Early functional recovery following accelerated rehabilitation after arthroscopic anterior talofibular ligament repair.
Abstract
Background
Postoperative rehabilitation following anterior talofibular ligament (ATFL) repair commonly incorporates an initial period of protection with progressive weight-bearing and range of motion. Accelerated rehabilitation may facilitate earlier functional recovery, but clinical evidence remains limited.
Methods
A retrospective cohort study was performed on consecutive patients who underwent arthroscopic ATFL repair for chronic lateral ankle instability at a tertiary institution between January 2024 and June 2025. All patients followed a standardised accelerated rehabilitation protocol that included immediate weight-bearing and supervised range-of-motion exercises after surgery. Outcomes assessed included Foot and Ankle Ability Measure (FAAM) scores, Visual Analogue Scale (VAS), time to return to jogging, return to pre-injury level of sport and documented postoperative complications.
Results
Twenty patients were included, with a mean follow-up of 11.1 ± 3.5 months. Median FAAM Activities of Daily Living scores improved from 76.2 (Q1-Q3, 67.0-83.0) preoperatively to 99.2 (95.9-100.0) at 6 months, while median FAAM Sports scores improved from 43.5 (32.2-63.4) to 94.7 (82.8-100.0) (both p < 0.001). Median VAS scores decreased from 5.0 (4.0-6.0) preoperatively to 0.0 (0.0-1.0) at 6 months (p < 0.001). The median time to return to jogging was 42 days. Seventeen patients participated in sport preoperatively, all of whom returned to their pre-injury level of sport (17/17, 100%) at a median of 8 weeks (Q1-Q3, 6-11 weeks). No recurrent instability, repair failure, wound complication, or reoperation was observed.
Conclusion
Accelerated rehabilitation following isolated arthroscopic ATFL repair was associated with significant early functional improvement and return to pre-injury sporting level in all preoperatively active patients, with no repair failures or recurrent instability observed during short-term follow-up. LEVEL OF EVIDENCE IV.