Background: Recurrent inversion injuries are a major contributor to chronic ankle instability (CAI), resulting in long-term functional limitations, reduced physical activity, and diminished quality of life. While both arthroscopic and open surgical techniques are routinely employed worldwide, their outcomes remain unstudied in Mongolia. This study aimed to describe the national epidemiology of ankle ligament injuries and provide foundational data to inform future clinical and surgical research. Aim: To determine the prevalence, patterns, and associated demographic and environmental factors of ankle ligament injuries recorded in Mongolia between 2014 and 2023, and to conduct an epidemiological analysis. Materials and Methods: We performed a cross sectional, single-center epidemiological analysis using anonymized secondary data from the National Trauma and Orthopedic Research Center (NTORC), Mongolia’s national tertiary referral hospital. Patient records from January 2, 2014, to December 28, 2023, were extracted from the E-Health national database and coded using ICD-10. Eligible cases included malleolar fractures, ligament sprains, dislocations, nerve injuries, and other lower limb traumas. Data on age, sex, residence, admission date, length of stay, and injury mechanism were categorized into 167 specific etiologies and 14 major groups. Result: Falls were the predominant injury mechanism (71.1%), particularly among females (83.3%) and urban residents (76.4%). A seasonal peak occurred in winter, with 8.1% of injuries linked to ice- and snow-related falls. Rural males had a higher proportion of transport-related injuries, notably involving motorcycles. The anterior talofibular ligament (ATaFL) was the most frequently affected structure. Individuals aged 15–44 years represented the largest proportion of ligament injury cases. Conclusion Between 2014 and 2023, 4,757 ankle ligament injuries were recorded in Mongolia. Males accounted for 57.7% of cases, with the highest incidence observed in individuals aged 15–44 years (68.8%). Seventy-five percent of injuries occurred in Ulaanbaatar. Falls were the leading mechanism (>70%), particularly during winter, followed by road traffic accidents. Emergency department visits increased over time, while hospitalization rates remained low and stable.

Background: Anterior cruciate ligament (ACL) rupture is one of the most common sports-related knee injuries among young and physically active individuals, often leading to knee instability, functional impairment, and delayed return to sports. Although hamstring tendon (HT) autografts are widely used in ACL reconstruction, the optimal graft choice remains controversial. The superficial rectus femoris (SRF) tendon has recently emerged as a potential alternative autograft with favorable biomechanical properties. This study aimed to compare the clinical stability and functional outcomes of ACL reconstruction using SRF and HT autografts. Aim: This study aimed to characterize the epidemiology and risk profile of knee joint injuries in Mongolia over a 10-year period, and to evaluate the comparative clinical efficacy and functional recovery following ACL reconstruction using hamstring tendon (HT) versus superficial rectus femoris (SRF) autografts. Materials and Methods: A randomized parallel-group clinical study was conducted at the Sports Injury Center of the National Trauma and Orthopedic Research Center. Fifty patients aged ≥18 years with complete ACL rupture were enrolled and randomly assigned to undergo ACL reconstruction using either a superficial rectus femoris autograft (SRF group, n=25) or a hamstring tendon autograft (HT group, n=25). The primary outcome was mechanical knee stability. Secondary outcomes included functional performance assessed using three-dimensional motion analysis, as well as patient-reported outcomes measured using the International Knee Documentation Committee (IKDC) and Lysholm scores. Clinical and functional assessments were performed preoperatively and at 1, 3 and 6-month postoperative follow-up visits. Comparative analyses were conducted to evaluate differences in recovery patterns between the two groups. Result: Patients in the SRF group demonstrated significantly lower early postoperative pain levels and faster functional recovery compared with the HT group (p<0.01). Three-dimensional motion analysis revealed earlier restoration of limb symmetry and improved dynamic knee stability in the SRF group during the early postoperative period. These objective biomechanical findings supported the clinical observation of accelerated rehabilitation following ACL reconstruction using SRF autografts. At six months postoperatively, however, no statistically significant differences were observed between the SRF and HT groups in terms of mechanical knee stability or patient-reported functional outcomes. Conclusion ACL reconstruction using a superficial rectus femoris autograft demonstrated superior early functional recovery compared with the traditional hamstring autograft while achieving comparable short-term clinical stability. These findings suggest that the SRF autograft may represent a promising alternative graft option for patients requiring accelerated rehabilitation and earlier return to physical activity.

Background: During inversion injuries of the ankle joint, the anterior talofibular ligament (ATFL) is the most commonly injured structure. Injuries to the lateral collateral ligaments of the ankle, either in isolation or in combination with injury to the calcaneofibular ligament (CFL), account for approximately 60-65% of all ankle ligament injuries. In recent years, several studies have examined the impact of lateral ankle ligament injuries on lifestyle and overall health. Repeated inversion injuries-particularly those occurring three or more times-can lead to chronic ankle instability (CAI). In the treatment of ankle instability, both open and arthroscopic surgical techniques are widely used internationally. In Mongolia, there is an increasing clinical need to evaluate and compare the outcomes of arthroscopic versus open surgical repair of lateral ankle ligament injuries. This need forms the basis of the current study. Aim: The comparative studies on open vs arthroscopic anterior talofibular ligament (ATFL) repair are limited. This study aimed to compare the early therapeutic efficacy and cost between the traditional open Broström-Gould repair and all-arthroscopic anatomical repair of the ATFL for chronic lateral ankle instability. Materials and Methods: A total of 40 patients with chronic lateral ankle instability undergoing repair of the ATFL be tween September 2024 and February 2025 were retrospectively included with a traditional open surgery (n=10) group and an arthroscopy (n=17) group. The surgery duration, surgical cost, postoperative complications, and the preoperative/postoperative American Orthopaedic Foot & Ankle Society Score (AOFAS) and Karlsson-Peterson score were compared between groups. Results: Compared to the anatomical group, the non-anatomical group had significantly shorter surgery and hospitalization durations. Three months after the operation, the AOFAS and Karlsson scores significantly improved in both groups. Nevertheless, there was no significant difference in the AOFAS and Karlsson scores between groups at both preoperative and postoperative assessments. No significant difference was found in the incidence of postoperative complications between the two groups. Conclusion 1. These results suggest that open Broström-Gould repair and all-arthroscopic anatomical repair of the ATFL have comparable therapeutic efficacy for chronic lateral ankle instability. 2. The arthroscopic surgery had a smaller incision, while the open Broström-Gould had a shorter surgery duration and lower cost.