Postoperative rehabilitation practices and procedures following arthroscopic ankle lateral ligament repair in France.

Abstract

The purpose was to compare the rehabilitation practices and procedures following arthroscopic ankle lateral ligament repair (ALLR) (reconstruction/Broström repair) among high-volume and low-volume surgeons in France. The hypothesis was that there would be no differences in practices and procedures between high-volume and low-volume surgeons. In 2023, an online questionnaire was emailed to members of the francophone arthroscopy society (SFA). Fifty-two surgeons responded, of which 10 (19.2%) were excluded as they did not perform arthroscopic ALLR. The questionnaire focused on four main topics: (i) surgeon experience and technique, (ii) immobilisation, (iii) weight-bearing, and (iv) cryotherapy. Surgeons were divided into high- (≥35 cases/year) and low-volume (<35 cases/year) surgeons, according to the number of ankle arthroscopies performed. A greater proportion of high-volume surgeons prescribe less restrictive immobilisation compared to low-volume surgeons (46% vs 22%). A smaller proportion of high-volume surgeons restrict immediate weight-bearing compared to low-volume surgeons (8% vs 33%). A greater proportion of high-volume surgeons would prescribe crutches only if patients request them, compared to low-volume surgeons (79% vs 50%). A greater proportion of high-volume surgeons prescribe cryotherapy compared to low-volume surgeons, more frequently (87% vs 78%) and immediately following surgery (46% vs 22%). This survey revealed that high-volume surgeons prescribe less restrictive immobilisation and allow earlier weight-bearing following arthroscopic ALLR, compared to low-volume surgeons. The clinical relevance is that low-volume surgeons should gain greater confidence in prescribing less restrictive immobilisation and immediate weight-bearing, based on experience of high-volume peers, which could help improve outcomes of arthroscopic ALLR and reduce healthcare and economic burdens.