One in Five Patients Returns to Sport Before Assessment: Real-World Use of the Ankle-GO Composite Score in 6934...

Background: The Ankle-GO is a composite score integrating physical, functional, and psychological recovery after lateral ankle sprain (LAS). Its psychometric properties have been validated prospectively, but no large-scale data describe how it is used in routine practice. We aimed to characterise real-world usage patterns, score distributions, and the gap between intended and actual clinical use. Methods: Retrospective observational analysis of all Ankle-GO web-application sessions recorded between 1 February and 31 December 2024. Patients with at least one valid session and a single injured ankle were included. Quantitative variables were summarised as mean (SD) or median (IQR); proportions are reported with 95% Wilson confidence intervals (CIs). No inferential testing was performed. Results: Of 8988 registered patients, 6934 (77.1%) were analysed; 88.5% were assessed after ankle sprain (mean age 26.0 ± 10.0 years; 92.5% in France). Only 14.0% of sessions were follow-ups. Injured-ankle scores were consistently lower than contralateral scores and improved modestly across sessions. Notably, 20.4% (95% CI 19.4-21.4) of patients had already returned to sport before their first assessment. Conclusions: Real-world Ankle-GO implementation diverges substantially from its intended prospective use, defining clear priorities for future standardised, outcome-driven studies.