Chronic ankle instability: management of chronic lateral ligamentous dysfunction and the varus tibiotalar joint

Many techniques have been described in acute and chronic lateral ligament insufficiency in the ankle. At present, the Bostrom-Gould and Chrisman-Snook procedures and their variations remain the "gold standard". Recent assessment of important etiologic factors has shed some light on the relationship between the original injury or injuries and the subsequent development of the varus tibiotalar joint with or without secondary osteoarthritis. The development of Taylor Spatial Frame may well revolutionize its management. In the meantime, further consideration should be given to well-designed and evaluated randomized controlled trials, improved understanding of the biomechanics, and function of the ligaments, for example, proprioceptive function and their healing. Newer and less invasive arthroscopic and percutaneous techniques are being developed.