title: Return to sport following acute lateral ligament repair of the ankle in professional athletes.
abstract: OBJECTIVE
  Recent literature supports early reconstruction of severe acute lateral ligament injuries in professional athletes, suggesting earlier rehabilitation and reduced recurrent instability incidence. Not previously reported, predicting the time to return to training and play is important to both athlete and club. We evaluate the effectiveness and complications of lateral ligament reconstruction in professional athletes. We aim to estimate the time to return to training and sports in both isolated injuries and patients with additional injuries.
  
  
  METHODS
  A consecutive series of 42 athletes underwent modified Broström repair for clinically and radiologically confirmed acute grade III lateral ligament injury. Of 42, 30 had isolated complete rupture of ATFL and CFL. Of 42, 12 had additional injuries (osteochondral lesions, deltoid ligament injuries). All patients received minimum of 2 years post-operative assessment.
  
  
  RESULTS
  The median return to training and sports for isolated injuries was 63 days (49-110) and 77 days (56-127), respectively. However, for concomitant injury results were 86 days (63-152) and 105 days (82-178). This delay was significant (p < 0.001). Despite no difference in pre- and post-op VAS scores between the groups, those with combined injuries had significantly lower FAOS pain and symptoms sub-scores post-operatively (p = 0.027, p < 0.001). Two superficial infections responded to oral antibiotics. No patient developed recurrent instability. All returned to their pre-injury level of professional sports.
  
  
  CONCLUSIONS
  Lateral ligament reconstruction is a safe and effective treatment for acute severe ruptures providing a stable ankle and expected return to sports at approximately 10 weeks. Despite return to the same level of competition, club and player should be aware that associated injuries may delay return and symptoms may continue. These results may act as a guide to predict the expected time to return to training and to sport after surgical repair of acute injuries and also the influence of associated injuries in prolonging rehabilitation.
  
  
  METHODS
  III.
authors.affiliation: Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK. wjameswhite@hotmail.com.
authors.forename: W James
authors.initials: WJ
authors.lastname: White
authors.affiliation: Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK.
authors.forename: Graham A
authors.initials: GA
authors.lastname: McCollum
authors.affiliation: Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK.|Fortius Clinic, 17 Fitzhardinge St, London, W1H 6EQ, UK.
authors.forename: James D F
authors.initials: JD
authors.lastname: Calder
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000601:surgery*; D001265:Athletic Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D017844:Lateral Ligament, Ankle / Q000293:injuries / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D000068958:Return to Sport; D055815:Young Adult
keywords: Acute; Ankle; Athlete; Broström; Lateral; Ligament; Professional; Repair