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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2023

08-12-2022 | Ankle

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

Authors: Choon Chiet Hong, James Calder

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2023

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Abstract

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 modified 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.

Results

The 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 significant difference found in time to RTS between gender, age, and types of sports. However, there was a statistically significant difference 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; 95% CI 25.1–35.5; 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 findings 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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Metadata
Title
Ability to return to sports after early lateral ligament repair of the ankle in 147 elite athletes
Authors
Choon Chiet Hong
James Calder
Publication date
08-12-2022
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-022-07270-2

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