One of the most common conditions I see in my clinic are those patients who have experienced a severe ankle sprain in the past and now suffer from the feeling of being "unstable", difficulty with uneven ground, or their ankle giving out on them for no apparent reason.
80% of patients who experience an acute ankle sprain recover with basic treatment such as RICE therapy, boot/bracing, and a short course of physical therapy. However, 20% of patients progress to lateral ankle instability leading to the ankle feeling "loose" often complaining of repeat ankle sprains (sometimes multiple a month). Two concerns arise for patients who are functioning with ankle instabiltiy: 1) Patients are more prone to further injury and safety is a concern, 2) An ankle joint is more susceptible to arthritis when functioning loose.
When patients present to my clinic for chronic ankle instability, they have often tried many levels of conservative care; however, we always discuss the options for physical therapy, bracing, and activity modification. Physical therapy can attempt to strengthen the ankle, provide proprioceptive training (how are mind knows where our joints are in space), and hopefully decrease the patients level of instability. Unfortunately, conservative measures are not always successful and more definitive treatment options are necessary.
Prior to discussing surgical options an MRI is ordered to not only look at the loose ligaments, but also to screen for other problems in the joint as well as other tendons on the outside of the ankle. Both the MRI report AND images are discussed with the patient in detail to provide a thorough understanding of the patients problems.
In Chicago I was fortunate to have trained under extremely talented surgeons who perform minimally invasive surgery for loose ankle ligaments. Traditionally, surgery to correct loose ankle ligaments requires a 1.5-2 cm incision on the front/outside of the ankle allowing for placement of soft tissue anchors and repair of the ligaments. Patients then are instructed to no put any weight on their surgical leg for 6 to 8 weeks while being in a cast and/or boot.
CURRENTLY, I perform this same surgery by makeing ONLY 3 poke holes in the skin which allows not only for decreased pain/swelling post operatively, but also for my patients to begin walking on the surgical leg just 2 weeks after surgery. Physical therapy also starts 2 weeks after surgery and patients are returning to regular shoe gear at 6 weeks. Multiple patients will return to their regular activity SIGNIFICANTLY quicker than the traditional open technique. (also confirmed with current literature regarding minimally invasive ankle surgery)
Please schedule your appointment with us today if you suffer from chronic ankle sprains!!