Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons · 2025
Functional and return-to-sport outcomes after arthroscopic anatomic reconstruction of the lateral ligaments of the ankle.
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Ancelin D, Philippe C
Аннотация
BACKGROUND: Chronic lateral ankle instability (CLAI) affects 20-40 % of patients following a lateral ankle sprain and is frequently managed with surgical reconstruction when conservative treatments fail. Although arthroscopic anatomic reconstruction techniques have been increasingly adopted, few studies specifically examine their functional outcomes and rates of return to sport (RTS).
OBJECTIVE: This study aimed to evaluate functional outcomes and RTS rates after arthroscopic anatomic reconstruction of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) using gracilis autograft with a minimum follow-up of three year. Secondary objectives included assessing patient satisfaction and identifying predictive factors for RTS.
METHODS: Ninety-three patients who underwent isolated arthroscopic anatomic reconstruction of the ATFL and CFL for CLAI were retrospectively reviewed. Functional outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) Hindfoot Scale, the Simple Foot and Ankle Value (SFAV), and the Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI) scale. RTS and satisfaction rates were analyzed. Statistical analyses examined potential predictors for RTS, including preoperative sports activity level, age, and postoperative complications.
RESULTS: At a mean follow-up of 55.2 months (range: 36-93 months), 91.5 % of patients resumed sports, with 76.6 % returning to their preinjury level or higher. Mean functional scores included AOFAS (90.4 ± 11.6), SFAV (77.7 ± 17.7), and ALR-RSI (70,28 ± 19,86). Complications were reported in 8.6 % of cases, with one case of graft ruptures and surgical revisions.
CONCLUSIONS: Arthroscopic anatomic reconstruction of the lateral ankle ligaments yields excellent functional outcomes and high RTS rates. The preoperative level of sports activity may influence postoperative RTS, highlighting the importance of preoperative patient counseling and individualized rehabilitation.
OBJECTIVE: This study aimed to evaluate functional outcomes and RTS rates after arthroscopic anatomic reconstruction of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) using gracilis autograft with a minimum follow-up of three year. Secondary objectives included assessing patient satisfaction and identifying predictive factors for RTS.
METHODS: Ninety-three patients who underwent isolated arthroscopic anatomic reconstruction of the ATFL and CFL for CLAI were retrospectively reviewed. Functional outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) Hindfoot Scale, the Simple Foot and Ankle Value (SFAV), and the Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI) scale. RTS and satisfaction rates were analyzed. Statistical analyses examined potential predictors for RTS, including preoperative sports activity level, age, and postoperative complications.
RESULTS: At a mean follow-up of 55.2 months (range: 36-93 months), 91.5 % of patients resumed sports, with 76.6 % returning to their preinjury level or higher. Mean functional scores included AOFAS (90.4 ± 11.6), SFAV (77.7 ± 17.7), and ALR-RSI (70,28 ± 19,86). Complications were reported in 8.6 % of cases, with one case of graft ruptures and surgical revisions.
CONCLUSIONS: Arthroscopic anatomic reconstruction of the lateral ankle ligaments yields excellent functional outcomes and high RTS rates. The preoperative level of sports activity may influence postoperative RTS, highlighting the importance of preoperative patient counseling and individualized rehabilitation.