The ankle ligament reconstruction-return to sport after injury (ALR-RSI) is a valid and reproducible scale to quantify psychological readiness before returning to sport after ankle ligament reconstruction

Abstract

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.

The ALR-RSI score is a valid and reproducible scale to assess psychological readiness before returning to sport after modified Broström-Gould procedure

“…In particular, Webster et al [ 33 ] designed a scale of 12 items in patients following anterior cruciate ligament reconstruction (ACLR) to assess their psychological readiness to resume sports. This was followed by the development of numerous psychological assessment scales for return to sport after sport-related injuries, including shoulder instability (SIRSI) [ 8 ], hip arthroscopy with femoroacetabular impingement (FAI) syndrome (Hip-RSI) [ 35 ] or ankle ligament reconstruction (ALR-RSI) [ 28 ]. To date, no tool exists to analyze the psychological readiness after MBG procedure.…”

Translation and validation of the shoulder instability-return to sport after injury (SIRSI) score in French

“…Despite successful surgery and physical therapy, treatment fails in certain patients or their performance is poorer for no objective physical reason [ 18 ]. Indeed, patients must not only be physically ready but also psychologically prepared to return to sport after surgery [ 35 ].…”

“…Gerometta et al [ 24 ] reported that a patient’s psychological readiness should be taken into account in the decision to return to sport [ 2 ]. The SIRSI score, like the ACL-RSI [ 11 ], and the ALR-RSI for ankle instability [ 35 ], makes it possible to identify patients who will have psychological difficulty returning to their preinjury sport. Indeed, a significant difference was found in patients’ psychological readiness, quantified by the SIRSI.…”

“…Moreover, the SIRSI was developed as an adaptation of the ACL-RSI score. Nevertheless, the questions are not specific for a certain body joint, and can be easily applied to other joints involved in sports injuries [ 35 ].…”

“…Webster et al [ 43 ] developed the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) score to quantify the psychological readiness of athletes to return to sport following ACL reconstruction. This questionnaire was translated and validated into French [ 11 ], then other versions of the questionnaires were adapted, such as the Shoulder Instability-Return to Sport after Injury (SIRSI) for shoulder instability [ 23 ] and the Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI) for the ankle [ 35 ].…”