Predictive Modeling for Functional Outcomes After All-Inside Arthroscopic Anterior Talofibular Ligament Repair of Chronic Ankle Instability

被引:4
作者
Chen, Ziyi [1 ]
Zhao, Yujie [2 ]
Xue, Xiao'ao [1 ]
Gu, Xicheng [1 ]
Li, Yi [1 ]
Hua, Yinghui [1 ]
机构
[1] Fudan Univ, Huashan Hosp, Dept Sports Med, 12 Urumq Middle Rd, Shanghai 200040, Peoples R China
[2] Fudan Univ, Huashan Hosp, Dept Nursing, Shanghai, Peoples R China
基金
中国国家自然科学基金;
关键词
arthroscopic anterior talofibular ligament repair (AATFLR); chronic ankle instability (CAI); risk factors; outcomes prognostic tool; MODIFIED BROSTROM PROCEDURE; RECONSTRUCTION; IMPINGEMENT; RUPTURE; LESIONS; INJURY;
D O I
10.1177/10711007241252091
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Arthroscopic anterior talofibular ligament repair (AATFLR) is a surgical strategy to treat chronic ankle instability (CAI) patients. This study identified risk factors that influenced the functional outcomes of AATFLR for CAI and developed prognostic nomogram for predicting functional outcomes in future AATFLR cases.Methods: Patients undergoing AATFLR from January 2016 to June 2022 with at least 10 months of follow-up were included in the study. The Karlsson Ankle Functional Score (KAFS) was evaluated preoperatively and at last follow-up visit. A total of 15 potential predictors including age, sex, body mass index, side affected, time from injury to surgery, sports-related injury, osteophyte, loose bodies, distal tibiofibular syndesmosis, ATFL avulsion fracture, Outerbridge classification of osteochondral lesions, postoperative immobilization method, ambulation time, walking time, and follow-up time, were recorded. We first used univariate binary logistic regression analysis to select the potential significant prognostic features, which were then subjected to the least absolute shrinkage and selection operator (LASSO) regression algorithm for final feature selection. A nomogram based on the regression model was developed to estimate the functional outcomes of patients. Models were validated internally using bootstrapping and externally by calculating their performance on a validation cohort.Results: Overall, 200 ankles fit inclusion criteria. Of these 200, a total of 185 (92.5%) ankles were eligible and divided into development (n = 121) and validation (n = 64) cohorts. Four predictors were ultimately included in the prognostic nomogram model: age, sex, sports-related injury, and postoperative immobilization method.Conclusion: We found in our cohort that the significant predictors of poorer functional outcomes of AATFLR were postoperative immobilization with lower-leg cast, female sex, non-sports-related ankle sprain, and increasing age. Prognostic nomograms were created.Level of Evidence: Level III, retrospective cohort study.
引用
收藏
页码:852 / 861
页数:10
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