In arthroscopic ATFL suture surgery, patients who had talar and/or tibial plafond cartilage damage may have extended duration to return sports activity more than patients who had no talar cartilage damage, in spite of good clinical outcomes for patients with or without cartilage damage.
We perform to suture the anterior talofibular ligament (ATFL) with arthroscopy for old ATFL injury.
Purpose in this study was to investigation of the factors to affect the duration to return to sports activity after the surgery of arthroscopic ATFL suture for chronic ankle instability.
Ten patients (four males and six females), with an average age of 32 (range, 14–60) years, were included in this study. All patients were performed arthroscopic examination to evaluate the fibers of ATFL and intra-articular comorbidity, and then were performed ATFL suture by Lasso loop technique with two suture anchors which were inserted into the fibula. They were followed to over 6 months after surgery.
Japanese Society for Surgery of the Foot (JSSF) scale became postoperative mean 90 points from preoperative mean 61 points. The talar tilt angle (TTA) in varus stress radiography improved to postoperative 3.4 degrees (0-5 degrees) from preoperative 7.4 degrees (3-14 degrees). Anterior talar translation (ATT) in anterior drawer stress radiography improved to postoperative 4.0mm (2.0-6.0mm) from preoperative 6.4mm (4.5-8.5mm). Five patients with talar cartilage damage in arthroscopy required 4.6 months to start jogging after surgery, although five patients without talar cartilage damage required 2.2 months. In patients with talar and/or tibial plafond cartilage damage, there were three patients (60%) who could return to sports within a year. All of five patients without talar and/or tibial plafond cartilage damage could return to sports in averaged 3.4 months after surgery. Age, gender, body height, weight, degree of preoperative instability, and preoperative clinical score were not associated with the duration to start jogging and sports activity.
The clinical outcome of arthroscopic suture of ATFL was good. The duration to start sports activity in patients with talar cartilage damage may be extended more than patients without talar cartilage damage.