[Influencing factors of return to sport after all-inside arthroscopic lateral collateral ligament repair for chronic ankle instability]

Abstract

Objective: To investigate the outcomes and factors influencing postoperative return-to-sport of patients with chronic ankle instability (CAI) underwent all-inside arthroscopic lateral collateral ligament repair. Methods: Patients with CAI treated at Huashan Hospital of Fudan University from January 2017 to August 2019 were retrospectively recruited. Preoperative and postoperative Tegner and Karlsson scores were evaluated and compared, and a multivariate Cox regression model was applied to explore factors influencing postoperative return to desired sports postoperatively. Results: A total of 81 patients with CAI treated by all-inside arthroscopic lateral collateral ligament repair were assessed, including 44 males and 37 females with a mean age of (32.7±9.9) years. Karlsson scores (M(Q₁, Q₃)) increased from 55.0 (40.0,65.0) preoperatively to 90.0 (85.0,95.0) postoperatively (P<0.01), while Tegner scores increased from 3.0 (1.0,4.0) preoperatively to 5.0 (4.0,6.0) postoperatively (P<0.01). Sixty patients returned to their desired sports with a median return-to-sport time of 9.0 months. Multivariate Cox regression analysis showed that higher age (HR=0.95, 95%CI: 0.92-0.99, P<0.01) and lower preinjury activity levels (HR=1.43, 95%CI: 1.10-1.85, P<0.01) were independent factors affecting postoperative return-to-sport. The one-year postoperative return-to-sport cutoff scores were 37 years old and a Tegner score of 4, respectively. Conclusions: The all-inside arthroscopic lateral collateral ligament repair procedure can achieve good short-term outcomes for patients with CAI, permitting a high incidence of postoperative return-to-sport. Higher age and lower pre-injury activity levels are independent factors hindering postoperative return-to-sport.