Journal List > Korean J Sports Med > v.38(1) > 1143516

Kim, Yu, and Chae: The Time of Return to Play after Surgery for Chronic Lateral Ankle Instability in Athletes: A Systematic Review

Abstract

Purpose

The study aimed to assess the average time to return to play following surgery for chronic lateral ankle instability in athletes.

Methods

A literature search was conducted (1976 to 2019) by two independent reviewers using the Medline, Embase, and Cochrane library databases. Articles were retrieved by an electronic search using individual keywords (“lateral ankle instability,” “surgery,” “operation,” “return to sport,” “return to play”) and their combinations. Studies that met the inclusion criteria were assessed for pertinent data.

Results

Six randomized controlled trials were included in this analysis. The mean follow-up period was 44.8 months (range, 31.8–58.1 months) in 219 patients (male, 126; female, 113). The mean age was 23.2 years (range, 18.2–28.2 years). Different criteria for returning to sports were used in each paper. In the papers included in this study, different methods and definitions were used for the postoperative recovery method for lateral ankle instability injury. The average time until return to play was 16.53 weeks.

Conclusion

There are limitations to the application of different surgical techniques and data from different athletes for chronic lateral ankle instability. However, these results suggest that sports physicians evaluate the surgical outcome and may be utilized as reference data for informing the athletes about their time until return.

References

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Fig. 1.
Flowchart of the literature selection.
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Fig. 2.
Type of sports.
kjsm-38-12f2.tif
Fig. 3.
Summarized results of the quality evaluation of the study literature using the risk of bias assessment tool for non-randomized study.
kjsm-38-12f3.tif
Fig. 4.
Forest plot illustrating time until return to play. CI: confidence interval.
kjsm-38-12f4.tif
Fig. 5.
Funnel plot illustrating time until return to play. CI: confidence interval.
kjsm-38-12f5.tif
Table 1.
Descriptions of included studies
Study No. of cases Age (yr) Sex Type of sports Method of surgery Definition of RTP1 Definition of RTP2 Definition of RTP3 Time to RTP 1 (wk) Time to RTP2 (wk) Time to RTP3 (wk)
Lee et al.17 18 Mean+SD, 19.3+3 Male, 11 female, 7 Soccer=8, tennis=1, artistic gymnastics=2, basketball=2, athletics=1, dance sports=1, vol leyball=3 Modified Bröstrom operation Personal training Team training First official game start Mean+SD, 8.1+5.1 Mean+SD, 12.4+4.3 Mean+SD, 16.7+6
Miyamoto et al.18 15 Mean+SD, 27.7+8.1 Male, 10 female, 5 Not provided Reconstruction of the anterior talofibular ligament with a gracilis autograft Not provided Not provided Return to their previous athletic activity Not provided Not provided Mean+SD, 18.5+3.5
Sperati and Ceri19 35 Mean, 31 Male, 12 female, 23 Not provided Hemi-casting ligamentoplasty Not provided Not provided To practice sport at the same level as before intervention Not provided Not provided Mean, 12.4
Kramer et al.20 43 Mean+SD, 19.7+4 Male, 9 female, 34 Soccer=14, basketball=6, dance=5, gym routine=3, swimming=3, figure skating=2, other=21 Chrisman-Snook procedure Not provided Not provided Return to the same level as before Not provided Not provided SD, 25.7
White et al.21 42 Mean, 22 Male, 37 female, 5 Soccer=25 rugby=9, hockey=2, tennis=2, cricket=2, netball=1, kitesurfer=1 Modified Bröstrom operation Return to training Return to full sport Not provided Mean, 9 Mean, 11 Not provided
Li et al.22 62 Mean, 19.6 Male, 30 female, 32 Not provided Gould-modified Bröstrom with suture anchors Proprioception and strength training Plyometric starting Start straight running and functional activities Mean, 7 Mean, 9 Mean, 11

RTP: return to play, SD: standard deviation.

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