Ivan Urits1, Morgan Hasegawa2, Vwaire Orhurhu3, Jacquelin Peck4, Angele C Kelly5, Rachel J Kaye6, Mariam Salisu Orhurhu7, Joseph Brinkman2, Stephen Giacomazzi2, Lukas Foster2, Laxmaiah Manchikanti8, Alan D Kaye9, Omar Viswanath10,11,12. 1. Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA. iurits@bidmc.harvard.edu. 2. Creighton University School of Medicine at Regional Campus St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA. 3. Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA. 4. Mount Sinai Medical Center of Florida, Department of Anesthesiology, Miami Beach, FL, USA. 5. Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA. 6. Medical University of South Carolina, Charleston, SC, USA. 7. Department of Anesthesia, Critical Care, and Pain Medicine, Johns Hopkins Hospital, Baltimore, MD, USA. 8. Pain Management Centers of America, Paducah, KY, USA. 9. Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA. 10. Valley Anesthesiology and Pain Consultants, Phoenix, AZ, USA. 11. Department of Anesthesiology, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA. 12. Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA.
Abstract
PURPOSE OF REVIEW: Chronic ankle pain is a prevalent and significant cause of chronic pain. While the definition of chronic ankle pain is heterogeneous and poorly defined in the literature, systematic reviews and meta-analyses have estimated this condition to be a prevalent and debilitating source of chronic pain. The most identifiable and prominent cause of chronic ankle pain is chronic ankle instability (CAI), a condition defined by instability of the ankle-joint complex. It is a common consequence of lateral ankle sprains or ligamentous injuries and can be described as a failure of the lateral ankle joint complex after an acute, or recurring, ankle injury. The objective of this manuscript is to provide a comprehensive review of CAI diagnosis and our current understanding of minimally invasive treatment options. RECENT FINDINGS: First-line treatment is conservative management, some of which includes neuromuscular rehabilitation, balance training, nonsteroidal anti-inflammatory drugs (NSAIDs), manual mobilization, ice therapy, and compression. While conservative management is effective, additional treatments for those who fail conservative management, or who seek alternative options also have been explored. Recent advances and modern techniques have expanded available treatment options, many of which are becoming less invasive, and have shown improving functionality, recovery, and patient satisfaction. Minimally invasive treatments highlighted in this review include: arthroscopic surgery, steroid injections, plasma-rich plasma injections, hyaluronic acid (HA) injections, medicinal signaling cell injections, radiofrequency therapies, and shockwave therapies. This review will discuss some of these current treatments for minimally invasive treatment of CAI, as well as suggest novel treatments for clinical trials and further investigation.
PURPOSE OF REVIEW: Chronic ankle pain is a prevalent and significant cause of chronic pain. While the definition of chronic ankle pain is heterogeneous and poorly defined in the literature, systematic reviews and meta-analyses have estimated this condition to be a prevalent and debilitating source of chronic pain. The most identifiable and prominent cause of chronic ankle pain is chronic ankle instability (CAI), a condition defined by instability of the ankle-joint complex. It is a common consequence of lateral ankle sprains or ligamentous injuries and can be described as a failure of the lateral ankle joint complex after an acute, or recurring, ankle injury. The objective of this manuscript is to provide a comprehensive review of CAI diagnosis and our current understanding of minimally invasive treatment options. RECENT FINDINGS: First-line treatment is conservative management, some of which includes neuromuscular rehabilitation, balance training, nonsteroidal anti-inflammatory drugs (NSAIDs), manual mobilization, ice therapy, and compression. While conservative management is effective, additional treatments for those who fail conservative management, or who seek alternative options also have been explored. Recent advances and modern techniques have expanded available treatment options, many of which are becoming less invasive, and have shown improving functionality, recovery, and patient satisfaction. Minimally invasive treatments highlighted in this review include: arthroscopic surgery, steroid injections, plasma-rich plasma injections, hyaluronic acid (HA) injections, medicinal signaling cell injections, radiofrequency therapies, and shockwave therapies. This review will discuss some of these current treatments for minimally invasive treatment of CAI, as well as suggest novel treatments for clinical trials and further investigation.
Authors: Niall A Smyth; Christopher D Murawski; Amgad M Haleem; Charles P Hannon; Ian Savage-Elliott; John G Kennedy Journal: World J Orthop Date: 2012-07-18
Authors: Neeraj Vij; Heather N Kaley; Christopher L Robinson; Peter P Issa; Alan D Kaye; Omar Viswanath; Ivan Urits Journal: Orthop Rev (Pavia) Date: 2022-09-05