Epidemiology, costs, and management trends of lateral ankle ligament injury

Abstract

Objective: This study primarily aimed to determine the incidence of patients diagnosed with lateral ankle sprain who ultimately progressed to operative treatment. Secondary study aims included determining the implementation and costs of physical therapy (PT), ankle bracing, and NSAIDs generated by the treatment of an ankle sprain diagnosis. Methods: Data were collected using the Pearl Diver Humana dataset using ICD-9, ICD-10, and CPT codes pertaining to ankle sprain, ligament repair or reconstruction, physical therapy, ankle brace, and NSAIDs. Patients were categorized into nonoperative treatment, operative repair, and operative reconstruction. Incidence, cost, and PT attendance were compared among the three groups. Results: A total of 309,670 patients who sustained a lateral ankle sprain between 2007 and 2017 were identified. Of the patients, 306,180 (99%; 306,180/309,670) completed nonoperative management, and 2,774 (1%; 2,774/309,670) underwent operative intervention. Of the nonoperative management patients, 63,276 (21%; 63,276/306,180) received PT. Of the operative management patients, 1,536 (55%; 1,536/2,774) received PT pre operatively and/or post-operatively. The mean total cost was $923.32 for nonoperative management, $3,384.63 for operative repair, and $3,659.98 for operative reconstruction. Conclusions: Within orthopedics, there are different treatments for lateral ankle ligament sprains. This study demonstrates that most patients with lateral ankle ligament sprains do not require operative intervention, as 99% of patients completed nonoperative management. Patients treated nonoperatively attended fewer PT visits and generated lower costs than patients who underwent operative repair or reconstruction. Only 20% of nonoperative patients received PT. Level of evidence III; Retrospective observational cohort study