Functional results of modified Mason-Allen suture versus horizontal mattress suture in the arthroscopic Broström-Gould procedure for chronic ankle instability

Abstract

Background: The arthroscopic Broström-Gould procedure (ABG) gained particular attention among clinicians and researchers due to its high rate of satisfactory results. There is a lack of evidence regarding the differences in clinical outcomes for the various suture techniques. The purpose of this study was to compare the differences in clinical effect in patients treated with one-anchor modified Mason-Allen suture or two-anchor horizontal mattress suture for chronic ankle instability (CAI).

Methods: This retrospective cohort study examined CAI patients who underwent either one-anchor modified Mason-Allen suture or two-anchor horizontal mattress suture ABG between January 2018 and January 2020. Patients were divided into two groups based on the suture knot type used and the associated number of anchors. The operative time, surgical cost, Visual Analog Scale (VAS), American Orthopedic Foot & Ankle Society (AOFAS) Score, Karlsson Ankle Functional Score (KAFS), the rate of return to sports, complications, and measured biomechanical strength using standardized equipment were compared between groups.

Results: Sixty-four CAI patients were included (one-anchor modified Mason-Allen suture group n = 30, two-anchor horizontal mattress suture group n = 34). Compared to the two-anchor horizontal mattress suture group, the one-anchor modified Mason-Allen suture group had significantly shorter operative time (p < .001) and lower surgical cost (p < .001). There were no postoperative complications in the two groups, and no significant differences in the VAS, AOFAS, KAFS, and rate of return to sports in postoperative follow-up between the two groups at 1 and 2 years after surgery. There was no statistically significant difference in biomechanical strength anterior drawer test displacement (p > .05) between the one-anchor modified Mason-Allen suture and two-anchor horizontal mattress suture at 2 years after surgery.

Conclusion: ABG using a one-anchor modified Mason-Allen suture showed comparable clinical results to a two-anchor horizontal mattress suture in the treatment of CAI at intermediate-term follow-up time. However, one-anchor modified Mason-Allen suture may be a faster, simpler, cost-effective substitute technology.

Level of evidence: Level III, comparative study.

Keywords: Arthroscopic; Chronic ankle instability; Grappling; Modified Mason–Allen suture.