Ankle Instability: General facts
- Ankle sprains are the most common injury to the ankle
- ~25% of ankle sprains turn into chronic ankle instability
- Increased rates if inappropriate rehabilitation
- Patients with chronic ankle instability report ankle giving out with everyday activities, pain on the outside of the ankle, and avoidance of doing some activities due to feelings of instability
- If left untreated, ankle instability can lead to ankle arthritis
- Diagnosis is made based on clinical examination and history; MRI is often obtained to evaluate for associated injuries
Lateral Ankle Ligament Anatomy
- Three ligaments make up the lateral ankle ligament complex (ATFL, CFL, and PTFL)
- ATFL is most commonly injured, followed by the CFL
- The ligaments prevent the ankle from turning inwards
- When injured, they generally heal but if not rehabbed appropriately, can heal in a stretched out position
Non-Operative Treatment Ankle Instability
- Nonoperative treatment should be attempted on all patients with chronic instability
- PT for minimum of 6-12 weeks
- Activity modification
- Lace-up ankle brace
Operative Treatment Ankle Instability
- Surgery is recommended in patients who have continued pain and feelings of instability despite non-surgical treatment
- Surgery tightens up the ligaments and reattaches them to the bone in the appropriate position
- Lateral ligament repairs are often done at the same time as surgery on the peroneal tendons and ankle arthroscopy depending on the findings of MRI
