{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:17:58Z","timestamp":1790864278864,"version":"4.1.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>No study has compared functional outcomes measured by validated Patient-Reported Outcomes Measurement Information System (PROMIS) measures of physical function (PF) and pain interference (PI) between augmented and nonaugmented Brostr\u00f6m procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To determine whether the augmented Brostr\u00f6m procedure is associated with improved PROMIS scores compared with the nonaugmented procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      All patients who underwent lateral ankle ligament reconstruction at a single institution (2013-2024) were retrospectively reviewed. Revisions, allografts, nonanatomic reconstructions, flexor digitorum longus transfers, progressive collapsing foot deformities, concomitant hindfoot arthrodesis, associated ankle arthroplasties, concomitant fractures, and those without a minimum of 2 years of follow-up were excluded. A total of 97 eligible patients (97 ankles) completed postoperative surveys containing PROMIS and were included for final analysis. Augmentation was performed using the InternalBrace system (Arthrex). Bivariate comparisons of PROMIS were made using\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      tests. A weighted linear regression model with robust standard errors was fitted to examine associations between PROMIS and the Brostr\u00f6m technique, adjusting for clinically relevant covariates. Type-3 analysis of variance was performed to assess the significance of each predictor. Inverse probability of treatment was used to balance the distribution of covariates across techniques.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 97 patients, 56 (58%) underwent augmented Brostr\u00f6m procedures, and 41 (42%) underwent nonaugmented Brostr\u00f6m procedures. In unadjusted comparisons, the augmented type had a higher mean PF (51.2 \u00b1 8.5 vs 48.5 \u00b1 9.4;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .16) and a lower PI (49.3 \u00b1 9 vs 50.9 \u00b1 10.5;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .42) than the nonaugmented type. In adjusted models, the augmented type was associated with 4.68 (95% CI, 1.27 to 8.09) higher PF (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01) and 3.76 (95% CI, \u22127.85 to 0.33) lower PI (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .07) compared with the nonaugmented type. Higher body mass index was associated with significantly worse PROMIS PF and PI in both unadjusted (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01) and adjusted analysis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01). Varus deformity was associated with significantly lower PF compared with those with isolated ligamentous instability (\u20134.23 [95% CI, \u22128.42 to \u22120.04). No significant differences were observed in PF or PI at follow-up beyond 2 years (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .55 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .37, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our study showed that the augmented Brostr\u00f6m procedure was associated with significantly improved PROMIS scores compared with the nonaugmented Brostr\u00f6m procedure to a degree that reaches the minimal clinically important difference for PROMIS. The augmented Brostr\u00f6m procedure, therefore, may serve as an effective surgical option to maximize functional outcomes for patients suffering from chronic lateral ankle instability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671261424904","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T20:50:54Z","timestamp":1775595054000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Augmented Brostr\u00f6m and Improved Functional Outcomes as Measured by PROMIS Scores Compared With Brostr\u00f6m Without Augmentation"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2694-7334","authenticated-orcid":false,"suffix":"Jr","given":"Steven M.","family":"Hadley","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, 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