Investigation of lateral ankle ligament reconstruction

The problem of chronic instability of lateral ankle ligaments has been approached with both conservative and surgical measures. Many operative procedures have been devised to correct this problem, and of these the Watson-Jones, modified Elmslie and Evans procedures are the most commonly used in our community. This paper was designed to: 1) compare the results of the three procedures; 2) investigate subtalar motion in a population of uninjured ankles; and 3) compare these results to subtalar motion in ankles after lateral ligament reconstruction. We found that each of the three procedures had a surprisingly high incidence of postoperative pain. All procedures had a high rate of return to preinjury activity level, and the majority of the patients were satisfied with the results of the operation. Postoperatively, the Watson-Jones repair exhibited the highest percentage of subjective instability. Twenty-four per cent of the Watson-Jones repairs had a postoperative talar tilt greater than 5 degrees. It was determined that subtalar motion was affected by the type of reconstructive procedure, and although this fact had been theorized in the literature, it had not been documented by objective data.