Immediate Weightbearing After Augmented Modified Broström Reconstruction: A Retrospective Review of an Accelerated Rehabilitation Protocol.

BACKGROUND

An anatomic modified Broström reconstruction has replaced traditional nonanatomic procedures as the standard of care for chronic lateral ankle instability. This technique typically involves repair of both the anterior talofibular ligament and the calcaneofibular ligament. However, this reconstruction is often limited by damage to native tissue and prolonged healing time, which restricts early weightbearing.

HYPOTHESIS: The suture tape-augmented Broström procedure would allow for early weightbearing without increasing the risk of early reconstruction failure, while allowing a satisfactory return to sport.

STUDY

DESIGN

Case series; Level of evidence, 4.

METHODS

A retrospective chart review was conducted on patients who underwent a suture tape-augmented Broström reconstruction between August 2020 and January 2023. All patients followed a standardized accelerated rehabilitation protocol that included immediate postoperative weightbearing as tolerated. Primary outcomes included the ability to perform a single-leg hop and heel rise at 6 weeks postoperatively. Secondary outcomes included visual analog scale (VAS) scores, postoperative complications (eg, deep vein thrombosis [DVT], infection, return to operative suite, or failure), patient satisfaction, and return to sport.

RESULTS

A total of 133 patients were screened for inclusion in this retrospective review. A total of 119 patients met the inclusion criteria, with a mean follow-up duration of 16.7 ± 8.2 months (range, 6-52 months). A total of 27 patients had cartilage injuries requiring marrow stimulation; 20 of these were located in zone 6 of the talar dome. At 6 weeks postoperatively, 90% of patients were able to perform a single-leg heel raise and 81% could complete a single-leg hop. The mean VAS score at final follow-up (mean, 16.7 ± 8.2 months postoperatively) was 1.0 ± 1.9 (range, 0-8). At 1-year postoperative follow-up, 99% of patients reported satisfaction and 95% had returned to sport. Male patients were significantly more likely to complete the single-leg hop test at 6 weeks (P = .04). No instances of reconstruction failure, revision surgery, DVT, or postoperative infection were reported.

CONCLUSION

Suture tape-augmented modified Broström reconstruction enabled immediate postoperative weightbearing without evidence of reconstruction failure. Most patients achieved excellent functional outcomes by 6 weeks, with minimal complications, high satisfaction, and return to sport before 1 year.