Ankle Instability - chronic ankle ligament injury
The ligaments around the ankle are very commonly injured (ankle sprain). The vast majority of these injuries will heal by themselves and most patients do well with simple treatment such as rest, bracing and physiotherapy.
However a small percentage (approximately 10%) of patients will have ongoing episodes of instability and repeated “ankle sprains”. In these patients further instability in the ankle can lead to severe pain, a feeling of “giving way” and inability to work or play sport.
If ankle instability develops from repeated ankle sprains, surgery may be needed to repair the damaged ligament(s).
Ankle ligaments can be injured on either in the outside (lateral - most common), inside (medial - less common) or above the ankle (syndesmosis).
Figure 1: typical mechanism of injury and schematic of ligaments
Figure 2: common acute presentation of ligamentous injury of the ankle
Treatment options:
Most patients will do well with conservative management: 10-12 weeks of bracing, physiotherapy to work on strength, balance and proprioception and rest from heavy activities.
Operative treatment is typically offered to patients who have ongoing instability symptoms, associated cartilage damage. The cause of your instability will be targeted along with any other associated pathology.
Surgeries performed for this condition include:
Ankle cartilage repair