SLR - June 2016 - Christine Nguyen
Reference: White WJ, McCollum GA, Calder JD. Return to Sport Following Acute Lateral Ligament Repair of the Ankle in Professional Athletes. Knee Surg Sports Traumatol Arthrosc. 2016 Apr; 24(4): 1124-1129.Scientific Literature Review
Reviewed By: Christine Nguyen, DPM
Residency Program: Wyckoff Height Medical Center
Podiatric Relevance: About one-fourth of all musculoskeletal system injuries are sports related. Of those sports injuries, ankle sprains and ligament injuries are a common problem facing professional athletes. These injuries cost significant time lost for athletes to return to training and play. In addition, they may cause chronic instability, pain and ankle dysfunction. The aim of this study was to determine the time of return to training and game following reconstruction of acute grade III lateral ligament injuries.
Methods: Data was collected from a single surgeon who followed 42 athletes who were operatively treated for grade III lateral ligament injuries and underwent Brostrom repair. Twelve of the 42 athletes sustained associated injuries, which included osteochondral lesions, deltoid ligament injuries and combined deltoid ligament injury with osteochondral lesions. MRI and clinical examination, including anterior drawer and talar tilt, was used to diagnosis a grade III injury to confirm the complete rupture of the ATFL and CFL. Any patient with previous ankle injury or grade I or II injuries was excluded from the study and treated conservatively. All of the patients underwent the modified Broström repair.
Results: In the study, all patients underwent the surgical procedure within seven days (average) following the injury. The median time for all athletes to return to training was 63 days. The median time to return to full sports was 77 days. Despite no difference in pre- and postoperative VAS scores between the groups, those with combined injuries had lower FAOS pain and symptoms postoperatively (p=0.027, p<0.001). Of the 42 athletes who underwent the procedure, two had complications. However, all returned to their preinjury level of sports.
Conclusions: The results of the study indicated that lateral ligament reconstruction is effective treatment for acute lateral ligament rupture in athletes. This study can help podiatric physicians predict the expected time for their athletic patients to return to training and sports.