Purpose Chronic ankle instability is the main complication of ankle sprains and requires surgery if non-operative treatment fails. The goal of this study was to validate a tool to quantify psychological readiness to return to sport after ankle ligament reconstruction. Methods The form was designed like the anterior cruciate ligament-return to sport after injury scale and “Knee” was replaced by the term “ankle”. The ankle ligament reconstruction-return to sport after injury (ALR-RSI) scale was filled by patients who underwent ankle ligament reconstruction and were active in sports. The scale was then validated according to the international COSMIN methodology. The AOFAS and Karlsson scores were used as reference questionnaires. Results Fifty-seven patients (59 ankles) were included, 27 women. The ALR-RSI scale was strongly correlated with the Karlsson score (r = 0.79 [0.66–0.87]) and the AOFAS score (r = 0.8 [0.66–0.87]). A highly significant difference was found in the ALR-RSI between the subgroup of 50 patients who returned to playing sport and the seven who did not: 68.8 (56.5–86.5) vs 45.0 (31.3–55.8), respectively, p = 0.02. The internal consistency of the scale was high (α = 0.96). Reproducibility of the test–retest was excellent (ρ = 0.92; 95% CI [0.86–0.96]). Conclusion The ALR-RSI is a valid, reproducible scale that identifies patients who are ready to return to the same sport after ankle ligament reconstruction. This scale may help to identify athletes who will find sport resumption difficult. Level of evidence III.

Purpose Psychological readiness scores have been developed to optimize the return to play in many sports-related injuries. The purpose of this study was to statistically validate the ankle ligament reconstruction-return to sport injury (ALR-RSI) scale after modified Broström-Gould (MBG) procedure. Methods A similar version of the ACL-RSI scale with 12 items was adapted to quantify the psychological readiness to RTS after MBG and to describe construct validity, discriminant validity, feasibility, reliability and internal consistency of the scale, according to the COSMIN methodology. The term “knee” was replaced by “ankle”. The AOFAS and Karlsson scores were used as references patient-related outcome measurements (PROMs). Results A total of 71 patients were included. The ALR-RSI score after MBG procedure was highly (r > 0.5) correlated to the AOFAS and Karlsson scores, with a Pearson coefficient r = 0.69 [0.54–0.80] and 0.72 [0.53–0.82], respectively. The mean ALR-RSI score was significantly greater in the subgroup of 55 patients who resumed sports activity compared to those that no longer practiced sport: 61.9 (43.8–79.6) vs 43.4 (25.0–55.6), (p = 0.01). The test–retest showed an “excellent” reproducibility with a ρ intraclass correlation coefficient of 0.93 [0.86–0.96]. The Cronbach’s alpha statistic was 0.95, attesting an “excellent” internal consistency between the 12 ALR-RSI items. Conclusion The ALR-RSI score is a valid and reproducible tool for the assessment of psychological readiness to RTS after an MBG procedure for the management of CLAI, in a young and active population. The ALR-RSI score may help to identify and counsel athletes on their ability to return to sport. Level of evidence III.

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Objectives: The Internet, especially YouTube, is an important and growing source of medical information. The content of this information is poorly evaluated. The objective of this study was to analyze the quality of YouTube video content on meniscus repair. The hypothesis was that this source of information is not relevant for patients. Methods: A YouTube search was carried out using the keywords "meniscus repair". Videos had to have had more than 10,000 views to be included. The videos were analyzed by two evaluators. Various features of the videos were recorded (number of views, date of publication, "likes", "don’t likes", number of comments, source, type of content and the origin of the video). The quality of the video content was analyzed by two validated information system scores: the JAMA benchmark score (0 to 4) and the Modified DISCERN score (0 to 5). A specific meniscus repair score (MRSS scored out of 22) was developed for this study, in the same way that a specific score has been developed for other similar studies (anterior cruciate ligament, spine, etc.). Results: Forty-four (44) videos were included in the study. The average number of views per video was 180,100 (± 222,000) for a total number of views of 7,924,095. The majority of the videos were from North America (90.9%). In most cases, the source (uploader) that published the video was a doctor (59.1%). A manufacturer, an institution and a non-medical source were the other sources. The content actually contained information on meniscus repair in only 50% of the cases. The mean scores for the JAMA benchmark, MD score and MRSS were 1.6/4± 0.75, 1.2/5 ± 1.02 and 4.5/22 (± 4.01) respectively. No correlation was found between the number of views and the quality of the videos. The quality of videos from medical sources was not superior to those from other sources. Conclusion: The content of YouTube videos on meniscus repair is of very low quality. Physicians should inform patients and, more importantly, contribute to the improvement of these contents.

Objectives: Chronic instability is the main complication of ankle sprains and requires surgical intervention if non-surgical treatment fails. The aim of this study was to validate a tool to quantify psychological readiness to return to sports after ankle ligament reconstruction. Methods: The form was designed like the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale, and the term "anterior cruciate" was replaced by "ankle". The Ankle Ligament Reconstruction - Return to Sport after Injury Scale (ALR-RSI) was completed by patients who had undergone ankle ligament reconstruction and who practiced a sport. The scale was then validated according to the COSMIN international methodology. The AOFAS and Karlsson scores were used as reference questionnaires. Results: 57 patients (59 ankles) were included, 27 of whom were women. The ALR-RSI scale was highly correlated with the Karlsson score (r=0.79 [0.66-0.87]) and the AOFAS score (r=0.8 [0.66-0.87]). A highly significant difference was noted on the ALR-RSI scale between the subgroup of 50 patients who returned to sports and the 7 who did not: 68.8 (56.5-86.5) versus 45.0 (31.3-55.8), respectively, p = 0.02. The internal consistency of the scale was high (α = 0.96). Reproducibility of the test-retest was excellent (ρ = 0.92, 95% CI [0.86-0.96]). Conclusion: The ALR-RSI is a valid, reproducible scale with which to identify patients who are ready to resume the same sport after ankle ligament reconstruction. This scale can help to identify athletes who will have difficulty returning to sports.

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