2015 ISAKOS Biennial Congress ePoster #109
Randomized Comparison of Tape Versus Semi-Rigid and Versus Lace-Up Ankle Support in the Treatment of Acute Lateral Ankle Ligament Injury
Robert Van De Kimmenade, Utrecht NETHERLANDS
Inger Sierevelt, Amsterdam NETHERLANDS
Karin Eggink, MD, Apeldoorn NETHERLANDS
Gino M. M. J. Kerkhoffs, MD, PhD, Prof., Amsterdam NETHERLANDS
C. Niek van Dijk, MD, PhD, Abcoude NETHERLANDS
Eric Raven, MD, Apeldoorn NETHERLANDS
Michel Van Den Bekerom, MD, Amsterdam NETHERLANDS
Department of Orthopaedic Surgery and Traumatology, Gelre Hospital, Apeldoorn, NETHERLANDS
FDA Status Cleared
Summary: There is no difference in outcome 6 months after treatment of acute lateral ankle ligament injury using a tape, semi rigid or a lace up brace
Functional treatment is the optimal non-surgical treatment for acute lateral ankle ligament injury in favour of immobilization treatment. According to the Cochrane Systematic Review concerning different functional treatment options (tape, semi-rigid brace, lace-up brace) for acute lateral ankle ligament injuries ‘there is no most effective treatment either clinically and in costs based on currently available randomised trials’. The objective of this study is to compare these three different functional treatments for acute lateral ankle ligament injuries with regard to clinical outcome and cost effectiveness.
This study is designed as a randomized controlled trial to evaluate the difference in functional outcome after treatment with tape versus semi-rigid versus lace-up ankle support (brace) for grade II and III acute lateral ankle ligament injuries.
One hundred and ninety-three patients (52% males) were randomised, 70 patients were treated with a tape, 60 patients with a semi rigid brace and 63 patients with a lace-up brace. There were no significant differences in any baseline characteristic between the 3 groups. Mean age of the patients was 37.3 years (35.1 – 39.5; SD 15.3). In 48 % of patients the right side was injured and in 52% of patients the left side was injured. Fifty-one percent of the patient had a Tegner score of 1, 24 % had a score of 2, and 25% had a higher Tegner score.
One hundred sixty-one (59 + 50 + 52) patients completed the study until final follow-up; 32% lost to follow-up. In 2 patients treated with tape support the treatment was changed to a semi rigid brace because of skin blisters. Except for the significant difference in Foot and Ankle Outcome Score sport between the Lace-up and the semi rigid brace, there are no differences in any of the outcome measures after 6 months follow-up. Karlsson score after six months was in the group treated with tape respectively 32.2, 32.6 in the semi-rigid and 40.0 in the lace-up brace.
Remarkable in this young aged patient group are the percentages of returning to sport to a normal level at six months, respectively 62% treated with tape, 52% with semi-rigid and 66% with lace-up brace.
The most important finding of current study was that there is no difference in outcome 6 months after treatment with a tape, semi rigid brace and a lace up brace. In all treatment groups patients had better functional results (Karlsson and FAOS) at follow-up compared to baseline.