Measurement of Functional Instability before and after Modified Bröstrom Operation Using Pedobarography in Patients with Chronic Ankle Instability
10.4055/jkoa.2024.59.6.406
- Author:
Jae Wan SUH
1
;
Young Kwang SHIN
;
Hyun-Woo PARK
Author Information
1. Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea
- Publication Type:Original Article
- From:The Journal of the Korean Orthopaedic Association
2024;59(6):406-414
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:The modified Bröstrom operation (MBO) is a prominent surgical treatment for patients with chronic lateral ankle instability. This study examined the improvement of functional instability by quantitatively assessing the changes in postural control using pedobarography after MBO and proprioceptive exercises.
Materials and Methods:This study was conducted on 38 patients who underwent MBO for chronic lateral ankle instability from May 2015 to December 2021. The mechanical instability was evaluated pre- and post-operatively using the Manual-Anterior Drawer Test, and the clinical outcomes were assessed using the AOFAS-AHFS (American Orthopaedic Foot and Ankle Society ankle-hindfoot scale).Pedobarography was used to evaluate postural control measuring foot pressure center variables, specifically the envelope area (ENV) of the pressure center trajectory and the sway velocity (SV) of the pressure center movement. The improvement of postural balance ability was evaluated according to age by classifying the participants into young adult and middle-aged adult groups based on a threshold of 40 years.They were further analyzed by dividing into groups according to sex.
Results:The AOFAS-AHFS and Manual-Anterior Drawer Test improved significantly when the pre-surgery and post-surgery final followup assessments were compared (69.2 to 86.3, p<0.001; 2.3 to 0.2, p<0.001; respectively). When comparing pre-surgery and post-surgery final follow-up assessments with the eyes open, the ENV of the pressure center trajectory and SV significantly decreased (108.0 to 66.3, p=0.010; 23.0 to 18.8, p=0.030; respectively). When classified according to age, patients under 40 years showed a significant decrease in SV when measured with the eyes open post-surgery (20.5 to 18.0, p=0.030), while patients over 40 years showed a significant decrease in both ENV and SV when measured with eyes open post-surgery (149.7 to 84.7, p<0.01; 37.7 to 20.9, p=0.020; respectively). The male and female groups showed a significant decrease in SV when measured with the eyes open post-surgery (21.0 to 18.7 and p<0.01 vs. 25.5 to 18.9 and p=0.020, respectively).
Conclusion:The postural control changes were quantitatively evaluated using pedobarography after MBO and proprioceptive exercises, showing that the functional ankle instability improved regardless of age or sex.
