Return to Sports and Sports Activities after Treatment of Osteochondral Lesions of the Ankle in Elite Athletes

Category: Ankle Introduction/Purpose: The aim of this study is to assess the return to sports rate and times after treatment of osteochondral lesions of the ankle in elite level athletes. Methods: All elite level athletes treated for an OLT(P) were selected from a cross-sectional database consisting of consecutive patients with cartilage injuries of the ankle and subsequently underwent prospective follow-up. Outcomes included return to sports outcomes, patient reported outcomes and a qualitative assessment regarding mental health Results: 26 patients with a median age of 22 years (IQR: 19.0 – 24.5) were included with a median follow-up time of 48 months (IQR: 34.5 – 71.0). Seven patients (27%) underwent conservative treatment and 19 patient (73%) operative treatment. Conservative treatment yielded a return to sport rate at any level of 86%, return to pre-injury and return to performance level of both 57%. For operative treatment these rates were 100%, 74% and 63% respectively. Mean time to return to pre-injury level overall was 8.3 months. At latest follow-up only 11 patients (44%) were still active at an elite level of sport. Conclusion: Both conservative and surgical treatment for osteochondral lesions of the ankle yielded return to sport rates above 86% in elite level athletes. The results of this study can be used in the decision-making process between the physician and the elite athlete to inform them about the expected return to sport rates and times for the different treatment options for OLT(P)s. As most athletes at the time of injury and treatment are still highly motivated and disciplined to return to their sport at the same level and be able to compete at the highest level available in their sport.