TITLE:
Ankle Arthroscopy, Lateral Ligament Repair and Peroneal Tendon Reefing for Chronic Lateral Ankle Instability: The Triad vs Arthroscopy with Ligament Repair
AUTHORS:
John J. Anderson, Loren K. Spencer, Zflan Fowler
KEYWORDS:
Broström-Gould, Lateral Ankle Instability, Triad Procedure
JOURNAL NAME:
Surgical Science,
Vol.6 No.9,
September
8,
2015
ABSTRACT: Peroneal tendon and retinacular pathology contributes to
chronic lateral ankle instability. The “gold standard” surgical treatment for
chronic lateral ankle instability has been the Brostrom-Gould procedure with
its modifications. An ankle arthroscopy is an adjuvant procedure to address any
intra-articular pathology. We review our results of two study groups. The first
group underwent an ankle arthroscopy and a Brostrom-Gould procedure. The second
group (triad) underwent an ankle arthroscopy, the Brostrom-Gould procedure and
excision of low lying peroneal muscle belly with tightening of the inferior
peroneal retinaculum. The triad technique was performed on 97 patients and
results compared to 71 ankle arthroscopies with the Brostrom-Gould procedure.
The patients were contacted at a mean follow-up time of 30 months for
postoperative ACFAS scores, VAS scores, and overall satisfaction. Patients were
also asked to report incidence of ankle sprain recurrence. The average
postoperative ACFAS hindfoot and ankle score was 92 for the triad group and 89
for the arthroscopic debridement and Brostrom-Gould group. The average overall
satisfaction was 98% in the triad group and 91% in the scope and Brostrom
group. There were 4 (4.3%) recurrences in the triad group and 12 (17.6%) in the
Brostrom-Gould with scope group. Each group had a similar incidence of wound
healing complications. Peroneal tendon and retinacular pathology contributes to
continued ankle instability and pain. We believe that the triad procedure is
superior to the Brostrom-Gould procedure.