Sex-Specific Differences Following Lateral Ankle Ligament Repair

Foot Ankle Int. 2021 Oct;42(10):1311-1318. doi: 10.1177/10711007211004191. Epub 2021 May 22.


Background: Chronic ankle instability is a common condition that can be treated with lateral ankle ligament repair. These procedures have a reported success rate greater than 85% in the literature, but little has been reported about the differences in postoperative outcomes between males and females. The purpose of this study was to evaluate sex-specific outcomes following lateral ankle ligament repair.

Methods: In this systematic review and meta-analysis, we used Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria to search for articles on electronic databases and included studies in which study participants underwent primary lateral ligament repair and sex-specific outcomes were evaluated. Functional postoperative outcomes for males and females were recorded and statistically analyzed.

Results: Out of 2768 studies, 7 (0.25%) met inclusion criteria and were analyzed in this review. These studies included 618 patients (402 males [65%] and 216 females [35%]) who underwent primary lateral ligament repair for ankle instability. Karlsson score (P = .1582) and American Orthopaedic Foot & Ankle Society (AOFAS) score (P = .1586) analyses found no statistically significant difference between males and females. Postoperative success rate-defined as a "good" or "excellent" Karlsson score (>81)-was not found to be significantly different between males and females (P = .9374).

Conclusion: There was no difference in postoperative mean Karlsson scores, AOFAS scores, or success rates between males and females who underwent primary lateral ankle ligament repair.

Level of evidence: Level IV, therapeutic.

Keywords: chronic ankle instability; lateral ankle ligament repair; sex.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Ankle
  • Ankle Injuries* / surgery
  • Ankle Joint / surgery
  • Female
  • Humans
  • Joint Instability* / surgery
  • Lateral Ligament, Ankle* / surgery
  • Male