Return to Sports and Clinical Outcomes in Suture-Tape Augmentation for Ankle Instability: A Systematic Review

Category: Ankle; Sports Introduction/Purpose: There is minimal literature on the use of suture-tape augmentation in the treatment of chronic lateral ankle instability (CLAI), prompting an investigation on its use and effect during surgery of the lateral ankle. The purpose of this systematic review is to evaluate the evidence for the use of suture-tape augmentation in the treatment of CLAI, and the outcomes following this technique. Methods: A literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they evaluated the use of suture-tape for CLAI. Quantitative and qualitative analysis was performed. Results: There were 11 studies (LOE II: 2, LOE III: 1, LOE IV: 8) with 334 patients and 334 ankles, and 66.7% were females. The mean age of patients was 27.3 years. The mean follow-up was 27.6 months (range: 11.5-38.5). Overall, 9 recurrent instability events (4.1%) were reported for suture-tape augmentation, with no significant difference between Modified Broström repair and suture-tape augmentation (MD;.81, 95% CI,.19, 3.50, I2 = 0%, p = 0.78). There was no significant difference in talar tilt angle (TTA) improvement between Modified Broström repair and suture-tape augmentation (MD; -0.07, 95% CI, -0.68, 60.54, I2 = 0%, p = 0.82). There was no significant difference in anterior talar translation (ATT) improvement between Modified Broström repair and suture-tape augmentation (MD; -0.06, 95% CI, -0.69, 0.56, I2 = 0%, p = 0.84). Conclusion: Suture-tape augmentation did not significantly improve clinical or radiological outcomes in the setting of Modified Broström repair for CLAI. Quicker return to play was the single most important advantage of the suture-tape augmentation procedure identified in the current study. This indicates that there is a role for suture-tape augmentation in ATFL repair for athletes and high-demand patients.