Postoperative evaluation of the treatment of chronic ankle ligament instability: Broström Gould vs Arthroscopic Brostöm – 10 years of follow-up

Abstract

Introduction: Ankle sprain is one of the most frequent ligament injuries in the lower limbs, with a high prevalence in athletes. Although conservative treatment is effective for most patients, about 20% develop chronic instability and may require surgical intervention. The modified Broström-Gould technique is considered the gold standard, while the arthroscopic Arthro-Brostrom technique appears as a minimally invasive alternative. This study aims to functionally compare the outcomes of both techniques with a 10-year follow-up, using the AOFAS scale. Methods: This is a retrospective longitudinal study comparing two treatment groups that evaluated 113 patients with chronic lateral ankle ligament instability, operated between January 2011 and December 2014, divided into two groups: modified Broström-Gould (n = 46) and Arthro-Broström (n = 67). All had previously undergone conservative treatment for at least six months. The AOFAS score was applied pre- and postoperatively. Results: There was no statistically significant difference between the groups regarding clinical characteristics. Both groups showed a significant increase in the postoperative AOFAS score (p < 0.001), with a mean improvement of 38.6 points for Broström-Gould and 39 points for Arthro-Broström. The final mean score was slightly higher in the Arthro-Broström group (92.1 vs. 91.4), but there was no statistically significant difference between the methods (p = 0.847). Conclusion: Both the modified Broström-Gould and Arthro-Broström techniques proved to be effective for the treatment of chronic ankle instability, providing significant functional improvement and a low rate of complications. The arthroscopic approach showed advantages, including lower morbidity and improved visualization of associated lesions, making it a safe and effective option.