Return to sport following acute lateral ligament repair of the ankle in professional athletes

2015 ◽  
Vol 24 (4) ◽  
pp. 1124-1129 ◽  
Author(s):  
W. James White ◽  
Graham A. McCollum ◽  
James D. F. Calder
Keyword(s):  
Return To Sport ◽  
Professional Athletes ◽  
Lateral Ligament ◽  
Ligament Repair

scholarly journals Return to Sport After Primary Lateral Ligament Repair vs. Suture Tape Augmentation: Meta-Analysis

2021 ◽  
Vol 37 (1) ◽  
pp. e36
Author(s):  
Matthew L.G. Vopat ◽  
Maaz S. Hassan ◽  
Brandon Morris ◽  
Armin Tarakemeh ◽  
Scott Mullen ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Return To Sport ◽  
Lateral Ligament ◽  
Ligament Repair ◽  
Primary Lateral ◽  
Suture Tape

Functional Results of Open Broström Ankle Ligament Repair Augmented With a Suture Tape

2018 ◽  
Vol 39 (3) ◽  
pp. 304-310 ◽  
Author(s):  
J. Chris Coetzee ◽  
J. Kent Ellington ◽  
James A. Ronan ◽  
Rebecca M. Stone
Keyword(s):  
Plantar Flexion ◽  
Case Series ◽  
Return To Sport ◽  
Contralateral Side ◽  
Normal Function ◽  
Lateral Ligament ◽  
Ligament Repair ◽  
Level Of Evidence ◽  
Chronic Instability ◽  
Significant Difference

Background: The Broström procedure is the most commonly used lateral ligament repair for chronic instability, but there is concern about the strength of the repair and the risk of reinjury. Currently, the InternalBraceTM ligament augmentation repair is an accepted augmentation method for management of a Broström procedure. Our hypothesis was that augmentation of the Broström repair with an InternalBraceTM would allow accelerated rehabilitation and return to activity and would aid in stability of the repair without a tendency to stretch. Methods: Eighty-one patients with lateral ankle instability procedures repaired with a Broström and InternalBraceTM augmentation were evaluated at a one-time postoperative visit between 6 and 24 months. Outcomes included demographics, surgical time, the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score, Veterans Rand 12-Item Health Survey (VR-12), Foot and Ankle Ability Measure (FAAM), Visual Analog Scale (VAS), satisfaction, and objective clinical measurements. Eighty-one patients were analyzed including 30 males and 51 females. Median age was 34 years (range, 18-62 years) with a median return for follow-up of 11.5 months (range, 6-27 months). Results: Average postoperative VAS and satisfaction were 0.8 ± 1.4 and 9.1 ± 1.6, respectively. Mean return to sport (n = 68) was 84.1 days. Average AOFAS Ankle-Hindfoot score was 94.3. A score of 90 or higher on the FAAM Sports subscale was seen in 79.0% of the subjects. The single-leg hop test (Limb Symmetry Index %) showed that 86.4% of patients returned to normal or near normal function. The tape measure method and ankle dorsiflexion comparisons showed a significant difference: 9.2 ± 3.3 cm (operative side) and 10.4 ± 3.7 cm (contralateral side) ( P = .034). Ankle plantar flexion comparison (goniometer) was 48.5 ± 11.5 degrees (operative side) and 49.7 ± 11.9 degrees (contralateral side), showing no difference ( P = .506). Conclusion: These results suggest that InternalBraceTM augmentation of a Broström procedure is a safe and efficacious procedure that produces favorable outcomes in patients in terms of preventing recurrent instability in the ankle in the short term. Level of Evidence: Level IV, case series.

scholarly journals Early versus Delayed Mobilization Post-Operative Protocols for Primary Lateral Ankle Ligament Repair: A Systematic Review and Meta-analysis

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0007
Author(s):  
Matthew L. Vopat ◽  
Armin Tarakemeh ◽  
Brandon Morris ◽  
Maaz Hassan ◽  
Pat Garvin ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Meta Analysis ◽  
Return To Sport ◽  
Early Mobilization ◽  
Lateral Ligament ◽  
Ligament Repair ◽  
Lateral Ankle ◽  
Ankle Ligament ◽  
Lateral Ankle Ligament ◽  
Primary Lateral

