Research Articles

Clinical and Functional Results Using Autologous Conditioned Serum in the Treatment of Acute Ankle Injuries in Sporting Activities

Abstract

Background: Ankle ligament injuries in the sports like basketball, volleyball, and cricket are the most common reasons for missed participation in athletics, accounting for 14% of all sports injuries. These injuries may often require splinting and rest for a longer duration, leading to a permanently reduced level of sports performance. The autologous conditioned cytokine-rich serum (ACRS) is becoming a reliable treatment option in acute ankle injuries as it enhances biological healing. The objective of this study is to evaluate the role of ACRS in acute ankle injuries and report the efficacy of ACRS injections on time to return to physical activities.

Methods: 42 patients with clinical and radiological signs of ankle ligamentous injuries (grades 1 and 2) secondary to sporting or gaming activity were recruited for this study. Each patient received one injection of ACRS at the injury site and was put on a soft cast for one week. Clinical and functional evaluation was performed using the Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, and the Foot and Ankle Disability Index (FADI) scores before the injection, at one week, i.e., after removing the soft cast, three weeks, six weeks, and three months.

Results: Our study showed gradual improvement of all the evaluation scales at all the follow-ups. Few patients showed minor side effects like aseptic effusion. The least common complaint was a pain in the subsequent days after the injection.

Conclusion: Our results, in conjunction with pre-existing studies in the literature regarding the biological effects of ACRS, demonstrate the viability of this therapy for the treatment of acute ankle injuries, showing the positive influence on pain and healing capacity and returning to gaming activities immediately in about two weeks without significant adverse effects.

1. Fong DT, Chan YY, Mok KM, Yung PS, Chan KM. Understanding acute ankle ligamentous sprain injury in sports. Sports Med Arthrosc Rehabil Ther Technol. 2009;1:14. doi: 10.1186/1758-2555- 1-14. [PubMed: 19640309]. [PubMed Central: PMC2724472].
2. Roos KG, Kerr ZY, Mauntel TC, Djoko A, Dompier TP, Wikstrom EA. The epidemiology of lateral ligament complex ankle sprains in National Collegiate Athletic Association Sports. Am J Sports Med. 2017;45(1):201-9. doi: 10.1177/0363546516660980. [PubMed: 27573356].
3. Porter DA. Ligamentous injuries of the foot and ankle. In: Fitzgerald RH, Kaufer H, Malkani AL, editors. Orthopaedics. St. Louis, MO: Mosby 2002.
4. Delee JC, Drez DJ. Orthopaedic sports medicine: Principles and practice. Vol 2. Philadelphia, PA: Saunders; 2003.
5. Mei-Dan O, Kots E, Barchilon V, Massarwe S, Nyska M, Mann G. A dynamic ultrasound examination for the diagnosis of ankle syndesmotic injury in professional athletes: A preliminary study. Am J Sports Med. 2009;37(5):1009-16. doi: 10.1177/0363546508331202. [PubMed: 19336613].
6. Lynch SA, Renstrom PA. Treatment of acute lateral ankle ligament rupture in the athlete. Conservative versus surgical treatment. Sports Med. 1999;27(1):61-71. doi: 10.2165/00007256- 199927010-00005. [PubMed: 10028133].
7. Gauffin H, Tropp H, Odenrick P. Effect of ankle disk training on postural control in patients with functional instability of the ankle joint. Int J Sports Med. 1988;9(2):141-4. doi: 10.1055/s-2007- 1024996. [PubMed: 3384520].
8. Wehling P, Moser C, Frisbie D, McIlwraith CW, Kawcak CE, Krauspe R, et al. Autologous conditioned serum in the treatment of orthopedic diseases: The orthokine therapy. BioDrugs. 2007;21(5):323-32. doi: 10.2165/00063030-200721050- 00004. [PubMed: 17896838].
9. Evans CH, Chevalier X, Wehling P. Autologous conditioned serum. Phys Med Rehabil Clin N Am. 2016;27(4):893-908. doi: 10.1016/j.pmr.2016.06.003. [PubMed: 27788906].
10. Woodell-May J, Steckbeck K, King W. Potential mechanism of action of current point-of-care autologous therapy treatments for osteoarthritis of the knee-a narrative review. Int J Mol Sci. 2021;22(5). doi: 10.3390/ijms22052726. [PubMed: 33800401]. [PubMed Central: PMC7962845].
11. Frizziero A, Giannotti E, Oliva F, Masiero S, Maffulli N. Autologous conditioned serum for the treatment of osteoarthritis and other possible applications in musculoskeletal disorders. Br Med Bull. 2013;105:169-84. doi: 10.1093/bmb/lds016. [PubMed: 22763153].
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IssueVol 8, No 3 (2022) QRcode
SectionResearch Articles
DOI https://doi.org/10.18502/jost.v8i3.9906
Keywords
Ankle Injuries Cytokines ; Interleukin-1 Receptor Antagonist Protein Athletic Injuries
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How to Cite
1.
Koduru S, Bathina B, Sane M. Clinical and Functional Results Using Autologous Conditioned Serum in the Treatment of Acute Ankle Injuries in Sporting Activities. J Orthop Spine Trauma. 2022;8(3):87-9.