Chronic Lateral Ankle Instability: Surgical Management

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Anatomy

Background:

• Chronic lateral ankle ligament instability often persists despite nonoperative treatments.
• Surgical intervention is indicated for patients who have not responded to conservative management.
• Intra-articular pathology can coexist with lateral ankle instability, requiring concurrent treatment.

Purpose of the Study:

• To evaluate the efficacy of surgical management for chronic lateral ankle ligament instability.
• To compare open anatomic reconstruction with arthroscopic approaches.
• To identify patient factors and techniques influencing surgical outcomes.

Main Methods:

• Review of surgical techniques for lateral ankle ligament reconstruction, including open anatomic repair and arthroscopic stabilization.
• Discussion of adjunctive procedures such as ankle arthroscopy for intra-articular disorders.
• Consideration of augmentation options like allograft or suture tape for specific patient populations.

Main Results:

• Open anatomic reconstruction provides stability, full range of motion, and facilitates return to sport.
• Ankle arthroscopy is recommended for addressing intra-articular issues prior to ligament stabilization.
• Allograft or suture tape augmentation benefits patients with generalized laxity, high BMI, or elite athletes, and may be useful in revisions.

Conclusions:

• Surgical management, particularly open anatomic reconstruction, is an effective treatment for chronic lateral ankle instability.
• Arthroscopic stabilization shows promise, though long-term outcome data is still developing.
• Augmentation strategies enhance surgical outcomes in select patient groups, including revision cases.