Accelerated Versus Traditional Rehabilitation After Anterior Talofibular Ligament Reconstruction for Chronic Lateral Instability of the Ankle in Athletes

Miyamoto, Wataru; Takao, Masato; Yamada, Kazuaki; Matsushita, T.

doi:10.1177/0363546514527418

Cited by 48 publications

(60 citation statements)

References 33 publications

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“…This is a bit different from our definition, the time from surgery to participation in the first official game. In terms of return to team training (2.9 months) and first official game (3.9 months) in this series, the results are similar with those in the literature 101213)…”

Section: Discussionsupporting

confidence: 89%

Return to Play after Modified Broström Operation for Chronic Ankle Instability in Elite Athletes

Lee¹,

Jegal²,

Chung

et al. 2019

Clin Orthop Surg

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Background This study assessed the average time to return to training and official game participation after modified Broström operation (MBO) in elite athletes. Methods Sixty athletes diagnosed with lateral ankle instability underwent MBO from October 2011 to December 2013. Their average age was 19.3 years, and the average follow-up time was 28.8 months. We measured the time sequence of three phases of rehabilitation: start of personal training, start of team training, and start of the first official game after recovery. Patients were divided into an early return to play (RTP) group and late RTP group. The groups were compared to identify possible risk factors affecting the RTP time. Results The mean length of time to return to personal training was 1.9 months, return to team training was 2.9 months, and return to competitive play was 3.9 months. There were no significant differences of any variables including age, sex, body mass index, level of sports, grade of instability, presence of os subfibulare, and preoperative functional score between the early RTP and late RTP groups. Conclusions The RTP was 83.3% at 4 months after lateral ankle ligament repair and 100% at 8 months postoperatively. The results provide reference data for orthopedic surgeons in evaluating surgical results and informing patients about expectations after surgery in terms of performance level and timing of return to sports.

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Section: Discussionsupporting

confidence: 89%

Return to Play after Modified Broström Operation for Chronic Ankle Instability in Elite Athletes

Lee¹,

Jegal²,

Chung

et al. 2019

Clin Orthop Surg

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“…In the study by Miyamoto et al, 141 18 patients started ankle ROM and muscle training 2 days after ATFL reconstruction, while the other 15 patients began this regimen 1 month after the same procedure. No significant difference was found in the Karlsson score, Peterson score, anterior talar translation, or talar tilt angle.…”

Section: Resultsmentioning

confidence: 99%

Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data

Song

Liu

Sun

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: The surgical management of chronic lateral ankle instability (CLAI) has evolved since the 1930s, but for the past 50 years, the modified Broström technique of ligament repair has been the gold standard. However, with the development of arthroscopic techniques, significant variation remains regarding when and how CLAI is treated operatively, which graft is the optimal choice, and which other controversial factors should be considered. Purpose: To develop clinical guidelines on the surgical treatment of CLAI and provide standardized guidelines for indications, surgical techniques, rehabilitation strategies, and assessment measures for patients with CLAI. Study Design: A consensus statement of the Chinese Society of Sports Medicine. Methods: A total of 14 physicians were queried for their input on guidelines for the surgical management of CLAI. After 9 clinical topics were proposed, a comprehensive systematic search of the literature published since 1980 was performed for each topic through use of China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), PubMed, Web of Science, EMBASE, and the Cochrane Library. The recommendations and statements were drafted, discussed, and finalized by all authors. The recommendations were graded as grade 1 (strong) or 2 (weak) based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) concept. Based on the input from 28 external specialists independent from the authors, the clinical guidelines were modified and finalized. Results: A total of 9 topics were covered with regard to the following clinical areas: surgical indications, surgical techniques, whether to address intra-articular lesions, rehabilitation strategies, and assessments. Among the 9 topics, 6 recommendations were rated as strong and 3 recommendations were rated as weak. Each topic included a statement about how the recommendation was graded. Conclusion: This guideline provides recommendations for the surgical management of CLAI based on the evidence. We believe that this guideline will provide a useful tool for physicians in the decision-making process for the surgical treatment of patients with CLAI.

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“…This procedure may not provide adequate stability and lead to recurrence using the weakened and scarred remnants. Subsequently, researchers have described several anatomic reconstruction procedures using autograft or allograft tendon [ 14 , 15 ]. Studies have demonstrated that anatomic reconstruction can improve lateral ankle instability and restore normal ankle motion [ 16 – 19 ].…”

Section: Discussionmentioning

confidence: 99%

A new minimally invasive method for anatomic reconstruction of the lateral ankle ligaments with a Tightrope system

Cao

Yuan

et al. 2018

Arch Orthop Trauma Surg

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BackgroundSeveral minimally invasive anatomic reconstruction techniques of the lateral ligaments have been introduced for the treatment of chronic lateral ankle instability. However, these strategies may not always follow accurate ligament anatomic attachments, especially in the construction of the fibular bone tunnels.ObjectivesThis study reported a new percutaneous technique for reconstruction of the ligaments of lateral ankle anatomically with a Tightrope system.MethodsFrom April 2016 to August 2016, 25 ankles of 24 patients with chronic ankle instability underwent our new percutaneous anatomic reconstruction of the lateral ligaments with a Tightrope system. The operation was performed through several small incisions. The fibular tunnel was made obliquely from the anteromedial side of lateral malleolus tip towards retro-malleolar cortex. The graft was fixed in the tunnel with the help of a Tightrope system. The calcaneal tunnel and talar tunnel were made as our previous method. The mean final follow-up was 12.2 months (range 10–14). Visual Analogue Scale for pain, American Orthopaedic Foot and Ankle Society score, and patients’ subjective satisfaction were used to measure clinical outcomes. Preoperative and postoperative stress tests were performed and radiographic parameters were measured.ResultsThe Visual Analogue Scale decreased from 3.0 ± 1.4 to 1.3 ± 0.8 at the last follow-up (p < 0.01). The American Orthopaedic Foot and Ankle Society score was improved from 70.2 ± 5.4 preoperatively to 92.4 ± 5.3 at the final follow-up (p < 0.01). Radiologically, the mean anterior talar displacement was 13.1 ± 2.7 mm preoperatively versus 5.6 ± 1.3 mm at last follow-up (p < 0.01),and the mean varus talar tilt angle was 15.0° ± 2.4° preoperatively versus 5.6° ± 1.9° at the last follow-up (p < 0.01). Patients were satisfied (‘excellent’ or ‘good’) in 23 ankles (92%). Two patients reported residual instability but less apprehension than the preoperative condition.ConclusionsPercutaneous anatomic reconstruction of the lateral ligaments of the ankle with a Tightrope system is an anatomic and effective procedure for the treatment of chronic lateral ankle instability.

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Accelerated Versus Traditional Rehabilitation After Anterior Talofibular Ligament Reconstruction for Chronic Lateral Instability of the Ankle in Athletes

Abstract: Patients in group A returned to full athletic activity 5 weeks earlier than those in group I, demonstrating the advantage of accelerated rehabilitation after surgery.

Cited by 48 publications

References 33 publications

Return to Play after Modified Broström Operation for Chronic Ankle Instability in Elite Athletes

Return to Play after Modified Broström Operation for Chronic Ankle Instability in Elite Athletes

Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data

A new minimally invasive method for anatomic reconstruction of the lateral ankle ligaments with a Tightrope system

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