Background:Short-term results after arthroscopic/endoscopic lateral ligament repair for chronic lateral ankle instability have been satisfactory, although medium- to longer-term results are lacking.Purpose/Hypothesis:The purpose of this study was to report the medium-term results of an all-inside endoscopic classic Bröstrom-Gould procedure where both the both lateral ligaments and the inferior extensor retinaculum can be approached directly, interchanging between arthroscopy for intracapsular structures and endoscopy for extracapsular structures. It was hypothesized that the all-inside endoscopic classic Bröstrom-Gould procedure would produce sustainable good outcomes at a medium term of 5 years.Study Design:Case series; Level of evidence, 4Methods:A prospective database for 43 patients who underwent an all-inside endoscopic classic Bröstrom-Gould repair of the anterior talofibular ligament and calcaneofibular ligament with inferior extensor retinaculum augmentation was reviewed. Patient details, American Orthopaedic Foot & Ankle Society score, Karlsson score, ankle activity score (AAS), and patient satisfaction were collected and analyzed.Results:The study cohort of 43 patients with a mean age of 29.4 years (SD, 11.9 years) were reviewed at a mean follow-up of 63.1 months (SD, 8.5 months). The American Orthopaedic Foot & Ankle Society scores showed significant improvement from a mean of 69.6 (SD, 13.9) to 93.7 (SD, 10.7), while the Karlsson score improved from 59.7 (SD, 14.5) to 91.5 (SD, 14.5) at the final follow-up. The AAS showed that 32 (74.4%) patients maintained or had improvement in the AAS, from a mean of 5.38 (SD, 2.8) to 5.41 (SD, 2.8), with a mean satisfaction rate of 9.1 (SD, 1.3). Although the remaining 11 patients had a reduced AAS, at a mean of 4.6 (SD, 2.6), they reported a mean satisfaction rate of 7.4 (SD, 2.9). There were no surgical complications or reoperations reported in this cohort, although there were 3 patients with recurrent instability at their last follow-up, resulting in a failure rate of 7%.Conclusion:The current study is the first to report the medium-term outcomes of an all-inside endoscopic classic Bröstrom-Gould procedure. Overall, 93% of the patients had good functional outcomes, but approximately 25% of patients had decreased ankle activity levels at a mean of 5 years postoperatively, albeit with good satisfaction rates.

中文翻译：

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全内窥镜经典 Bröstrom-Gould 技术：中期结果


背景： 关节镜/内窥镜下外侧韧带修复治疗慢性外侧踝关节不稳定后的短期结果令人满意，但缺乏中长期结果。目的/假设： 本研究的目的是报告全内窥镜经典 Bröstrom-Gould 手术的中期结果，其中外侧韧带和下伸肌支持带都可以直接接近，在囊内结构的关节镜检查和囊外结构的内窥镜检查之间互换。据推测，全内窥镜经典 Bröstrom-Gould 手术将在 5 年的中期产生可持续的良好结果。研究设计： 病例系列;证据水平， 4方法： 回顾了 43 例接受距腓前韧带和跟腓韧带增大全内镜经典 Bröstrom-Gould 修复术患者的前瞻性数据库。收集并分析了患者详细信息、美国骨科足踝协会评分、Karlsson评分、踝关节活动评分（AAS）和患者满意度。结果： 对 43 例平均年龄为 29.4 岁 （SD，11.9 岁） 的患者的研究队列进行了回顾，平均随访时间为 63.1 个月 （SD，8.5 个月）。美国骨科足踝协会的评分显示显著改善，平均值从69.6 （SD， 13.9）提高到93.7 （SD， 10.7），而Karlsson评分在最后的随访中从59.7 （SD，14.5）提高到91.5（SD）14.5。AAS 显示 32 例 （74.4%） 患者维持或改善 AAS，平均值为 5.38 （SD， 2.8） 至 5.41 （SD， 2.8），平均满意率为 9.1 （SD， 1.3）。尽管其余 11 例患者的 AAS 降低，但平均为 4。6 （SD， 2.6） 报告的平均满意度为 7.4 （SD， 2.9）。该队列中没有手术并发症或再次手术的报道，尽管有 3 例患者在最后一次随访时出现复发性不稳定，导致失败率为 7%。结论： 目前的研究首次报道了全内窥镜经典 Bröstrom-Gould 手术的中期结局。总体而言，93% 的患者具有良好的功能结果，但大约 25% 的患者在术后平均 5 年内踝关节活动水平下降，尽管满意度良好。