Background

Arthroscopic surgery for treating ankle instability is increasingly popular. Several studies showed similar functional outcomes to those seen after open surgery, with no increase in complications. The objective of this study was to evaluate the return-to-sports (RTS) rate and time after arthroscopic surgery to treat chronic lateral ankle instability.

Hypothesis

The rate and time of RTS are satisfactory after arthroscopic surgery to treat chronic lateral ankle instability.

Material and methods

This single-centre retrospective study included patients managed arthroscopically for chronic lateral ankle instability, with no other procedures, between February 2014 and May 2017. We evaluated the time and rate of RTS, as well as factors associated with RTS such as motivation, athletic level before surgery and whether the injury was work-related. Follow-up was at least 1 year.

Results

Of the 40 included patients, 30 (75%) returned to their main sport, after a median of 6 months. Moreover, 22 (55%) patients resumed their main sport at the same or a higher level within 12 months after surgery, their median postoperative follow-up being 29 months (range, 13–61). The AOFAS score improved significantly, from 67 (30–90) before surgery to 88.5 (39–100) at last follow-up (p < 0.001). The numerical pain score decreased significantly between these two timepoints, from 6 (0–10) to 1 (0–10) (p < 0.001). By multivariate analysis, a high level of motivation before surgery was the main factor significantly associated with RTS at the same or a higher level within 12 months after surgery (odds ratio, 16.47; 95%CI, 3.33–81.20; p = 0.007). Persistent pain was more common in patients with work-related injuries (p = 0.016).

Conclusion

At 12 months, the RTS rate was 75% overall, with 55% of patients returning to the same or a higher level. Median time to RTS was 6 months (4–8). Both the rate of and the time to RTS were independently associated with greater preoperative motivation.

Level of evidence

IV, retrospective observational cohort study.

中文翻译：

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重返运动：慢性外侧踝关节不稳关节镜手术后的恢复率和时间

背景

用于治疗踝关节不稳的关节镜手术越来越受欢迎。几项研究显示与开放手术后观察到的功能结果相似，并发症没有增加。本研究的目的是评估关节镜手术治疗慢性外侧踝关节不稳后的恢复运动 (RTS) 率和时间。

假设

关节镜手术治疗慢性外侧踝关节不稳后，RTS 的发生率和时间令人满意。

材料与方法

这项单中心回顾性研究纳入了 2014 年 2 月至 2017 年 5 月期间接受关节镜治疗的慢性外侧踝关节不稳患者，未进行其他手术。我们评估了 RTS 的时间和发生率，以及与 RTS 相关的因素，例如动机、运动水平手术前以及受伤是否与工作有关。随访至少 1 年。

结果

在 40 名患者中，有 30 名 (75%) 在中位数 6 个月后恢复了他们的主要运动。此外，22 名 (55%) 患者在术后 12 个月内恢复了相同或更高水平的主要运动，他们的中位术后随访时间为 29 个月（范围，13-61）。AOFAS 评分显着改善，从手术前的 67 (30–90) 提高到最后一次随访时的 88.5 (39–100) ( p  <  0.001)。数值疼痛评分在这两个时间点之间显着下降，从 6 (0–10) 到 1 (0–10) ( p  <  0.001)。通过多变量分析，手术前的高水平动机是与术后 12 个月内相同或更高水平的 RTS 显着相关的主要因素（比值比，16.47；95%CI，3.33-81.20；p  = 0.007）。持续性疼痛在工伤患者中更为常见 ( p  =  0.016)。

结论

在 12 个月时，总体 RTS 率为 75%，55% 的患者恢复到相同或更高的水平。RTS 的中位时间为 6 个月 (4–8)。RTS 的发生率和时间都与更大的术前动机独立相关。

证据等级

IV、回顾性观察队列研究。