W James White1, Graham A McCollum2, James D F Calder2,3. 1. Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK. wjameswhite@hotmail.com. 2. Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK. 3. Fortius Clinic, 17 Fitzhardinge St, London, W1H 6EQ, UK.
Abstract
PURPOSE: Recent literature supports early reconstruction of severe acute lateral ligament injuries in professional athletes, suggesting earlier rehabilitation and reduced recurrent instability incidence. Not previously reported, predicting the time to return to training and play is important to both athlete and club. We evaluate the effectiveness and complications of lateral ligament reconstruction in professional athletes. We aim to estimate the time to return to training and sports in both isolated injuries and patients with additional injuries. METHODS: A consecutive series of 42 athletes underwent modified Broström repair for clinically and radiologically confirmed acute grade III lateral ligament injury. Of 42, 30 had isolated complete rupture of ATFL and CFL. Of 42, 12 had additional injuries (osteochondral lesions, deltoid ligament injuries). All patients received minimum of 2 years post-operative assessment. RESULTS: The median return to training and sports for isolated injuries was 63 days (49-110) and 77 days (56-127), respectively. However, for concomitant injury results were 86 days (63-152) and 105 days (82-178). This delay was significant (p < 0.001). Despite no difference in pre- and post-op VAS scores between the groups, those with combined injuries had significantly lower FAOS pain and symptoms sub-scores post-operatively (p = 0.027, p < 0.001). Two superficial infections responded to oral antibiotics. No patient developed recurrent instability. All returned to their pre-injury level of professional sports. CONCLUSION: Lateral ligament reconstruction is a safe and effective treatment for acute severe ruptures providing a stable ankle and expected return to sports at approximately 10 weeks. Despite return to the same level of competition, club and player should be aware that associated injuries may delay return and symptoms may continue. These results may act as a guide to predict the expected time to return to training and to sport after surgical repair of acute injuries and also the influence of associated injuries in prolonging rehabilitation. LEVEL OF EVIDENCE: III.
PURPOSE: Recent literature supports early reconstruction of severe acute lateral ligament injuries in professional athletes, suggesting earlier rehabilitation and reduced recurrent instability incidence. Not previously reported, predicting the time to return to training and play is important to both athlete and club. We evaluate the effectiveness and complications of lateral ligament reconstruction in professional athletes. We aim to estimate the time to return to training and sports in both isolated injuries and patients with additional injuries. METHODS: A consecutive series of 42 athletes underwent modified Broström repair for clinically and radiologically confirmed acute grade III lateral ligament injury. Of 42, 30 had isolated complete rupture of ATFL and CFL. Of 42, 12 had additional injuries (osteochondral lesions, deltoid ligament injuries). All patients received minimum of 2 years post-operative assessment. RESULTS: The median return to training and sports for isolated injuries was 63 days (49-110) and 77 days (56-127), respectively. However, for concomitant injury results were 86 days (63-152) and 105 days (82-178). This delay was significant (p < 0.001). Despite no difference in pre- and post-op VAS scores between the groups, those with combined injuries had significantly lower FAOS pain and symptoms sub-scores post-operatively (p = 0.027, p < 0.001). Two superficial infections responded to oral antibiotics. No patient developed recurrent instability. All returned to their pre-injury level of professional sports. CONCLUSION: Lateral ligament reconstruction is a safe and effective treatment for acute severe ruptures providing a stable ankle and expected return to sports at approximately 10 weeks. Despite return to the same level of competition, club and player should be aware that associated injuries may delay return and symptoms may continue. These results may act as a guide to predict the expected time to return to training and to sport after surgical repair of acute injuries and also the influence of associated injuries in prolonging rehabilitation. LEVEL OF EVIDENCE: III.
Authors: Michel P J van den Bekerom; Gino M M J Kerkhoffs; Graham A McCollum; James D F Calder; C Niek van Dijk Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-10-30 Impact factor: 4.342
Authors: Frederick Michels; H Pereira; J Calder; G Matricali; M Glazebrook; S Guillo; J Karlsson; Jorge Acevedo; Jorge Batista; Thomas Bauer; James Calder; Dominic Carreira; Woojin Choi; Nuno Corte-Real; Mark Glazebrook; Ali Ghorbani; Eric Giza; Stéphane Guillo; Kenneth Hunt; Jon Karlsson; S W Kong; Jin Woo Lee; Frederick Michels; Andy Molloy; Peter Mangone; Kentaro Matsui; Caio Nery; Saturo Ozeki; Chris Pearce; Hélder Pereira; Anthony Perera; Bas Pijnenburg; Fernando Raduan; James Stone; Masato Takao; Yves Tourné; Jordi Vega Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-04-25 Impact factor: 4.342
Authors: Gwendolyn Vuurberg; Jasper S de Vries; Rover Krips; Leendert Blankevoort; Alex W F M Fievez; C Niek van Dijk Journal: Foot Ankle Int Date: 2017-07-26 Impact factor: 2.827
Authors: Christina Hermanns; Reed Coda; Sana Cheema; Matthew L Vopat; Megan Bechtold; Armin Tarakemeh; Scott Mullen; John Paul Schroeppel; Bryan G Vopat Journal: Kans J Med Date: 2020-06-25