Return to sport following lateral ligament repair of the ankle in professional athletes

J. Calder, G. McCollum, J. White

Background: Lateral ligament injuries of the ankle account for up to 50% of all sporting injuries. Recent literature has supported early reconstruction of severe acute lateral ligament injuries in professional athletes suggesting that it may allow earlier rehabilitation whilst reducing the incidence of recurrent instability. The results of acute lateral ligament reconstruction in respect to return to sport in professional athletes has not been previously reported.

Methods: A consecutive series of professional athletes were treated operatively for clinically and radiologically confirmed grade III lateral ligament injury. All patients were assessed at a minimum of 2 years post surgery.

Results: 33 ankles in 33 athletes underwent anatomical reconstruction (modified Brostrum repair) for acute lateral ligament injury. 22/33 had isolated complete rupture to ATFL and CFL whilst 11/33 had additional injuries - three OCL, six deltoid ligament injuries, a syndesmosis injury and a combined deltoid ligament injury with OCL. The mean time to return to training and sports for those with an isolated lateral ligament injury was 58 days (range 49-110) and 72 days (range 56-127) respectively. However, for those with a concomitant injury the time to return to training and sports 98 days (63-152) and 116 days (82-178) days respectively. This delay was significant (p< 0.01). No patient developed recurrent instability of the ankle and all returned to their pre-injury level of professional sports.

Conclusions: Lateral ligament reconstruction is a safe and effective treatment for acute severe lateral ligament ruptures providing a stable ankle and an expected return to sports at about 10 weeks. Associated ankle injuries may allow the athlete to return to the same level of competition but the club and player need to know that timing of return may be delayed.