Persistent Pain After Operative Treatment for Chronic Lateral Ankle Instability

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Anatomy

Background:

• Chronic lateral ankle instability frequently presents with associated intraarticular and extraarticular pathologies.
• These comorbidities, including osteochondral lesions and impingement syndromes, require careful preoperative assessment.
• Persistent postoperative pain impacts outcomes in 13-35% of patients despite successful ligament repair or reconstruction.

Purpose of the Study:

• To review and discuss the various causes of persistent pain following operative treatment for chronic lateral ankle instability.
• To highlight the importance of identifying and addressing associated injuries before surgery.
• To improve patient satisfaction and clinical outcomes by understanding residual pain etiologies.

Main Methods:

• Literature review of studies on chronic lateral ankle instability and associated injuries.
• Analysis of factors contributing to persistent pain after ankle stabilization surgery.
• Synthesis of current understanding regarding intraarticular and extraarticular pathologies.

Main Results:

• Associated injuries are common in chronic lateral ankle instability, encompassing intraarticular lesions, impingement, and peroneal tendon issues.
• Failure to address these comorbidities can contribute to postoperative residual pain.
• Preoperative clinical correlation and surgical planning are crucial for managing these complex cases.

Conclusions:

• A high index of suspicion for associated pathologies is essential in patients with chronic lateral ankle instability.
• Comprehensive preoperative evaluation and tailored surgical planning are necessary to minimize residual pain.
• Understanding the causes of persistent pain is key to enhancing patient outcomes and satisfaction after surgery.