Clinical and Research Institute for Foot and Ankle Surgery, 341-1, Mangoku, Kisarazu, Chiba, 292-0003, Japan.
Department of Health Services Research, Faculty of Medicine, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba, Ibaraki, Japan.
Knee Surg Sports Traumatol Arthrosc. 2021 Jun;29(6):2006-2014. doi: 10.1007/s00167-020-06264-2. Epub 2020 Sep 15.
To determine the effects of unilateral and bilateral ankle stabilization surgery with or without additional concurrent procedures for other pathologies on return to activity in patients who were allowed unrestricted weight bearing postoperatively.
Ninety-three athletes underwent 120 ankle stabilization surgeries including 27 that underwent bilateral simultaneous surgery using the all-inside arthroscopy-modified lasso-loop technique and were divided into two groups: arthroscopic ligament repair alone without concurrent procedures (group A) and with simultaneous procedures for other pathologies (group B). Group A was further subdivided into unilateral (group A1) and simultaneous bilateral ankle surgery (group A2), and group B into ankle stabilization surgery with simultaneous procedures not requiring weight bearing postoperatively (Group B1) and with concurrent procedures allowing weight bearing (Group B2). Return to activity postoperatively was assessed by recording the time to walk without any support, jog, and return to full athletic activities. Clinical outcomes were assessed preoperatively and 12 months postoperatively using a subjective clinical score.
The average time between surgery and unsupported walk, jog, and return to full athletic activities was 1.6 ± 2.5, 16.9 ± 3.7, and 42.4 ± 19.3 days in group A, 17.2 ± 19.6, 34.5 ± 20.8, and 60.9 ± 22.8 days in group B, 1.7 ± 2.9, 16.1 ± 2.4, and 41.6 ± 18.2 days in group A1, 1.3 ± 0.6, 18.9 ± 5.5, and 44.6 ± 22.5 days in group A2, 25.3 ± 20.2, 43.3 ± 21.1, and 70.7 ± 23.1 days in group B1, and 4.8 ± 11.7, 20.7 ± 11.7, and 45.0 ± 13.7 days in group B2, respectively. These results indicate that the patients in group B2 showed a statistically significant faster time to return to activity than did those restricted from weight bearing. Differences in ankle stabilization alone between patients in groups A1 and A2 as well as groups B2 and A were not statistically significant. Clinical outcomes were similar for patients in groups B2 and A1 versus group A2.
Time to return to activity and clinical outcomes after ankle stabilization surgery using the modified lasso-loop technique were negatively affected if simultaneous bilateral surgery or simultaneous concurrent procedures were added or if weight bearing was unrestricted. However, a delay in return to athletic activity was observed when ankle stabilization surgery was performed using the modified lasso-loop technique with concurrent procedures that require non-weight bearing postoperatively.
Level III.
确定单侧和双侧踝关节稳定手术是否有或没有其他病理的同时进行的附加手术，对允许术后不受限制负重的患者重返活动的影响。
93 名运动员接受了 120 次踝关节稳定手术，其中 27 次采用全关节镜改良套索环技术进行双侧同时手术，分为两组：单纯关节镜下韧带修复而无同时进行的其他病理手术（A 组）和同时进行其他病理手术（B 组）。A 组进一步分为单侧（A1 组）和同时双侧踝关节手术（A2 组），B 组分为同时进行不需要术后负重的踝关节稳定手术（B1 组）和同时进行允许负重的手术（B2 组）。术后通过记录无任何支撑物行走、慢跑和恢复全运动活动的时间来评估重返活动情况。术前和术后 12 个月使用主观临床评分评估临床结果。
A 组无支撑物行走、慢跑和恢复全运动活动的平均时间分别为 1.6±2.5、16.9±3.7 和 42.4±19.3 天，B 组分别为 17.2±19.6、34.5±20.8 和 60.9±22.8 天，A1 组分别为 1.7±2.9、16.1±2.4 和 41.6±18.2 天，A2 组分别为 1.3±0.6、18.9±5.5 和 44.6±22.5 天，B1 组分别为 25.3±20.2、43.3±21.1 和 70.7±23.1 天，B2 组分别为 4.8±11.7、20.7±11.7 和 45.0±13.7 天。这些结果表明，与限制负重的患者相比，B2 组患者的活动恢复时间明显更快。A1 组和 A2 组以及 B2 组和 A 组之间单纯踝关节稳定的患者之间的差异无统计学意义。B2 组和 A1 组的患者的临床结果与 A2 组相似。
采用改良套索环技术进行踝关节稳定手术后，如果同时进行双侧手术或同时进行其他附加手术，或者允许不受限制负重，活动恢复时间和临床结果都会受到负面影响。然而，当采用改良套索环技术进行同时需要术后非负重的手术时，观察到运动员重返活动的时间延迟。
III 级。
