Return to Activity After Augmented Brostrom Repair Using InternalBrace vs FlexBand

Research Type: Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies Introduction/Purpose: The modified Broström procedure has been the mainstay treatment for chronic lateral ankle instability. Suture tape augmentation of the modified Broström procedure has allowed for successful accelerated rehabilitation and earlier return to preinjury level of activity. Despite historical success of suture tape augmentation, complications related to the non-absorbable nature of these products do exist, such as overtightening and implant irritation. This has prompted the development of more biologically integrative materials, such as Artelon’s copolymer, FlexBand. The purpose of this study is to compare clinical outcomes and return to pre-injury level of activity after augmented Brostrom lateral ligament reconstruction using the Arthrex InternalBrace versus the FlexBand. Methods: A retrospective review was performed of patients undergoing modified Broström lateral ligament reconstruction with either InternalBrace suture tape or FlexBand copolymer augmentation between 2021 and 2024 at a single institution. Patient demographics including age at the time of procedure, sex, smoking history, diabetes history, BMI, and laterality of procedure, and time since surgery were collected and compared between groups. Time to return to full activity and presence of complications were collected and analyzed. Results: A total of 43 patients underwent modified Broström lateral ligament reconstruction. Sixteen underwent lateral ligament reconstruction with Artelon FlexBand augmentation, while 27 underwent augmentation with Arthrex InternalBrace. Demographics were similar between the two treatment groups, with an average time since surgery of 2.4 years. Average time to full activity was similar between the two groups of 4.7 months for the FlexBand group versus 4.6 months for the InternalBrace group (p=0.9). The was also no significant difference in complication rate with no reported complications among the FlexBand while the InternalBrace group one reported complication of the presence of a surgical scar eschar. Conclusion: The modified Broström procedure with either InternalBrace or FlexBand offer a safe and effective augmentation for the treatment of chronic lateral ankle instability, demonstrating similar time to return to preinjury level of activity with no significant differences in complication rates.