Category: Ankle, Sports, Post-op protocol Introduction/Purpose: Lateral ankle instability represents a common orthopaedic diagnosis. Nonoperative treatment through focused physical therapy provides satisfactory results in most patients. Some patients, however, experience persistent chronic lateral ankle instability despite appropriate nonoperative treatment. These patients may require stabilization which can include primary lateral ligament repair to restore ankle stability. Optimal post-operative rehabilitation of lateral ankle ligament repairs remains unknown, as surgeon vary in how they balance protection of surgical repair with immobilization with the need for ankle joint mobilization to restore range of motion. The aim of this review is to provide insight into early and delayed mobilization post- operative protocols in patients undergoing primary lateral ankle ligament repairs to determine if an optimal evidence-based post- operative rehabilitation protocol exists in the literature. Methods: Following PRIMSA criteria, a meta-analysis using the PubMed/Ovid Medline database was performed (10/11/1947- 10/16/2017). Manuscripts that were duplicates, non-lateral ligament repair, biomechanical and non-English language were excluded. Protocols were reviewed and divided into two categories; early mobilization (within 3 weeks of surgery) and delayed mobilization (after 4 weeks of surgery). Return to sport, outcome scores (AOFAS, Karlsson scores) and complications of both populations were recorded and statistically analyzed. Results: 31 out of 1,844 studies met the criteria for the final analysis, representing 1,608 patients undergoing primary lateral ligament repair. There was no statistical difference in pre-operative AOFAS scores with delayed mobilization having a score of 67.3 and early mobilization having a score of 67.6 (p<0.639). There was statistical significance in the post-operative AOFAS score comparing delayed mobilization group versus early mobilization group with 91.8 versus 98.8, respectively (p<0.001) and post- operative Karlsson scores with values of 90.0 vs. 92.2 in delayed versus early respectively (p<0.001). Return to sport in the delayed group was 11.8 weeks versus 10.9 in early (p<0.044). No significant difference was found in complication rates between groups with delayed having a rate of 3.7% and early 4.8% (p<0.389). Conclusion: Patients may benefit from early mobilization protocols after lateral ankle ligament repair. The early mobilization protocols group had improved functional outcomes and decreased time until return to sport without a difference in complications. More studies are needed to definitively evaluate early versus delayed rehabilitation protocols due to heterogeneity of the studies.

scholarly journals Location and Morphology of Acute Lateral Ligament Injury of the Ankle

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0031
Author(s):  
Hideo Noguchi
Keyword(s):  
Ankle Instability ◽  
Surgical Reconstruction ◽  
Ligament Injury ◽  
Lateral Ligament ◽  
Ligament Injuries ◽  
Ligament Repair ◽  
Reconstruction Procedure ◽  
Side Body ◽  
Lateral Ligament Injury ◽  
Almost All

Category: Ankle, Sports, Trauma Introduction/Purpose: Acute ankle ligament injuries are usually treated non-operatively, even if the injury is severe. However, when chronic ankle instability is symptomatic, operative treatment is required. When planning local repair, the condition of the remaining ligament is important. We surgically treated acute severe lateral ligament injuries in 103 ankles and investigated the locations of the injuries in the anterior talofibular (ATF) and calcaneofibular (CF) ligaments, subdividing each into three parts. This paper should facilitate more precise planning of the surgical reconstruction procedure. Methods: From 2006 to 2014, 1,042 patients visited our outpatient clinic with a diagnosis of acute lateral ligament injury of the ankle. In total, 103 feet underwent surgical treatment and the locations of the ATF and CF ligament ruptures were investigated. The rupture location in the ATF ligament was subclassified as fibular side, body, or talar side, while for the CF ligament it was classified as fibular side, body, or calcaneal side. Results: The ATF ligament was ruptured on the fibular side in 38 feet (36.9%), body in 30 feet (29.1%), and talar side in 35 feet (34.0%). The CF ligament was ruptured on the fibular side in 15 feet (14.6%), body in 26 feet (25.2%), and calcaneal side in 62 feet (60.2%). Conclusion: Almost all surgical reports on lateral ligament reconstruction procedures (Brostrom et al.) describe ATF ligament repair and advancement on the fibular side, although only one-third of the ligaments were injured on the fibular side in our series. About two-thirds of the CF ligaments had damage to the calcaneal side structure of the entheses. When CF ligament repair is needed, surgeons should be aware of our finding that this ligament was ruptured at the fibular attachment in only 15% of cases, and on the calcaneal side in 60%. This knowledge should lead to better results of surgical reconstruction.

