Age-Related Differences in Postoperative Outcomes After Arthroscopic Lateral Ligament Repair for Chronic Lateral Ankle Instability

BACKGROUND: Although arthroscopic lateral ankle ligament repair for chronic lateral ankle instability (CLAI) is widely performed, the association between patient age and postoperative outcomes remains unclear. This study aimed to investigate the clinical outcomes of arthroscopic lateral ankle ligament repair across a broad age spectrum. METHODS: We retrospectively reviewed 934 patients who underwent arthroscopic lateral ankle ligament repair for CLAI with a modified lasso-loop stitch using a suture anchor; all procedures were performed by a single surgeon. Patients were classified into 5 age groups: skeletally immature (SI; <13 years), adolescents (AD; 13-19 years), young adults (YA; 20-39 years), middle-aged adults (MA; 40-59 years), and elderly people (EP; ≥60 years). Clinical outcomes were assessed preoperatively and at 1 year postoperatively using the Self-Administered Foot Evaluation Questionnaire (SAFE-Q). Times to free gait, jogging, and return to full sports activities were also evaluated. Multivariable linear regression analyses were performed with postoperative SAFE-Q scores as dependent variables and age group, sex, and corresponding preoperative SAFE-Q scores as independent variables. RESULTS: < .001) differed significantly among groups; older patients tended to require longer recovery times. SI, AD, and YA groups demonstrated higher postoperative SAFE-Q scores than the EP group in several subscales, particularly in physical and social functioning. In contrast, no age-related differences were observed in the sports activity subscale. CONCLUSION: The association between age and postoperative outcomes after arthroscopic lateral ankle ligament repair varied across outcome domains. Younger patients demonstrated better outcomes in several functional subscales and achieved faster recovery milestones; however, advanced age alone should not be considered a contraindication to arthroscopic lateral ankle ligament repair. LEVEL OF EVIDENCE: Level III, retrospective cohort study.