Return to play after surgery for isolated unstable syndesmotic ankle injuries in 110 male professional football players

Transcription

1 Return to play after surgery for isolated unstable syndesmotic ankle injuries in 110 male professional football players D Hooghe P, Grassi A, Alkhelaifi K, Kaux JF, Baltes T, Zaffagnini S, Ekstrand J

2 Pieter D Hooghe MD Has no disclosure to the content of this presentation.

3 Introduction Current epidemiological data indicates a significant increase in the incidence of isolated syndesmotic ankle injuries in male professional football players. In this study, we looked at the actual time to return to play after surgery, especially in the isolated and unstable distal syndesmotic ankle injuries.

4 Methods 110 male professional football players were treated surgically at our institution after having sustained an isolated, unstable syndesmotic ankle injury (year ). We performed a longitudinal observational cohort study on all 110 male professional football players who have undergone surgical fixation for an isolated unstable syndesmotic injury of their ankle (year ).

5 Diagram Volker Musahl Jón Karlsson Werner Krutsch Bert R. Mandelbaum Pieter d Hooghe João Espregueira-Mendes Editors Return to Play in Football An Evidence-based Approach 1 23

6 Musahl Karlsson Krutsch Mandelbaum d Hooghe Espregueira-Mendes Eds. Results Orthopedics, Surgical Orthopedics & Sports Medicine ISBN Return to Play in Football In this book, leading experts employ an evidence-based approach to provide clear practical guidance on the important question of when and how to facilitate return to play after some of the most common injuries encountered in football. Detailed attention is paid to biomechanics, the female athlete, risk factors, injury prevention, current strategies and criteria for safe return to play, and future developments. Specific topics discussed in depth include concussion, anterior cruciate ligament and other knee injuries, back pathology, rotator cuff tears, shoulder instability, hip arthroscopy, and foot and ankle injuries. The chapter authors include renowned clinicians and scientists from across the world who work in the field of orthopaedics and sports medicine. Furthermore, experiences from team physicians involved in the Olympics, National Football League (NFL), Union of European Football Associations (UEFA), and Fédération Internationale de Football Association (FIFA) are shared with the reader. All who are involved in the care of injured footballers will find this book, published in cooperation with ESSKA, to be an invaluable, comprehensive, and up-to-date reference that casts light on a range of controversial issues. Volker Musahl Jón Karlsson Werner Krutsch Bert R. Mandelbaum Pieter d Hooghe João Espregueira-Mendes Editors Return to Play in Football An Evidence-based Approach 1 23

7 Musahl Karlsson Krutsch Mandelbaum d Hooghe Espregueira-Mendes Eds. Results Orthopedics, Surgical Orthopedics & Sports Medicine ISBN Return to Play in Football In this book, leading experts employ an evidence-based approach to provide clear practical guidance on the important question of when and how to facilitate return to play after some of the most common injuries encountered in football. Detailed attention is paid to biomechanics, the female athlete, risk factors, injury prevention, current strategies and criteria for safe return to play, and future developments. Specific topics discussed in depth include concussion, anterior cruciate ligament and other knee injuries, back pathology, rotator cuff tears, shoulder instability, hip arthroscopy, and foot and ankle injuries. The chapter authors include renowned clinicians and scientists from across the world who work in the field of orthopaedics and sports medicine. Furthermore, experiences from team physicians involved in the Olympics, National Football League (NFL), Union of European Football Associations (UEFA), and Fédération Internationale de Football Association (FIFA) are shared with the reader. All who are involved in the care of injured footballers will find this book, published in cooperation with ESSKA, to be an invaluable, comprehensive, and up-to-date reference that casts light on a range of controversial issues. Volker Musahl Jón Karlsson Werner Krutsch Bert R. Mandelbaum Pieter d Hooghe João Espregueira-Mendes Editors Return to Play in Football An Evidence-based Approach 1 23

8 Conclusion The majority of isolated, unstable syndesmotic injuries occurring during match-play were non-contact injuries (64%). Most of these injuries are Grade 2B (68%), while the rest are Grade 3. Ninety-five percent of injured players return to match-play within 6 months after surgery. Grade 3 syndesmotic injuries are 4 times more likely to involve cartilage injury than Grade 2B injuries. Consequently, Grade 2B injuries have a faster rehabilitation time, with return to exercise and return to match-play occurring sooner when compared to Grade 3 injuries. The predictors of return to sports in these players were found to depend on the presence of cartilage injury, the grade of the injury, and the age of the patient at the time of injury.

9 What are the new finding? 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 ankle injury. We also identified 3 specific injury characteristics (a grade III injury, a combined cartilage lesion and young age) as predictors for a delayed return to play in isolated unstable syndesmotic ankle injuries.

10 How can it impact our clinical practice? This study informs the football player with an unstable syndesmosis ankle injury on the expected postoperative time to return to play. It also presents 3 specific injury characteristics (a grade III injury, a combined cartilage lesion and young age) that can predict a prolonged rehabilitation time.

11 References Lubberts B et al. Epidemiology and return to play following isolated syndesmotic injuries in professional football players. Br J Sports Med 2017;21. pii: bjsports doi: /bjsports Hunt K et al. High Ankle Sprains and Syndesmotic Injuries in Athletes. J Am Acad Orthop Surg 2015;23: Calder J et al. Stable Versus Unstable Grade II High Ankle Sprains: A Prospective Study Predicting the Need for Surgical Stabilization and Time to Return to Sports. Arthroscopy 2016;32: