Blog Post

Should you have Surgery for Chronic Ankle Instability?

Digestive Diseases Center • Apr 24, 2018

Ankle instability occurs when someone suffers multiple ankle injuries, usually building up over a period of years. It can also occur after failure to properly heal a significant sprain that tears one or more of the supporting structures on the outside of the ankle. This can result in a loose or wobbly ankle that rolls excessively or “gives out” easily, a problem that is often painful and disruptive for regular daily activities and especially for athletic activities.

When is Surgery Indicated for Chronic Ankle Instability?

Most ankle sprains and some instances of ankle instability can be managed without surgery. Non-surgical treatment may include physical therapy, bracing, immobilization, medications and other options. Whenever feasible, we will utilize these treatment methods, as our goal is always to avoid surgery if possible. However, when a patient fails an appropriate course of non-surgical treatments, surgery can be considered.

Surgical Options for Chronic Ankle Instability

Surgical planning will vary from one patient to another depending on specific foot type and the extent of injury. However, the goal of surgery for chronic ankle instability is always the same: Tighten and stabilize the loose or torn ligaments on the outside of the ankle. The most common procedure for this is referred to as a modified-Brostrom procedure. This is an outpatient surgery that can be performed under IV sedation, or a “twilight sleep,” and combined with a local numbing medicine to the surgical site. A small incision is made on the outside of the ankle, and small absorbable anchors are placed to tighten or repair the damaged ligaments. The ankle is placed in a cast after the surgery to support it while it heals.

Your doctor might also perform an ankle arthroscopy at the time of the ligament repair. Arthroscopy involves placing a small scope or camera in the ankle to look for scar tissue or cartilage damage that should be removed or repaired at the same time.

How long is Recovery from Ankle Surgery?

Typically, the recovery process begins with two weeks of no weight on the surgical ankle. During this time, crutches, a walker, wheelchair or a rolling knee scooter are helpful. After two weeks, the stitches are removed, and patients begin bearing weight on the surgical ankle. A protective boot is placed at this time and is used for roughly four weeks. Depending on the individual repair and activity goals, physical therapy may be used during the recovery as well. At six weeks, sport-specific exercises can begin. Most patients can return to some athletic activities 10 weeks after surgery. A full recovery can take six months to a year.

What are the Results of Surgery for Chronic Ankle Instability?

Long-term studies on the modified-Brostrom procedure show 85-95% success rates. Potential complications are relatively low and include: infection, blood clot, re-rupture and nerve injury near the incision.

If you are suffering from the symptoms of chronic ankle instability, contact my office to schedule a consultation . With further evaluation of your ankle, we can develop a treatment regimen that may restore stability and strength. And, if other options fail, surgical repair is shown to bring pleasing results in the vast majority of cases.

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