Outcomes and Return to Sports Following the Ankle Lateral Ligament Reconstruction in Professional Athletes: A Systematic Review of the Literature

Goru, Poornanand; Talha, Samir; Majeed, Haroon

doi:10.1007/s43465-021-00532-0

Cited by 4 publications

(6 citation statements)

References 49 publications

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“…Furthermore, those with considerable laxity on initial presentation of a grade III injury risk failure of conservative management with functional rehabilitation and may require surgical intervention with further delay in return to competition. Therefore, surgical intervention in the form of acute lateral ligament repair may be considered in professional athletes as it provides a predictable recovery, high rate of RTS and reduced down- [3,[7][8][9][10][11][12][13][14][15]. With that being said, results obtained from this cohort of elite athletes are unique and are not advocated for the general population.…”

Section: Discussionmentioning

confidence: 99%

“…Although most of the acute lateral ligament injuries respond to nonoperative management with functional rehabilitation, up to 9% of professional soccer players may sustain a re-injury the 1 3 same season and 34% within 3 years [5,6]. Despite controversies regarding treatment of grade III injuries, emerging evidence suggests that operative treatment for acute grade III injuries may allow earlier rehabilitation and an earlier return to sports (RTS) for elite athletes [3,[7][8][9][10][11][12][13][14][15]. This is because signiicantly less objective instability has been reported following surgical repair compared to nonoperative treatment [7,9,12,13].…”

Section: Introductionmentioning

confidence: 99%

“…This is because signiicantly less objective instability has been reported following surgical repair compared to nonoperative treatment [7,9,12,13]. Since residual ankle instability is predictive of future ankle sprains [14,16,17], some authors have recommended considering early surgery for professional athletes with ankle instability following acute grade III lateral ligament injuries to prevent risks of complications from recurrent sprains and delayed RTS [3,[7][8][9][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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Ability to return to sports after early lateral ligament repair of the ankle in 147 elite athletes

Hong

Calder

2022

Knee surg. sports traumatol. arthrosc.

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Purpose The literature on elite athletes' ability to return to sports (RTS) after early lateral ligament repair of the ankle remains inadequate. The time needed to RTS after modiied Broström repair for acute grade III lateral ligament injuries in a large cohort of elite athletes was evaluated while assessing the impact of other associated injuries. Methods Prospective data from 147 elite athletes who underwent a primary lateral ligament repair for acute grade III injuries with clinical ankle instability from 2015 to 2019 with a minimum of 2-year follow-up were reviewed. Pertinent details such as characteristics of injury, time taken to RTS, impact of associated injuries on RTS and complications were recorded and analysed. ResultsThe average age was 24.4 years (S.D = 4.9) with 89.1% males. Approximately two-thirds of the elite athletes were football players (66.0%) and 21.1% were rugby players. Isolated lateral ligament complex injuries were sustained by 122 (83%) patients, while 25 (17%) had associated injuries (osteochondral lesions of the talus/deltoid injury/syndesmosis injury). All 147 athletes returned to their preinjury level of sports with a median time of 69 days (range 58-132 days). There was no signiicant diference found in time to RTS between gender, age, and types of sports. However, there was a statistically signiicant diference noted in the time taken to RTS earlier in patients with isolated lateral ligament injuries when compared to those with associated injuries (68.6 vs. 82.8 days; p = 0.004). Multiple conditional linear regression yielded three independent predictors of longer time taken to RTS which were associated deltoid injury (7.5 days longer; 95% CI 2.9-12.3; p = 0.002), associated syndesmosis injury (6.7 days longer; 95% CI 0.5-12.8; p = 0.034) and associated OLT (30.3 days longer;; p = 0.000). Conclusion Early surgical repair for acute grade III lateral ligament injuries in elite athletes yielded excellent rate of RTS at 9-10 weeks and a re-injury rate of 2%. Concomitant injuries will delay RTS after surgical intervention. These indings serve as important guide to managing elite athletes following acute rupture of the lateral ligament complex. Level of evidence Level III.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ability to return to sports after early lateral ligament repair of the ankle in 147 elite athletes

Hong

Calder

2022

Knee surg. sports traumatol. arthrosc.

