Use of Ankle-GO to Assess and Predict Return to Sport After Lateral Ankle Reconstruction for Chronic Ankle Instability.

IF 2.4 3区 医学 Q2 ORTHOPEDICS
Orthopaedic Journal of Sports Medicine Pub Date : 2025-03-21 eCollection Date: 2025-03-01 DOI:10.1177/23259671251322903
Alexandre Hardy, Kinan Freiha, Mohamad K Moussa, Eugénie Valentin, Gauthier Rauline, Kylian Alvino, Francois Fourchet, Brice Picot, Ronny Lopes
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引用次数: 0

Abstract

Background: Chronic ankle instability (CAI) develops in 20% to 40% of patients after ankle sprains because of inappropriate management or a premature return to sports (RTS). Patients become candidates for surgery when nonoperative treatment fails. The results of arthroscopic lateral ligament reconstruction have been shown to be excellent. However, there is no consensus on the RTS criteria in these cases. The Ankle-GO score, which has been validated in lateral ankle sprains, is an evidence-based protocol for RTS.

Purpose: To evaluate the discriminant and predictive capacity of the Ankle-GO score for RTS after arthroscopic lateral ankle reconstruction.

Study design: Cohort study. Level of evidence, 2.

Methods: This prospective multicenter cohort study, conducted between January 2022 and January 2023, evaluated patients with CAI who underwent arthroscopic anatomic lateral ankle ligament reconstruction using gracilis tendon autografts or allografts. The RTS rates at 4 and 6 months postoperatively were the primary and secondary outcomes, respectively. The evaluated variable at both timelines was the Ankle-GO score-a composite of 4 functional tests and 3 questionnaires. The study determined the discriminant validity of the Ankle-GO score for RTS at each timeline-Ankle-GO scores at 4 months for RTS at 4 months; Ankle-GO scores at 6 months for RTS at 6 months. The predictive capacity of the Ankle-GO score at 4 months for RTS at 6 months was also evaluated.

Results: A total of 51 patients, with a mean age of 32.8 years, were included, of whom 23 (45%) had returned to sports at 4 months and 39 (76.5%) at 6 months. The mean Ankle-GO score was significantly higher in the group that returned to sports than in the group that did not (12 ± 4.7 vs 8.8 ± 4.7 at 4 months, respectively, P = .003; 16.8 ± 3.6 vs 11.3 ± 4.8 at 6 months, respectively, P = .002).The predictive capacity of the Ankle-GO score at 4 months for RTS at 6 months was good, with an area under the curve of 0.74 (95% CI, 0.58-0.90; P = .005). The optimal threshold was 6 (sensitivity, 95%; specificity, 50%). The odds ratio of RTS when surpassing the Ankle-GO cutoff score was 18.5 (95% CI, 3-113.95; P = .002).

Conclusion: The Ankle-GO score is effective in discriminating the RTS status at 4 and 6 months after lateral ligament reconstruction of the ankle. In addition, the Ankle-GO score at 4 months was also moderately predictive of RTS at 6 months after surgery.

使用踝关节go评估和预测慢性踝关节不稳定的外侧踝关节重建后的运动恢复。
背景:踝关节扭伤后,由于治疗不当或过早恢复运动(RTS), 20%至40%的患者会出现慢性踝关节不稳定(CAI)。当非手术治疗失败时,患者成为手术的候选者。关节镜下外侧韧带重建的结果是非常好的。然而,在这些情况下,对RTS标准没有共识。踝关节go评分已在踝关节外侧扭伤中得到验证,是一种基于证据的RTS治疗方案。目的:评价踝关节镜下外侧踝关节重建后踝关节go评分对RTS的判别和预测能力。研究设计:队列研究。证据等级2。方法:这项前瞻性多中心队列研究于2022年1月至2023年1月进行,评估了采用自体股薄肌腱或同种异体肌腱进行关节镜解剖踝关节外侧韧带重建的CAI患者。术后4个月和6个月的RTS率分别为主要和次要结果。在两个时间线上评估的变量是踝关节go评分-一个由4个功能测试和3个问卷组成的组合。该研究确定了RTS在每个时间线的脚踝- go评分的判别效度——RTS在4个月时的脚踝- go评分;RTS在6个月时的踝关节go评分。还评估了4个月时踝关节go评分对6个月时RTS的预测能力。结果:共纳入51例患者,平均年龄32.8岁,其中23例(45%)在4个月时恢复运动,39例(76.5%)在6个月时恢复运动。4个月时,恢复运动组的平均踝关节go评分显著高于未恢复运动组(12±4.7 vs 8.8±4.7),P = 0.003;6个月时分别为16.8±3.6 vs 11.3±4.8,P = 0.002)。4个月时踝关节go评分对6个月时RTS的预测能力良好,曲线下面积为0.74 (95% CI, 0.58-0.90;P = .005)。最佳阈值为6(灵敏度为95%;特异性,50%)。超过踝部- go临界值时RTS的比值比为18.5 (95% CI, 3-113.95;P = .002)。结论:踝关节外侧韧带重建后4个月和6个月,踝部go评分可有效区分RTS状态。此外,4个月时的Ankle-GO评分也可中度预测术后6个月时的RTS。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Orthopaedic Journal of Sports Medicine
Orthopaedic Journal of Sports Medicine Medicine-Orthopedics and Sports Medicine
CiteScore
4.30
自引率
7.70%
发文量
876
审稿时长
12 weeks
期刊介绍: The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty. Topics include original research in the areas of: -Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries -Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot) -Relevant translational research -Sports traumatology/epidemiology -Knee and shoulder arthroplasty The OJSM also publishes relevant systematic reviews and meta-analyses. This journal is a member of the Committee on Publication Ethics (COPE).
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