Return to Sport After Anatomic Lateral Ankle Stabilization Surgery for Chronic Ankle Instability: A Systematic Review and Meta-analysis

Abstract

Background: Chronic lateral ankle instability that develops after ankle sprains has a severe, negative influence on the patient’s lower extremity function. Anatomic repair or reconstruction of the lateral ankle ligament is an effective treatment for people with chronic lateral ankle instability who want to regain their preinjury levels of work and sport. Purpose: To determine the rate of return to sport (RTS) and related factors after anatomic lateral ankle stabilization (ALAS) surgery. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: Electronic databases including Medline, Embase, the Cochrane Library, and EBSCO Rehabilitation & Sports Medicine Source were searched from the earliest feasible entrance until August 2021. Articles reporting the number of patients who returned to sport after ALAS surgery and analyzing the relevant factors were included. The results were combined using proportion meta-analyses. Results: A total of 25 publications were reviewed, with a total of 1384 participants. Results showed that 95% of patients (95% CI, 91%-99%) returned to any sport, 83% (95% CI, 73%-91%) returned to their preinjury level of sport, and 87% (95% CI, 71%-98%) returned to competitive sport after surgery. The mean time to RTS was 12.45 weeks (95% CI, 10.8-14.1 weeks). Each decade of age increased the likelihood of RTS failure by 6%, and increases in body mass index (BMI) of 5 kg/m2 raised the risk of RTS failure by 4%. The rate of RTS was higher in professional and competitive athletes (93%; 95% CI, 73%-100%) than in recreational athletes (83%; 95% CI, 76%-89%). Analysis showed no differences for arthroscopy versus open surgery, repair versus reconstruction, and early versus late weightbearing. Conclusion: In most cases, patients may return to some kind of sport after ALAS surgery, and some patients RTS at their preinjury level. The relative risk of RTS failure increases according to the magnitude of the increase in age and BMI. Elite athletes are more likely to return compared with nonelite athletes.

Effect of Progressive Balance Control Strategies on Chronic Ankle Instability in Middle-Aged Obese Women

“…Consistent with prior studies, our findings show that obese women with CAI exhibit significant deficits in postural control compared to healthy controls. Specifically, we found that the obese CAI patients required more time to stabilize after performing a task like jumping, indicating impaired neuromuscular control [ 44 ].…”

Avulsion fracture is associated with more pain after anatomic repair procedure for ATFL injury at the talar side

“…Ankle sprain is one of the most common sports injuries, often leading to injuries to the lateral ankle ligamentous complex [10, 16]. It is reported that 20–40% of patients with lateral ankle ligamentous injuries have chronic ankle instability (CAI) and requires surgical intervention [22, 29]. In patients with CAI, the most commonly injured ligament is the anterior talofibular ligament (ATFL) [24], which often presents as ligament rupture, localized hyperintensity or scarring on magnetic resonance imaging (MRI).…”