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“…While comparability is limited due to differences in prevalence of risk factors in the patient populations, results have to be benchmarked against the Broström repair technique and its modifications as the gold standard [ 2 , 5 , 12 ]. Heterogenous rates of RTS to previous level of sports rates ranging between 20 and 100% have been described following Broström repair, resulting in a pooled rate of 85% at a mean of 4.7 ± 1.5 [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the timing of RTS postoperatively, Ibrahim et al [20] reported a mean RTS at 6.8 months following ankle ligament reconstruction with a gracilis autograft, while Coughlin et al [3] reported RTS at a time point of 6.5 months postoperatively following ankle ligament reconstruction with a GT allograft; comparable to the results observed in the present study. Similarly, previous study observed diiculties to return to pre-injury level of sports following ankle ligament reconstruction [3,5] While comparability is limited due to differences in prevalence of risk factors in the patient populations, results have to be benchmarked against the Broström repair technique and its modiications as the gold standard [2,5,12]. Heterogenous rates of RTS to previous level of sports rates ranging between 20 and 100% have been described following Broström repair, resulting in a pooled rate of 85% at a mean of 4.7 ± 1.5 [18].…”

Section: Discussionmentioning

confidence: 99%

High return to sports and return to work rates after anatomic lateral ankle ligament reconstruction with tendon autograft for isolated chronic lateral ankle instability

Rupp

Degenhardt

Winkler

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose To evaluate clinical outcomes as well as return to sports (RTS) and return to work (RTW) rates following anatomic lateral ankle ligament reconstruction with a tendon autograft for chronic lateral ankle instability (CLAI) in a high-risk population, and to compare these outcome parameters between patients having received a gracilis tendon autograft (GT) and free split peroneus brevis tendon (PBT) autograft. Methods Twenty-eight consecutive patients, who were diagnosed with CLAI, presenting with ≥ 1 risk factor (ligamentous hyperlaxity, insufficient substance of native ligament and/or high-demand athlete), who underwent ankle ligament reconstruction with a tendon autograft between January 2011 and December 2018, were included in this retrospective study. At 63.7 ± 28.0 months (24–112), 23 patients with a mean age of 29.7 ± 10.9 years were available for follow-up. The Karlsson Score, the Foot and Ankle Outcome Score (FAOS), the Tegner Activity Scale and the visual analog scale (VAS) for pain were collected at a minimum follow-up of 24 months. RTS and RTW were evaluated by questionnaire. A subgroup analysis with regard to the graft used for ankle ligament reconstruction (GT versus PBT) was performed. Results Patients reported a Karlsson score of 82.1 ± 17.5 (37–100), a FAOS score of 87.8 ± 8.4 (73–99), a median Tegner activity scale of 5.0 (IQR 4–6) and a VAS for pain of 0.5 ± 0.9 (0–4) at rest and of 2.0 ± 2.1 (0–7) during activities at final follow-up. Postoperatively, 96% of patients had returned to sports after 8.3 ± 6.2 months. All patients (100%) had returned to work at 3.5 ± 5.7 (0–24) months, with 87% reporting an equal or improved working ability compared to that preoperatively. Postoperatively, exercise hours per week were significantly reduced compared to preoperatively in patients with a split PBT (n = 12; 13.0 ± 12.9 to 5.6 ± 6.4 h, p = 0.038) autograft as opposed to patients with a GT autograft (n = 11; 13.1 ± 8.7 to 12.4 ± 7.1 h, n.s.). No other group differences were observed. Conclusion Good patient-reported outcomes as well as excellent RTS and RTW rates can be achieved in high-risk patients undergoing ankle ligament reconstruction with a tendon autograft for CLAI. These results may be helpful in preoperatively managing patients’ expectations regarding sports- and work-related outcomes and provide tangible data on the expectable time frame of the individual return to sports and work trajectory. Level of evidence IV.

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Functional outcomes and rates of return to sport activities in a non-athlete population after the open Brostrom–Gould repair: a seven-year follow-up

Nishikawa,

Saito,

Mendes

et al. 2024

Eur J Orthop Surg Traumatol

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Outcomes and Return to Sports Following the Ankle Lateral Ligament Reconstruction in Professional Athletes: A Systematic Review of the Literature

Cited by 4 publications

References 49 publications

Ability to return to sports after early lateral ligament repair of the ankle in 147 elite athletes

Ability to return to sports after early lateral ligament repair of the ankle in 147 elite athletes

High return to sports and return to work rates after anatomic lateral ankle ligament reconstruction with tendon autograft for isolated chronic lateral ankle instability

Functional outcomes and rates of return to sport activities in a non-athlete population after the open Brostrom–Gould repair: a seven-year follow-up

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