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Published on: October 28, 2022
Patient-reported evolution of the Cumberland Ankle Instability Tool after arthroscopic anatomic lateral ligament
Ibrahim Saliba1, Olivier Grimaud2, Vincent Fontanier3
1Orthopedic Surgery Department Necker hospital Paris France.
Purpose:
To describe the longitudinal evolution of the Cumberland Ankle Instability Tool (CAIT) after arthroscopic anatomic lateral ligament reconstruction (AALR) and examine associations between CAIT-defined patient-perceived stability, return to sport (RTS) and preoperative factors.
Methods:
This retrospective single-centre cohort included 134 athletic patients who underwent AALR between January 2019 and January 2023 and had at least 12 months of follow-up. CAIT was assessed preoperatively and at 3, 6 and 12 months. Patient-perceived stability was defined as CAIT ≥ 24. Repeated continuous and binary outcomes were assessed using paired-data methods. RTS was defined as self-reported resumption of sport by 12 months, irrespective of level.
Results:
Median CAIT increased from 8 preoperatively to 23, 26 and 28 at 3, 6 and 12 months, respectively (overall p < 0.001). CAIT-defined stability increased from 5/134 (3.7%) preoperatively to 55/134 (41.0%), 91/134 (67.9%) and 96/134 (71.6%) at 3, 6 and 12 months (overall p < 0.001). Most improvement occurred by 6 months. Overall, 112 patients (83.6%) reported RTS by 12 months. Higher CAIT at 3, 6 and 12 months was associated with RTS. In exploratory multivariable analysis, preoperative ankle ligament reconstruction-return to sport after injury was positively associated with 12-month CAIT-defined stability (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.00-1.04; p = 0.043), whereas nonpivot sport was negatively associated compared with pivot-contact sport (OR: 0.27, 95% CI: 0.09-0.75; p = 0.014). Four patients (3.0%) underwent fibular button removal.
Conclusion:
Patient-reported ankle function measured by CAIT improved during the first postoperative year after AALR, with the largest change occurring by 6 months. CAIT may complement, but should not replace, objective examination and multidimensional RTS assessment. The identified associations are exploratory and require prospective validation.
Level Of Evidence:
Level III.