Patient Reported and Functional Outcomes for Revision Lateral Ankle Ligament Reconstruction

CATEGORY: Sports; Ankle INTRODUCTION/PURPOSE: Despite multiple surgical treatment options for revision lateral ankle ligament reconstruction surgery, few studies describe the functional or patient reported outcomes. The purpose of this study is to describe the patient reported and functional outcomes for patient who required revision lateral ankle ligament reconstruction. METHODS: We present follow-up of 26 patients who underwent revision lateral ankle ligament reconstruction between January 2010 and December 2019 at a single institution. Clinical notes and operative reports were reviewed to determine surgical techniques. Patient reported outcomes were completed using the Foot and Ankle Outcome Score (FAOS), Visual Analog Scale Pain, Visual Analog Scale for Ankle Instability, and Visual Analog Scale for Satisfaction. Functional outcome was evaluated with the hop test. Ankle stability was evaluated on physical exam with anterior drawer and inversion stress test. RESULTS: Initial ligament reconstruction consisted of Brostrom (n=15), Brostrom Evans (n=3), Allograft (n=2) and Unknown (n=6). Revision lateral ligament reconstruction consisted of Brostrom (n=15), Brostrom Evans (n=2) and Allograft (n=9). Median follow up time after revision was 22 months. At last follow up, 20 patients (76.9%) had grade 0 inversion stress and anterior drawer test indicating stability. Median FAOS ADL sub score was 97 and median FAOS Symptom sub score was 79. Median VAS Pain was 3, median VAS Instability was 3 and median VAS satisfaction was 9.5. The single-leg hop test (Limb Symmetry Index %) was completed by 18 patients, with median score of 86.4% compared to their non-operative extremity. Six patients had persistent pain, three of which required additional surgery. CONCLUSION: The high majority of patients that require revision lateral ankle ligament reconstruction maintain a stable ankle on exam and are satisfied with their surgical results. Functional outcomes are similar but not symmetrical to their non-operative extremity.