Effects of Broström vs Allograft Reconstruction Surgery on the Kinematic and Kinetic Gait Parameters in Chronic Ankle Instability

Research Type: Level 1 - Randomized controlled trial (RCT), Meta-analysis of randomized trials with homogeneous results Introduction/Purpose: In this study we aimed to evaluate the biomechanical parameters of the ankle after Broström repair and anatomic allograft tendon reconstruction in patients with chronic ankle instability (CLAI). Methods: Thirty patients with CLAI were enrolled, 15 had Broström repair (Brostrom group), 15 had anatomic allograft tendon reconstruction surgery (reconstruction group), and 16 individuals without any history of injury to the lower extremities were enrolled as controls. Kinematics included degree of dorsi/plantar flexion and inversion/eversion. Kinetics included ankle-power, moment, and force-plate reaction. Accordingly, different peaks within the gait cycle for the dorsi/plantar and inversion/eversion axis were assessed and compared among the groups (P>0.05 considered significant) Results: The reconstruction group showed more inversion in one peak during the heal contact to foot flat, one peak during foot flat to mid stance, two peaks during the push-off phase, one peak during mid-swing, and one during swing phase to the heal contact compared to the controls (p < 0.05). More dorsiflexion was seen in one peak during heel contact to foot flat phase (p=0.048). More dorsiflexion was seen in one measured peak in early swing (p=0.017), more plantar flexion in one peak during mid-swing (p=0.047), and more eversion in two peaks of the push-off phase (p < 0.05) Conclusion: Although both Broström repair and allograft tendon reconstruction surgery for CLAI change the biomechanics of the ankle joint, we found that postoperative ankle kinematics are more similar to the contralateral uninjured ankle following Broström repair.