Postoperative rehabilitation practices and procedures following ankle arthroscopy in France.

Abstract

The purpose was to compare the rehabilitation practices and procedures following arthroscopic ankle lateral ligament repair (ALLR) (reconstruction/Broström repair) among high-volume and low-volume surgeons in France. The hypothesis was that there would be no differences in practices and procedures between high-volume and low-volume surgeons. In 2023, an online questionnaire was emailed to members of the francophone arthroscopy society (SFA). Fifty-two surgeons responded, of which 10 (19.2%) were excluded as they did not perform arthroscopic ALLR. The questionnaire focused on four main topics: (i) surgeon experience and technique, (ii) immobilisation, (iii) weight-bearing, and (iv) cryotherapy. Surgeons were divided into high- (≥35 cases/year) and low-volume (<35 cases/year) surgeons, according to the number of ankle arthroscopies performed. A greater proportion of high-volume surgeons prescribe less restrictive immobilisation compared to low-volume surgeons (46% vs 22%). A smaller proportion of high-volume surgeons restrict immediate weight-bearing compared to low-volume surgeons (8% vs 33%). A greater proportion of high-volume surgeons would prescribe crutches only if patients request them, compared to low-volume surgeons (79% vs 50%). A greater proportion of high-volume surgeons prescribe cryotherapy compared to low-volume surgeons, more frequently (87% vs 78%) and immediately following surgery (46% vs 22%). This survey revealed that high-volume surgeons prescribe less restrictive immobilisation and allow earlier weight-bearing following arthroscopic ALLR, compared to low-volume surgeons. The clinical relevance is that low-volume surgeons should gain greater confidence in prescribing less restrictive immobilisation and immediate weight-bearing, based on experience of high-volume peers, which could help improve outcomes of arthroscopic ALLR and reduce healthcare and economic burdens.