Department of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Engineering Research Center of Sports Trauma Treatment Technology and Devices of Ministry of Education, Beijing, China.
Am J Sports Med. 2024 Feb;52(2):555-566. doi: 10.1177/03635465231170699. Epub 2023 May 30.
BACKGROUND: Chronic lateral ankle instability that develops after ankle sprains has a severe, negative influence on the patient's lower extremity function. Anatomic repair or reconstruction of the lateral ankle ligament is an effective treatment for people with chronic lateral ankle instability who want to regain their preinjury levels of work and sport. PURPOSE: To determine the rate of return to sport (RTS) and related factors after anatomic lateral ankle stabilization (ALAS) surgery. STUDY DESIGN: Systematic review and meta-analysis; Level of evidence, 4. METHODS: Electronic databases including Medline, Embase, the Cochrane Library, and EBSCO Rehabilitation & Sports Medicine Source were searched from the earliest feasible entrance until August 2021. Articles reporting the number of patients who returned to sport after ALAS surgery and analyzing the relevant factors were included. The results were combined using proportion meta-analyses. RESULTS: A total of 25 publications were reviewed, with a total of 1384 participants. Results showed that 95% of patients (95% CI, 91%-99%) returned to any sport, 83% (95% CI, 73%-91%) returned to their preinjury level of sport, and 87% (95% CI, 71%-98%) returned to competitive sport after surgery. The mean time to RTS was 12.45 weeks (95% CI, 10.8-14.1 weeks). Each decade of age increased the likelihood of RTS failure by 6%, and increases in body mass index (BMI) of 5 kg/m raised the risk of RTS failure by 4%. The rate of RTS was higher in professional and competitive athletes (93%; 95% CI, 73%-100%) than in recreational athletes (83%; 95% CI, 76%-89%). Analysis showed no differences for arthroscopy versus open surgery, repair versus reconstruction, and early versus late weightbearing. CONCLUSION: In most cases, patients may return to some kind of sport after ALAS surgery, and some patients RTS at their preinjury level. The relative risk of RTS failure increases according to the magnitude of the increase in age and BMI. Elite athletes are more likely to return compared with nonelite athletes.
背景：踝关节扭伤后出现的慢性外侧踝关节不稳定对患者下肢功能有严重的负面影响。外侧踝关节韧带解剖修复或重建是治疗慢性外侧踝关节不稳定患者、使其恢复受伤前工作和运动水平的有效方法。
目的：确定解剖外侧踝关节稳定术（ALAS）后重返运动（RTS）的比率及其相关因素。
研究设计：系统回顾和荟萃分析；证据水平，4 级。
方法：从最早可行的检索入口开始，电子数据库包括 Medline、Embase、Cochrane 图书馆和 EBSCO 康复与运动医学资源，检索截至 2021 年 8 月。纳入报告 ALAS 手术后重返运动患者数量并分析相关因素的文章。使用比例荟萃分析合并结果。
结果：共综述了 25 篇文献，共纳入 1384 名参与者。结果显示，95%（95% CI，91%-99%）的患者重返任何运动，83%（95% CI，73%-91%）重返受伤前的运动水平，87%（95% CI，71%-98%）重返竞技运动。RTS 的平均时间为 12.45 周（95% CI，10.8-14.1 周）。每增加 10 岁，RTS 失败的可能性增加 6%，BMI 增加 5kg/m2，RTS 失败的风险增加 4%。专业和竞技运动员的 RTS 率较高（93%；95% CI，73%-100%），而非休闲运动员（83%；95% CI，76%-89%）。分析显示关节镜与开放手术、修复与重建以及早期与晚期负重之间无差异。
结论：在大多数情况下，患者在 ALAS 手术后可能会恢复某种运动，有些患者可恢复到受伤前的运动水平。RTS 失败的相对风险随年龄和 BMI 增加幅度的增加而增加。与非精英运动员相比，精英运动员更有可能重返运动。
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