Work

Chronic lateral ankle instability: A systematic review on comparison between operative treatments

Year: 2025

Type: review

Abstract: Chronic lateral ankle instability (CLAI) is characterized by recurrent ankle sprains. Conservative treatment may result in persistent instability requiring operative management. Surgical treatments such as the Modified Brostrom-Gould (MB) procedure with and without suture tape ligament augmentation (+ST) have become effective at strengthening and/or supplementing repair. However, there is little evidence regarding a superior technique regarding cost-benefits for patients receiving either treatment. This review performed a comparative cost analysis between these procedures using Web of Science, PubMed, and Scopus databases per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 3 studies (257 ankles) met the inclusion criteria. Of the four groups (open MB, arthroscopic MB, MB+ST, MB+Mason-Allen), the MB+Mason-Allen suture technique appeared to be the most cost-effective, owed to shorter operating times and the use of only one suture anchor. There was no significant difference in post-operative Patient Reported Outcome Scores (PROMS) using AOFAS scores. However, there was a significant difference in the aggregate cost for patients who had open Brostrom-Gould and arthroscopic Brostrom-Gould, with open being overall lower cost. Furthermore, the MB group was $2219 more expensive than the MB+ST (FiberTape internal brace augmentation ($20,970 vs. $18,751)) groups. Overall, utilizing an open technique (as opposed to arthroscopic), only placing one suture anchor (via Mason Allen configuration repair), and well-indicated internal brace utilization offer advantageous cost-efficacy in lateral ankle ligamentous stabilization. However, these findings should be interpreted cautiously and thoroughly considered due to the paucity of data on reported studies.

Source: Foot & Ankle Surgery Techniques Reports & Cases

DOI: 10.1016/j.fastrc.2025.100596

Authors: John N. Key, Matthew E. Wells, Justin D. Orr

Institution: Trinity University

Language: English

Topic: Foot and Ankle Surgery

Subfield: Orthopedics and Sports Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,000