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. 2020 Oct;54(19):1168-1173.
doi: 10.1136/bjsports-2018-100298. Epub 2019 Aug 31.

Return to play after surgery for isolated unstable syndesmotic ankle injuries (West Point grade IIB and III) in 110 male professional football players: a retrospective cohort study

Pieter D'Hooghe  1 , Alberto Grassi  2 , Khalid Alkhelaifi  3 , James Calder  4 , Thomas P A Baltes  5   6   7 , Stefano Zaffagnini  2 , Jan Ekstrand  3
Affiliations

Return to play after surgery for isolated unstable syndesmotic ankle injuries (West Point grade IIB and III) in 110 male professional football players: a retrospective cohort study

Pieter D'Hooghe et al. Br J Sports Med. 2020 Oct.

Abstract

Objectives: To evaluate time to return to play following surgical stabilisation of isolated unstable syndesmosis injuries in a cohort of professional male football players.

Methods: All professional football players undergoing surgery for isolated unstable syndesmosis injury (West Point grade ≥IIB) at a specialised Orthopaedic and Sports Medicine Hospital were followed up until return to play (minimum ≥6 months). Players with a stable syndesmosis, injuries older than 6 weeks, concomitant medial or lateral malleolar fracture or previous ankle surgery were excluded. During rehabilitation, time required to return to sports-specific rehabilitation, team training and first match play, were recorded.

Results: Between January 2012 and December 2017, a total of 110 male professional football players were included. The mean time required to begin on field rehabilitation was 37±12 days, while the mean time to return to team training was 72±28 days. The first official match was played on average 103±28 days postoperatively. Multivariable analysis revealed that the severity of injury, the concomitant presence of talar cartilage injury and the age of the player were significantly associated (p<0.00001) with time to return to on field rehabilitation, team training and match play.

Conclusion: In this cohort of professional football players, surgical stabilisation of isolated unstable syndesmosis injuries (West Point grade ≥IIB) allowed for relatively quick return to play. High grade injury (West Point grade III), concomitant cartilage injury and greater age were associated with longer return to play times.

Level of evidence: Longitudinal observational cohort study (level II).

Keywords: high ankle sprain; professional football player; return to play; syndesmosis; syndesmotic rupture.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Graphic anatomical image of the three syndesmotic ankle ligaments. AITFL, anterior inferior tibiofibular ligament; IOL, interosseous ligament; PITFL, posterior inferior tibiofibular ligament.
Figure 2
Figure 2
Selection algorithm to decide on inclusion in the study.
Figure 3
Figure 3
Graphic image on the time towards return to on field rehabilitation, training with team and first match.
Figure 4
Figure 4
Graphic image on the specific characteristics of return to sports (overall, grade IIB, grade III).
See this image and copyright information in PMC

References

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