Return to Sport After Ankle Syndesmotic Injury: A Systematic Review

Vancolen, Seline Y.; Nadeem, Irfan Ahmed; Horner, Nolan S.; Johal, Herman; Alolabi, Bashar; Khan, Moin

doi:10.1177/1941738118816282

Cited by 17 publications

(32 citation statements)

References 20 publications

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“…A systematic review and meta-analysis evaluated 48 studies with a total of 5770 subjects and reported that 63% of individuals returned to preinjury activity levels after anterior cruciate ligament reconstruction surgery [ 46 ]. Moreover, a systematic review evaluated 10 studies with 312 patients and reported that the rate of return to preinjury activity level after syndesmotic ankle injuries was 93.8% [ 47 ]. As in the study above, no difference in the impact variables and the lower extremity strength was found between groups by performing the jumping kick after complete recovery from injury.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Parameters that May Influence Lower Limb Injury during Landing in Taekwondo

Ryu

Lee

2021

Medicina

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Background and Objectives: The jumping kick of Taekwondo was a unilateral exercise that repeatedly moves in one direction. The exercise was exposed to the risk of injury due to the heavy ground reaction force and load in the landing. The first purpose of this study was to compare the impact force (IF), peak vertical ground reaction force (PVGRF), vertical loading rate (VLR), vertical stiffness (VS), and landing foot angle (LFA) during the landing of the jumping kick according to the experience of lower injury. The second purpose of this study was to investigate the lower extremities’ strength and the bilateral/ipsilateral asymmetry between the groups; Material and Methods: Ten injury-experience athletes (IG, age: 21.0 ± 0.8 years; height: 170.5 ± 4.1 cm; body weight: 66.7 ± 6.0 kg; career: 8.1 ± 5.0 years) and seven non-injury experience athletes (NG, age: 22.9 ± 4.0 years; height: 173.4 ± 3.1 cm; body weight: 67.9 ± 7.9 kg; career: 8.3 ± 5.0 years) participated; Results: There was no statistical difference between the two groups in the landing and lower extremity muscle strength impact variables. However, in the bilateral asymmetry of the ankle plantar flexor and the ipsilateral asymmetry of the hip abductor/adductor, IG was statistically larger than NG (p < 0.05). The landing foot angle also showed negative correlation to all impact variables (IF, PVGRF, VLR, and VS) (p < 0.05); Conclusions: It is desirable to place the landing foot down at a wide angle to prevent injury in performing Taekwondo jumping kicks. Although NGs have been shown to have better muscle strength symmetry and balance in some areas compared to IG, further research is needed to determine whether they are effective in preventing injury.

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Section: Discussionmentioning

confidence: 99%

Biomechanical Parameters that May Influence Lower Limb Injury during Landing in Taekwondo

Ryu

Lee

2021

Medicina

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“…3 Syndesmosis injuries can present with various obstacles during the rehabilitation process, including prolonged disability, recovery periods, and uncertainty regarding the ideal treatment approach. [4][5][6] There are several surgical options to consider in maintaining the structural integrity of the ankle joint after a grade II or higher syndesmosis injury has occurred. The current "gold standard" is the metallic syndesmotic screw.…”

Section: Clinical Scenariomentioning

confidence: 99%

“…PubMed, SportDiscus, and Google Scholar were searched, as well as reference lists, which resulted in 5 articles relating to the efficacy of utilizing the TightRope ™ surgical procedure in the treatment of syndesmosis injuries. [2][3][4]7,9 The search was limited to articles published within the last 10 years. Two randomized control trials and one cohort study comparing the TightRope ™ procedure with a metallic syndesmotic screw met the inclusion requirements and were utilized.…”

Section: Summary Of Key Findingsmentioning

confidence: 99%

“…2,3,7 All of the included articles demonstrated similar scores between the procedures; however, patients undergoing the Tight-Rope ™ experienced a reduction in the need to have a second surgical procedure to remove hardware. [2][3][4]7,9 With the reduced need for a second surgical procedure, the TightRope ™ allowed for a quicker return to normal activity by up to 2 weeks. 2,3,7,9 Return to sport was up to 5 weeks quicker with the TightRope ™ as compared with the traditional metallic syndesmotic screw.…”

Section: Summary Of Key Findingsmentioning

confidence: 99%

“…All 5 studies demonstrated a reduction in the necessity for a second intervention to remove hardware in groups using the TightRope ™ fixation system. [2][3][4]7,9 The studies also report better recovery time and a quicker return to work/activity in participants who underwent the TightRope ™ intervention. [2][3][4]7,9 Finally, clinician-based and patient-reported outcomes were not significantly different between groups undergoing the traditional metallic screw fixation and the TightRope ™ fixation.…”

Section: Implications For Practice Education and Future Researchmentioning

confidence: 99%

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Effectiveness of the TightRope® Fixation in Treating Ankle Syndesmosis Injuries: A Critically Appraised Topic

Street¹,

Rawlins²,

Miller³

2021

Journal of Sport Rehabilitation

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Clinical Scenario: Ankle fractures are a frequent occurrence, and they carry the potential for syndesmosis injury. The syndesmosis is important to the structural integrity of the ankle joint by maintaining the proximity of the tibia, fibula, and talus. Presently, the gold standard for treating an ankle syndesmosis injury is to insert a metallic screw through the fibula and into the tibia. This technique requires a second intervention to remove the hardware, but also carries an inherent risk of breaking the screw during rehabilitation. Another fixation technique, the Tightrope™, has gained popularity in treating ankle syndesmosis injuries. The TightRope™ involves inserting Fiberwire® through the tibia and fibula, which allows for stabilization of the ankle mortise and normal range of motion. Clinical Question: In patients suffering from ankle syndesmosis injuries, is the Tightrope™ ankle syndesmosis fixation system more effective than conventional screw fixation at improving return to work, pain, and patient-reported outcome measures? Summary of Key Findings: Five studies were selected to be critically appraised. The PEDro checklist was used to score 2 randomized control trials, and the Downs & Black checklist was used to score the cohort study on methodology and consistency. Two systematic reviews were also appraised. All 5 articles demonstrated support for using the TightRope™ fixation. Clinical Bottom Line: There is moderate evidence to support the use of the TightRope™ syndesmosis fixation system, as it provides both clinician- and patient-reported outcomes that are similar to those using the conventional metallic screw, with a shortened time to recover and return to activity. Strength of Recommendation: Grade A evidence exists in support of using the TightRope™ fixation system in place of the metallic screw following ankle syndesmosis injury.

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