Abstract
Background
Few studies have investigated return to play after surgical stabilization of syndesmotic injuries without fracture with minimal data on patient-reported outcome measures. The purpose of this study was to evaluate patient-reported outcomes, patient satisfaction, and return to play after surgical repair of syndesmosis injuries in competitive athletes.
Methods
A retrospective review of competitive athletes who underwent surgery for an unstable syndesmosis was performed. Patients were excluded if they were not competitive athletes or had the presence of a concomitant fracture. Patient-reported outcome measures were collected via telephone questionnaires. These included the Foot and Ankle Ability Measure (FAAM) Sports Subscale as well as 7 other questions regarding subjective assessment of function, patient satisfaction, and return to play.
Results
A total of 29 ankles in 28 competitive athletes were included. Twenty-four of 28 (86%) patients were male, and 4 of 28 (14%) patients were female. Average age at surgery was 20.7 ± 2.4 (15-24). Twenty-five of 28 (89.3%) athletes completed the post-operative telephone questionnaire with a mean follow-up of 41 months (minimum 9 months). In total, 100% of patients returned to athletic activity. Nineteen of 20 patients (95%) eligible to do so returned to competition, with 16 of 25 (64%) patients reporting a return to pre-injury level of function. The average FAAM-sports score was 29.6 (max 32) ± 3.5. Twenty-four of 25 patients reported post-operative function as normal or nearly normal. Twenty-four of 25 patients reported that they were either very satisfied or satisfied. Patient-reported time of return to unrestricted play was 19.9 ± 9.8 weeks. Injury grade, repair technique, acuity of injury, and concomitant injuries were not associated with prolonged return to play or decreased FAAM scores.
Conclusion
A high percentage of competitive athletes undergoing surgical treatment of syndesmosis injury were able to return to their previous level of competition, with nearly all achieving good-to-excellent outcome scores and satisfaction. Severity of injury, concomitant injury, or repair technique was not found to have an effect on outcomes.
Level of Evidence
IV, single-arm retrospective case series.
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