Current Concepts in Acute and Chronic Lateral Ankle Instability

Injuries to the lateral ankle ligaments are among the most common sports injuries in both professional athletes and the general population. Adequate management with consequent bracing after excluding relevant concomitant injuries, and functional aftertreatment, including balance and proprioceptive training, are crucial in preventing chronic lateral ankle instability (CLAI). It is estimated that CLAI develops in approximately 25% of patients following an ankle sprain. The condition is divided into mechanical and functional instability. Diagnosis is primarily clinical, but imaging such as X-rays and magnetic resonance imaging can be very useful in detecting additional pathologies. Most patients improve with non-operative treatment. When this fails, surgery is indicated. Surgical treatment of CLAI is divided into direct ligament repair and indirect reconstruction. Extra-anatomical tenodesis is generally not indicated. Currently, the gold standard is ligament repair with the Broström-Gould technique, with excellent results. Early rehabilitation, including balance and proprioceptive training, plays a pivotal role in regaining postural stability in both acute and chronic lateral ankle instability.