Global ankle instability: clinical and functional assessment at average 26-month follow-up

Abstract

Objective: Ankle sprains are common affecting 2.15 per 10,000 persons per year. They are among the most common athletic injuries and represent 15 to 20% of all athletic injuries. Typically patients injure the lateral ligaments; however, a subset of patients sustain injury to the medial and lateral ligamentous complexes, representing a more severe injury. We present a group of patients with this disease, and evaluate the results of surgical treatment and its evolution. Methods: We retrospectively reviewed a consecutive cohort of patients that were treated with medial sided ligamentous reconstruction and were greater than 6 months from their index procedure. Patients that had an isolated medial sided repair or patients that had a medial sided repair in conjunction with a degenerative flatfoot reconstruction were excluded. Patients returned for radiographs, clinical examination by a blinded observer and a functional evaluation. Descriptive statistics were performed. Results: The mean follow-up was 26.4 months (range 8 to 62 months). At final follow-up 13 of 14 patients with “satisfied” or “very satisfied” with their surgery. Twelve would have the procedure again, one was unsure and one would not have the procedure again. The average Foot Function Index was 17% (zero to 62%). The average American Orthopaedic Foot & Ankle Society (AOFAS) score was 88.15 (66 to 100). Conclusion: Some patients who sustain ankle sprains will have medial and lateral sided pathology or global ankle instability. When treated surgically with medial and lateral ligament reconstruction, these patients can have reasonable outcomes and levels of clinical stability and in the intermediate-term. Level of Evidence: Case Series IV.