Ankle instability after traumatic sprains is a very common condition. After excluding an associated fracture with an X-ray the initial treatment of a sprained ankle involves support of the ankle in a CAM boot and/or ASO lace up ankle brace combined with a physiotherapist led ankle rehabilitation program. With this approach 9 in 10 patients after their first bad ankle sprain will do well. Unfortunately, however, 1 in 10 patients will experience further instability symptoms or persistent ankle pain. At this point referral to our clinic is appropriate for consideration of ankle stabilization surgery.

Usually our surgeons will arrange for an MRI scan of the ankle prior to determining the best surgical procedure for the problematic ankle. Frequently the MRI scan will identify problems such as cartilage and peroneal tendon injuries that also need to be addressed at the time of ligament reconstruction surgery.

Case - 1

  • MRI shows damage to the cartilage img This MRI shows damage to the cartilage in the ankle. Such damage is often referred to as an Osteochondral Defect (OCD). Depending on symptoms and size of the lesion surgical intervention with an ankle arthroscopy (keyhole surgery) is sometimes necessary
  • symptoms and underwent ankle arthroscopy img Following the MRI, the patient noted above had ongoing symptoms and underwent ankle arthroscopy. This is the view of the ankle joint during arthroscopy showing normal cartilage and bare bone where the cartilage was damaged (OCD). Removing any loose pieces of cartilage and smoothing out the damaged areas of bone or cartilage are usually effective in relieving symptoms.
  • patient with pain at the front img This is an MRI of patient with pain at the front of the ankle joint. It shows early arthritis of the ankle joint with a prominent bony spur at the front of the ankle (red arrow) . Pain can result from this spur as it catches or pinches the soft tissues at the front of the ankle with movement
  • bony spur img This is the view of the bony spur during ankle arthroscopy
  • View of the ankle img View of the ankle after spur removed and rough edge of the ankle joint smoothed out

  • This video demonstrates the mechanism of ankle instability (rolling the ankle)

  • Video illustrating the repair of the ankle ligaments

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