Clinical Outcomes of a Minimally Invasive Percutaneous Brostrom Technique without Arthroscopic Assistance

Background/Objectives: Surgical management of chronic lateral ankle instability has traditionally been performed using an open technique. Arthroscopic-assisted and all-arthroscopic techniques have gained popularity as they have achieved strong clinical outcomes. However, they rely on the surgeon’s a...

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Main Authors: Ettore Vulcano, Gerard F. Marciano, Enrico Pozzessere
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/19/2252
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author Ettore Vulcano
Gerard F. Marciano
Enrico Pozzessere
author_facet Ettore Vulcano
Gerard F. Marciano
Enrico Pozzessere
author_sort Ettore Vulcano
collection DOAJ
description Background/Objectives: Surgical management of chronic lateral ankle instability has traditionally been performed using an open technique. Arthroscopic-assisted and all-arthroscopic techniques have gained popularity as they have achieved strong clinical outcomes. However, they rely on the surgeon’s arthroscopic skills and familiarity with arthroscopic anatomy. Recently, a minimally invasive percutaneous technique without arthroscopic assistance has been developed that incorporates the benefits of arthroscopy, such as minimal soft tissue disruption, without the additional requirements of performing an arthroscopic technique. The aim of the current study is to describe the minimally invasive percutaneous technique for chronic lateral ankle instability and report on its clinical outcomes. Methods: Fifty-four consecutive patients without intra-articular ankle pathology underwent lateral ligament repair for chronic ankle instability with a percutaneous technique at a single institution by a fellowship-trained foot and ankle surgeon. Foot Function Index (FFI) score was recorded pre-operatively and post-operatively at final follow-up. All patients had a minimum follow-up of 12 months. Post-operative complications and patient satisfaction were also recorded. Results: A significant improvement (<i>p </i>< 0.001) in FFI compared to pre-operative values (from 55, SD 4.1, to 10, SD 1.9) was observed. A single patient required a return to the operating room for open revision with allograft reconstruction following a fall 2.5 months post-operatively. There were no other complications including infection or nerve injury. The overall rate of satisfaction after surgery was 98.1%, with one patient dissatisfied due to excessive ankle stiffness. Conclusions: The described minimally invasive percutaneous Brostrom procedure is safe and effective for the treatment of chronic lateral ankle instability without intra-articular ankle pathology.
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spelling doaj-art-b95c27e76ebd492a88361ccf3ef1923a2025-08-20T01:47:42ZengMDPI AGDiagnostics2075-44182024-10-011419225210.3390/diagnostics14192252Clinical Outcomes of a Minimally Invasive Percutaneous Brostrom Technique without Arthroscopic AssistanceEttore Vulcano0Gerard F. Marciano1Enrico Pozzessere2Mount Sinai Medical Center, Columbia University, Miami, FL 33140, USADepartment of Orthopedics, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY 10032, USADepartment of Orthopaedics and Traumatology, University of Insubria, Ospedale di Circolo—Fondazione Macchi, 21100 Varese, ItalyBackground/Objectives: Surgical management of chronic lateral ankle instability has traditionally been performed using an open technique. Arthroscopic-assisted and all-arthroscopic techniques have gained popularity as they have achieved strong clinical outcomes. However, they rely on the surgeon’s arthroscopic skills and familiarity with arthroscopic anatomy. Recently, a minimally invasive percutaneous technique without arthroscopic assistance has been developed that incorporates the benefits of arthroscopy, such as minimal soft tissue disruption, without the additional requirements of performing an arthroscopic technique. The aim of the current study is to describe the minimally invasive percutaneous technique for chronic lateral ankle instability and report on its clinical outcomes. Methods: Fifty-four consecutive patients without intra-articular ankle pathology underwent lateral ligament repair for chronic ankle instability with a percutaneous technique at a single institution by a fellowship-trained foot and ankle surgeon. Foot Function Index (FFI) score was recorded pre-operatively and post-operatively at final follow-up. All patients had a minimum follow-up of 12 months. Post-operative complications and patient satisfaction were also recorded. Results: A significant improvement (<i>p </i>< 0.001) in FFI compared to pre-operative values (from 55, SD 4.1, to 10, SD 1.9) was observed. A single patient required a return to the operating room for open revision with allograft reconstruction following a fall 2.5 months post-operatively. There were no other complications including infection or nerve injury. The overall rate of satisfaction after surgery was 98.1%, with one patient dissatisfied due to excessive ankle stiffness. Conclusions: The described minimally invasive percutaneous Brostrom procedure is safe and effective for the treatment of chronic lateral ankle instability without intra-articular ankle pathology.https://www.mdpi.com/2075-4418/14/19/2252ankle instabilityankle sprainlateral ligament repairminimally invasive Brostrom
spellingShingle Ettore Vulcano
Gerard F. Marciano
Enrico Pozzessere
Clinical Outcomes of a Minimally Invasive Percutaneous Brostrom Technique without Arthroscopic Assistance
Diagnostics
ankle instability
ankle sprain
lateral ligament repair
minimally invasive Brostrom
title Clinical Outcomes of a Minimally Invasive Percutaneous Brostrom Technique without Arthroscopic Assistance
title_full Clinical Outcomes of a Minimally Invasive Percutaneous Brostrom Technique without Arthroscopic Assistance
title_fullStr Clinical Outcomes of a Minimally Invasive Percutaneous Brostrom Technique without Arthroscopic Assistance
title_full_unstemmed Clinical Outcomes of a Minimally Invasive Percutaneous Brostrom Technique without Arthroscopic Assistance
title_short Clinical Outcomes of a Minimally Invasive Percutaneous Brostrom Technique without Arthroscopic Assistance
title_sort clinical outcomes of a minimally invasive percutaneous brostrom technique without arthroscopic assistance
topic ankle instability
ankle sprain
lateral ligament repair
minimally invasive Brostrom
url https://www.mdpi.com/2075-4418/14/19/2252
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AT enricopozzessere clinicaloutcomesofaminimallyinvasivepercutaneousbrostromtechniquewithoutarthroscopicassistance