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Clinical outcomes of concurrent surgery with weight bearing after modified lasso-loop stitch arthroscopic ankle stabilization

  • ANKLE
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To determine the effects of unilateral and bilateral ankle stabilization surgery with or without additional concurrent procedures for other pathologies on return to activity in patients who were allowed unrestricted weight bearing postoperatively.

Methods

Ninety-three athletes underwent 120 ankle stabilization surgeries including 27 that underwent bilateral simultaneous surgery using the all-inside arthroscopy-modified lasso-loop technique and were divided into two groups: arthroscopic ligament repair alone without concurrent procedures (group A) and with simultaneous procedures for other pathologies (group B). Group A was further subdivided into unilateral (group A1) and simultaneous bilateral ankle surgery (group A2), and group B into ankle stabilization surgery with simultaneous procedures not requiring weight bearing postoperatively (Group B1) and with concurrent procedures allowing weight bearing (Group B2). Return to activity postoperatively was assessed by recording the time to walk without any support, jog, and return to full athletic activities. Clinical outcomes were assessed preoperatively and 12 months postoperatively using a subjective clinical score.

Results

The average time between surgery and unsupported walk, jog, and return to full athletic activities was 1.6 ± 2.5, 16.9 ± 3.7, and 42.4 ± 19.3 days in group A, 17.2 ± 19.6, 34.5 ± 20.8, and 60.9 ± 22.8 days in group B, 1.7 ± 2.9, 16.1 ± 2.4, and 41.6 ± 18.2 days in group A1, 1.3 ± 0.6, 18.9 ± 5.5, and 44.6 ± 22.5 days in group A2, 25.3 ± 20.2, 43.3 ± 21.1, and 70.7 ± 23.1 days in group B1, and 4.8 ± 11.7, 20.7 ± 11.7, and 45.0 ± 13.7 days in group B2, respectively. These results indicate that the patients in group B2 showed a statistically significant faster time to return to activity than did those restricted from weight bearing. Differences in ankle stabilization alone between patients in groups A1 and A2 as well as groups B2 and A were not statistically significant. Clinical outcomes were similar for patients in groups B2 and A1 versus group A2.

Conclusion

Time to return to activity and clinical outcomes after ankle stabilization surgery using the modified lasso-loop technique were negatively affected if simultaneous bilateral surgery or simultaneous concurrent procedures were added or if weight bearing was unrestricted. However, a delay in return to athletic activity was observed when ankle stabilization surgery was performed using the modified lasso-loop technique with concurrent procedures that require non-weight bearing postoperatively.

Level of evidence

Level III.

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Acknowledgements

The authors acknowledge the statistical advice and assistance of Dr. Masao Iwagami.

Ankle Instability Group

Jorge Acevedo, Jorge Batista, Thomas Bauer, James Calder, Nuno Corte-Real, Christopher DiGiovanni, Eric Giza, Mark Glazebrook, Stéphane Guillo, Siu Wah Kong, Peter G. Mangone, Kentaro Matsui, Frederick Michels, Caio Nery, Xavier M. Oliva, Satoru Ozeki, Christopher Pearce, Anthony Perera, Hélder Pereira, Bas Pinenburg, Fernando Raduan, James W. Stone, Masato Takao, Yves Tourné, Jordi Vega, Jin Woo Lee, Hua Yinghui.

Funding

All authors have no financial relationships relevant to this article to disclose.

Author information

Authors and Affiliations

  1. Clinical and Research Institute for Foot and Ankle Surgery, 341-1, Mangoku, Kisarazu, Chiba, 292-0003, Japan

    Masato Takao, Ryota Inokuchi, Yasuyuki Jujo, Kosui Iwashita, Kazuaki Okugura, Yukinori Mori, Keisuke Hayashi & Kenta Komesu

  2. Department of Health Services Research, Faculty of Medicine, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba, Ibaraki, Japan

    Ryota Inokuchi

  3. Division of Orthopaedic Surgery, Queen Elizabeth II Health Sciences Center Halifax Infirmary (Suite 4867), Dalhousie University, 1796 Summer Street 902 473-7137, Halifax, NS, B3H3A7, Canada

    Mark Glazebrook

Authors
  1. Masato Takao
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  2. Ryota Inokuchi
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  3. Yasuyuki Jujo
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  4. Kosui Iwashita
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  5. Kazuaki Okugura
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  6. Yukinori Mori
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  7. Keisuke Hayashi
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  8. Kenta Komesu
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  9. Mark Glazebrook
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Consortia

Ankle Instability Group

  • Jorge Acevedo
  • , Jorge Batista
  • , Thomas Bauer
  • , James Calder
  • , Nuno Corte-Real
  • , Christopher DiGiovanni
  • , Eric Giza
  • , Mark Glazebrook
  • , Stéphane Guillo
  • , Siu Wah Kong
  • , Peter G Mangone
  • , Kentaro Matsui
  • , Frederick Michels
  • , Caio Nery
  • , Xavier M. Oliva
  • , Satoru Ozeki
  • , Christopher Pearce
  • , Anthony Perera
  • , Hélder Pereira
  • , Bas Pinenburg
  • , Fernando Raduan
  • , James W. Stone
  • , Masato Takao
  • , Yves Tourné
  • , Jordi Vega
  • , Jin Woo Lee
  •  & Hua Yinghui

Contributions

MT was the principal investigator and was involved with study design, recruitment, analysis and manuscript write up. RI, YJ, KI, KO, YM, KH, KK and MG were involved with the study design, analysis and manuscript preparation. All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Masato Takao.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethics Committee of the Japan Medical Association (approved number: R1-6).

Informed consent

All patients provided written informed consent to participate in this study.

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The members of “Ankle Instability Group” are listed in acknowledgements.

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Takao, M., Inokuchi, R., Jujo, Y. et al. Clinical outcomes of concurrent surgery with weight bearing after modified lasso-loop stitch arthroscopic ankle stabilization. Knee Surg Sports Traumatol Arthrosc 29, 2006–2014 (2021). https://doi.org/10.1007/s00167-020-06264-2

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  • DOI: https://doi.org/10.1007/s00167-020-06264-2

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