Results: The mean FAOS and FAAM scores improved significantly to 87.5 (73 to 94) and 85.1 (70 to 95) points at final follow-up, respectively (p < 0.001). The mean angle of talar tilt and anterior talar translation improved significantly to 2.8° (0° to 6°) and 4.1 mm (2 to 7) at final follow-up, respectively (p < 0.001). Side to side comparison in stress radiographs at final follow-up showed no significant difference. The revision failed in one patient who underwent a further revision using allograft tendon.

Conclusion: The revision modified Broström procedure augmented with suture tape is an effective form of treatment for recurrent instability of the ankle following a failed Broström procedure. This technique provides reliable stability and satisfactory clinical outcomes at intermediate-term follow-up. Cite this article: Bone Joint J 2017;99-B:1183-9.

Keywords: Ankle; Failed Broström procedure; Recurrent instability; Revision ligament repair; Suture-tape augmentation.

MeSH terms

  • Adult
  • Ankle Joint / surgery*
  • Female
  • Humans
  • Joint Instability / surgery*
  • Lateral Ligament, Ankle / surgery*
  • Male
  • Prospective Studies
  • Reconstructive Surgical Procedures / instrumentation*
  • Reoperation
  • Sutures
  • Treatment Outcome