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Review
. 2020 Sep 15;8(9):2325967120948491.
doi: 10.1177/2325967120948491. eCollection 2020 Sep.

No Differences in Clinical Outcomes of Suture Tape Augmented Repair Versus Broström Repair Surgery for Chronic Lateral Ankle Instability

Hong Li  1 , Yujie Zhao  2 , Wenbo Chen  1 , Hongyun Li  1 , Yinghui Hua  1
Affiliations
Review

No Differences in Clinical Outcomes of Suture Tape Augmented Repair Versus Broström Repair Surgery for Chronic Lateral Ankle Instability

Hong Li et al. Orthop J Sports Med. .

Abstract

Background: Suture tape (ST) augmented repair, an alternative to traditional Broström repair (BR), may protect the repaired anterior talofibular ligament during ligament healing. No systematic review of cohort studies has been conducted to compare traditional BR with ST-augmented repair for chronic lateral ankle instability.

Purpose: To review the current evidence in the literature to ascertain whether ST-augmented repair is superior to traditional BR in managing chronic lateral ankle instability.

Study design: Systematic review; Level of evidence, 3.

Methods: A literature search was performed to identify relevant articles published in PubMed, Embase, and Cochrane Library databases in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included cohort studies comparing the efficacy of BR and ST-augmented repair procedures in terms of incidence of instability recurrence, functional scores, talar tilt angle (TTA), anterior talar translation (ATT), and complication rate. Methodological quality was assessed using the Jadad scale for randomized studies and the Newcastle-Ottawa Scale for nonrandomized studies.

Results: A total of 4 clinical trials with 254 patients were included. No significant differences were detected between BR and ST-augmented repair procedures in terms of incidence of recurrent instability, American Orthopaedic Foot & Ankle Society score, Foot and Ankle Outcome Score, Foot and Ankle Ability Measure, TTA, ATT, or complication rate. The ST group appeared to have a shorter operation time compared with the BR group.

Conclusion: No significant differences were found between ST-augmented repair and BR surgery regarding incidence of recurrent instability, functional outcome scores, or complication rates. Although technically challenging, the ST-augmented repair procedure appears to be a safe and fast option.

Keywords: ankle instability; anterior talofibular ligament; meta-analysis; repair; suture tap.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: This study was supported by the National Natural Science Foundation of China (No. 81572209), Shanghai Excellent Talents Program (No. 201609), and Shanghai Sports Science and Technology “Comprehensive Plan” Project (18Z004). AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Flow chart of the literature search process using the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines.
Figure 2.
Figure 2.
Results of aggregate analysis for comparison of recurrence rate of instability between suture tape (ST) group and Broström repair (BR) group. Numbers for “events” refer to failure; numbers for “total” refer to total participants. M-H, Mantel-Haenszel method.
Figure 3.
Figure 3.
Results of aggregate analysis for comparison of Foot and Ankle Ability Measure scores between suture tape (ST) group and Broström repair (BR) group. IV, inverse variance.
Figure 4.
Figure 4.
Results of aggregate analysis for comparison of Foot and Ankle Ability Measure sports activity scores between suture tape (ST) group and Broström repair (BR) group. IV, inverse variance.
Figure 5.
Figure 5.
Results of aggregate analysis for comparison of talar tilt angle between suture tape (ST) group and Broström repair (BR) group. IV, inverse variance.
Figure 6.
Figure 6.
Results of aggregate analysis for comparison of anterior talar translation between suture tape (ST) group and Broström repair (BR) group. IV, inverse variance.
Figure 7.
Figure 7.
Results of aggregate analysis for comparison of complication rate between suture tape (ST) group and Broström repair (BR) group. M-H, Mantel-Haenszel method.
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