Are Prospective Criteria or Objective Clinical Measures Utilized in Return to Play (RTP) Decision Making After Ankle...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Rehabilitation Science

Background:

• Return to play (RTP) following ankle surgery lacks clear definitions and consistent determination methods.
• Physically active patients undergoing ankle surgery face uncertainty regarding RTP criteria.
• Existing literature on RTP after ankle surgery is common but lacks standardization.

Purpose of the Study:

• To clarify the definition of RTP after ankle surgery in active patients.
• To identify key factors, including objective clinical measures, that inform RTP decision-making.
• To provide recommendations for future research in this area.

Main Methods:

• A scoping literature review was conducted in April 2021.
• Searches included PubMed, EMBASE, and Nursing and Allied Health databases.
• Thirty studies reporting objective clinical tests and RTP documentation after ankle surgery were included.

Main Results:

• The review covered five ankle pathologies: Achilles tendon rupture, chronic lateral ankle instability, anterior ankle impingement, peroneal tendon dislocation, and ankle fracture.
• RTP criteria were absent in most studies (18/30); when provided, they were often time-based (8/12) rather than validated.
• Objective clinical and patient-reported outcome measures (PROMs) were documented, typically over one year post-surgery.

Conclusions:

• RTP after ankle surgery in active patients is largely undefined and not consistently based on objective criteria or PROMs.
• Standardization of RTP terminology is recommended.
• Adoption of prospective criteria for clinical measures and PROMs is advised to guide RTP decisions and enhance patient safety.