Summary

This study establishes the time required to start with on field rehabilitation, team training and match play in professional football players that were surgically treated for acute isolated unstable syndesmosis injury.

Abstract

Background

Stabilization of the distal tibiofibular joint is rapidly becoming the mainstay of treatment for acute unstable isolated syndesmotic injuries in elite athletes. Return to play outcome data for surgical treatment is essential to counsel professional football players and their supportive medical staff.

Purpose

To establish the time required to begin on field rehabilitation; team training and match play in professional football players surgically treated for acute isolated unstable syndesmosis injury.

Methods

In this retrospective cohort study we evaluated a series of 110 male professional football players, surgically treated for unstable syndesmosis injury at our institution between January 2012 and December 2017. Professional football players who sustained an acute (=6 weeks) MRI-confirmed unstable syndesmosis injury (Westpoint =IIB) with a post-operative follow-up of > 6 months were included in this study. Patients were excluded if they had previously undergone ankle surgery or if the syndesmotic injury was associated with an ankle fracture. A multi-variate analysis was performed to determine predictors of a prolonged rehabilitation.

Results

A total of 110 male professional football players with a mean age at surgery of 24.9 ± 4.0 years were included in this study. Return to play data was available for all patients (100%). The mean time required to begin sport-specific rehabilitation was 37 ± 12 days, the time to return to team training was 72 ± 28 days and the first official match was played on average after 103 ± 28 days, with ninety-five percent of injured players returning to matchplay within 6 months after surgery. Injury severity (Westpoint grade IIB vs. III), the presence of concomitant cartilage injury and the age at time of surgery were found to be predictive of a prolonged rehabilitation.

Conclusion

In our cohort or professional football players, surgical stabilization of acute isolated unstable syndesmosis injury allowed for relatively quick return to field rehabilitation; team training and match play. We also identified that injury severity, concomitant cartilage injury and the age at time of surgery are predictive of a prolonged rehabilitation.