Clinical Outcomes and Return to Sport After Minimally Invasive Reconstruction of the Lateral Ligament Complex with Semitendinosus Tendon Autograft in Chronic Lateral Ankle Instability

2020 ◽  
Author(s):  
Federico Usuelli ◽  
Cristian Indino ◽  
Claudia Angela Di Silvestri ◽  
Luigi Manzi ◽  
Nicola Maffulli
Keyword(s):  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Ankle Instability ◽  
Return To Sport ◽  
Semitendinosus Tendon ◽  
Lateral Ligament ◽  
Ankle Sprains ◽  
Lateral Ligaments ◽  
The Mean ◽  
Tendon Autograft

&lt;p&gt;Background: Ankle sprains are common, affecting especially the lateral ligament complex of the ankle, often leading to chronic symptoms and instability. Many procedures have been described for chronic ankle instability. This study analyses clinical outcomes and returns to sport in patients who underwent minimally invasive reconstruction of the lateral ligaments complex of the ankle with a semitendinosus tendon autograft.&lt;/p&gt;&lt;p&gt;Methods: Twenty-three patients (mean age: 33.9 years) with grade 3 lesion of both anterior-talofibular (ATFL) and calcaneofibular (CFL) ligaments, underwent minimally invasive reconstruction of the ATFL and CFL ligaments with an ipsilateral semitendinosus tendon autograft. They were retrospectively reviewed and return to sport was evaluated with the Halasi ankle activity scale.&lt;/p&gt;&lt;p&gt;Results: The mean follow-up was 30 months (range 26-53 months). The mean AOFAS score increased from 68.6 to 95.3 point. The average VAS decreased from 3.6 to 1.3. The Halasi score changed from 5.0 to 5.1. Excepts for Halasi, the differences were statistically significant (p &lt;0.001).19 patients judged the received treatment as excellent, 2 as good. No revision procedures were performed. No major complications were reported.&lt;/p&gt; &lt;p&gt;Conclusions: This study confirms good clinical and sports outcomes following minimally invasive reconstruction of the lateral ligaments complex of the ankle with a semitendinosus autograft.&lt;/p&gt;

scholarly journals Impact of Patient Resilience on Outcomes of Open Brostrom-Gould Lateral Ligament Repair

2021 ◽  
Vol 5 (11) ◽  
Author(s):  
Nicholas A. Andrews ◽  
Aseel Dib ◽  
Timothy W. Torrez ◽  
Whitt M. Harrelson ◽  
Tanvee Sinha ◽  
...  
Keyword(s):  
Lateral Ligament ◽  
Ligament Repair

scholarly journals Arthroscopic Lateral Ligament Repair Through Two Portals in Chronic Ankle Instability

2017 ◽  
Vol 11 (1) ◽  
pp. 617-632 ◽  
Author(s):  
Jorge Pablo Batista ◽  
Jorge Javier del Vecchio ◽  
Luciano Patthauer ◽  
Manuel Ocampo
Keyword(s):  
Ankle Instability ◽  
Medical Condition ◽  
Surgical Techniques ◽  
Clinical Success Rate ◽  
Chronic Ankle Instability ◽  
Tilt Test ◽  
Lateral Ligament ◽  
Return To Sports ◽  
Ligament Repair

Objectives:Injury to the lateral ligament complex of the ankle is one of the most common sports-related injury.Usually lateral ankle evolves with excellent clinical recovery with non surgical treatment, however, near about 30% develop a lateral chronic instability sequela.Several open and arthroscopic surgical techniques have been described to treat this medical condition.Material and Methods:Of the 22 patients who were treated; 18 males and 4 females, and aged from 17-42 years (mean 28 years).All patients presented a history of more than three ankle sprains in the last two years and presented positive anterior drawer and talar tilt test of the ankle in the physical examination.We perform an anterior arthroscopy of the ankle in order to treat asociated disease and then we performed“All inside¨lateral ligament repair through two portals (anteromedial and anterolateral) using an anchor knotless suture.Results:Clinical outcome evaluations were performed at a mean follow up of 25 months. (R: 17-31).Overall results has been shown by means of the American Orthopaedic Foot and Ankle Society (AOFAS). Mean AOFAS scores improved from 63 points (range 52–77) preoperatively to 90 points (range 73–100) at final follow up.No recurrences of ankle instability were found in the cases presented.Conclusion:Several surgical procedures have been described during the last years in order to treat chronic ankle instability.¨All inside¨lateral ligament reconstruction presents lower local morbidity than open procedures with few complications. Moreover, it is a reproductible technique, with high clinical success rate, few complications and relatively quick return to sports activities. A high knowledge of the anatomic landmarks should be essential to avoid unwated injuries.

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