Rachel J Shakked1, Sydney Karnovsky2, Mark C Drakos2. 1. Rothman Institute, 3300 Tillman Drive, 2nd Floor, Bensalem, Philadelphia, PA, 19020-2071, USA. Rachel.shakked@rothmaninstitute.com. 2. Hospital for Special Surgery, New York, NY, USA.
Abstract
PURPOSE OF REVIEW: Ankle sprains, which account for 40% of sports injuries in the USA, can lead to chronic ankle instability. Chronic ankle instability can be classified as functional, mechanical, or a combination of both and is diagnosed using a combination of a physical exam, an MRI, and stress radiographs. This review focuses on different approaches to treatment, including non-operative and operative techniques, of chronic ankle instability, including reviewing traditional procedures as well as more novel and newer techniques. RECENT FINDINGS: Based on existing literature, non-operative treatment should always precede operative treatment of chronic ankle instability. If rehabilitation fails, Brostrom-Gould type ankle stabilization has been the preferred surgical option. Recent literature suggests that arthroscopic repair might reduce recovery time and improve outcomes in certain populations; however, there are higher rates of complication following these surgeries. In more high-risk populations, some literature reports that ligament repair with peroneus brevis transfer could be a more effective treatment option. Currently, varying surgical techniques exist for the treatment of chronic ankle instability. While the more recently reported techniques show promise, it is important to note that there is little evidence showing they are more successful than traditional techniques. It is imperative that future studies focus on outcomes and complication rates of these newer procedures.
PURPOSE OF REVIEW: Ankle sprains, which account for 40% of sports injuries in the USA, can lead to chronic ankle instability. Chronic ankle instability can be classified as functional, mechanical, or a combination of both and is diagnosed using a combination of a physical exam, an MRI, and stress radiographs. This review focuses on different approaches to treatment, including non-operative and operative techniques, of chronic ankle instability, including reviewing traditional procedures as well as more novel and newer techniques. RECENT FINDINGS: Based on existing literature, non-operative treatment should always precede operative treatment of chronic ankle instability. If rehabilitation fails, Brostrom-Gould type ankle stabilization has been the preferred surgical option. Recent literature suggests that arthroscopic repair might reduce recovery time and improve outcomes in certain populations; however, there are higher rates of complication following these surgeries. In more high-risk populations, some literature reports that ligament repair with peroneus brevis transfer could be a more effective treatment option. Currently, varying surgical techniques exist for the treatment of chronic ankle instability. While the more recently reported techniques show promise, it is important to note that there is little evidence showing they are more successful than traditional techniques. It is imperative that future studies focus on outcomes and complication rates of these newer procedures.
Authors: Mark C Drakos; Steve B Behrens; Dave Paller; Conor Murphy; Christopher W DiGiovanni Journal: Foot Ankle Int Date: 2014-05-21 Impact factor: 2.827
Authors: Eric Giza; Edward C Shin; Stephanie E Wong; Jorge I Acevedo; Peter G Mangone; Kirstina Olson; Matthew J Anderson Journal: Am J Sports Med Date: 2013-08-27 Impact factor: 6.202
Authors: Ibukunoluwa Araoye; Cesar De Cesar Netto; Brent Cone; Parke Hudson; Bahman Sahranavard; Ashish Shah Journal: Int Orthop Date: 2017-08-25 Impact factor: 3.075
Authors: Christina Hermanns; Reed Coda; Sana Cheema; Matthew L Vopat; Megan Bechtold; Armin Tarakemeh; Scott Mullen; John Paul Schroeppel; Bryan G Vopat Journal: Kans J Med Date: 2020-06-25