https://omny.fm/shows/healthy-lifestyle/dr-william-edwards-on-ankle-sprains

Chronic pain and instability following ankle sprain

An Ankle sprain is an extremely common sporting injury. Tearing of the lateral ligaments is often accompanied by intra – articular pathology which can contribute to longstanding ankle pain and instability.

If, after rigorous physiotherapy, recurrent ankle sprains and instability is experienced, surgery for stabilisation is recommended.

By ensuring the ankle ligaments are strong, this makes the ankle stable and helps prevent further injury

If, after rigorous physiotherapy, recurrent ankle sprains and instability is experienced, surgery for stabilisation is recommended.

Osteo Chondral Defect (OCD)

When a patient has a history of ankle instability and repeated sprains, both the bone and cartilage will be affected. There are differing severities of talus injury. Minor injury should recover with rest and elevation. More severe injuries may result in loose bone fragments and cartilage in the ankle joint which may result in surgery.

The severity of the injury determines if surgical intervention is required.

Ankle arthroscopy can be used to visualise and debride the ankle joint. If the injury is more extensive, cartilage grafting is an option.

Ultimately, if there is a significant effect, an ankle fusion may be required to alleviate the pain.

 

Arthroscopy and Reconstruction

This surgery is primarily aimed at debriding the ankle joint, stabilising the surrounding ligaments and preventing arthritis. Both surgeries are done at the same time and this allows any underlying joint pathology to be treated as well as stabilising the joint.

 

Ankle arthritis

Arthritis affecting the ankle joint typically presents as a painful stiff ankle. There are a variety of causes for ankle arthritis and there are a number of surgical procedures aimed at addressing symptoms. Non surgical or conservative treatment includes: bracing, shoe wear selection, exercise and pain medication.

The type of ankle surgery will depend on the severity of the disease and the level of symptoms experienced.

 

Ankle Fusion

An ankle fusion is the most reliable surgical option when the ankle is stiff and painful. The degenerate joint surface is surgically removed and then fixed together with screws.

The bones heal in this position and should remain insitu permanently. This surgery aims to convert a stiff painful ankle joint into a solid comfortable joint.

 

Ankle Replacement

This surgery is aimed at preserving ankle joint motion.

The worn out joint surfaces are removed  and replaced with a metal implant that functions similarly to a normal ankle joint. Whilst this is a less reliable option than the ankle fusion, performed on a suitable patient can produce desired results.