Hello, everyone. My name is Jonathan Dahlman, and I am a third-year medical student at the University of Kansas School of Medicine. Today, I will be talking about failure following surgical treatment for lateral ankle instability. My team and I have no conflict of interest for the presented project. Lateral ankle instability, also described as chronic ankle instability, is typically caused by a lateral ankle sprain and often subsequent recurrent ankle sprains. Treatment for lateral ankle instability varies drastically from conservative to operative management, depending on an individual's injury, symptoms, and lifestyle. Typically, surgical treatment is recommended when conservative treatments fail for lateral ankle instability. Failure is a term frequently used to describe an unfavorable outcome for patients who undergo surgical treatment for lateral ankle instability. However, a uniform failure definition has not been described in the literature. Therefore, the purpose of this systematic review was to identify current ankle instability treatment failure definitions and work towards standardization of the definition. Presented work is a systematic review. To begin, a research-focused librarian conducted a search utilizing the search engines Medline, SportsDISCUS, CINAHL, EMBASE, and Web of Science in April 2021. Next, research members included and excluded articles before collecting data. Inclusion criteria consisted of articles with the following descriptions. English language, human studies, evaluation of surgical lateral ankle instability treatment outcomes, and studies that have a definition of lateral ankle instability treatment failure. Studies with a level of evidence 1 through 4 were considered for inclusion, and during the initial search, 1,200 articles were identified, of which 42 or 3.5% met the inclusion criteria. The articles in the literature described a wide range of definitions for failure of surgical treatment of lateral ankle instability, which ranged from 4.8% of the articles utilized that Carlson score less than or equal to 80 points to 40.5% of the articles defined ankle instability failure as recurrent instability. The lack of definition clarity is further demonstrated by a failure rate range of 1.1% to 45.2% for the same surgical procedure. Among the many confounding variables for the failure rate, one of the broadest included the follow-up requirement, which ranged from six months to a minimum of five years for a study. In conclusion, our team suggests a uniform failure definition incorporating recurrent ankle sprains, re-rupture, further surgical intervention, AOFAS score of less than 79, Carlson score less than or equal to 80 points during follow-up, recurrent instability defined as a propensity for recurrent ankle sprains, frequent episodes or perception of the ankle giving way, and persistent symptoms such as pain, swelling, and limited motion, weakness, and diminished self-reported function. Additionally, a positive anterior and or posterior drawer test and a positive Taylor tilt test would be incorporated in the definition of failure. I have attached my references here, and I would like to thank my outstanding team for all the time and effort they have put into this project, as well as everyone who chose to listen to this presentation. If you have any questions, please contact myself, Jonathan Dahlman, at jdahlman, D-A-L-L-M-A-N, at kumc.edu. Thank you.

lateral ankle instability

standardized definition

systematic review

recurrent ankle sprains

further surgical intervention