Ankle instability and ligament repair
Our consultants at Parkside Orthopaedics and Sports Medicine Centre are experts at treating foot and ankle conditions. If your ankle feels unstable, we can make a fast diagnosis and offer you non-surgical or surgical treatment to improve your symptoms.
What is chronic ankle instability?
Chronic (persistent) ankle instability is when your ankle repeatedly feels as if it is ‘giving way’. This condition affects the outer side of the ankle. Your ankle may turn inward and feel wobbly or unstable, particularly when you walk on uneven surfaces.
If you have chronic ankle instability, your ankle often ‘gives way’ whenever you put pressure on the joint. This is most common when walking, running or playing sport, but your ankle may also feel unsteady when you are just standing. Other symptoms of chronic ankle instability are pain or tenderness, discomfort and swelling.
What causes chronic ankle instability?
Strong bands of tissue called ligaments support your ankle joint and help to keep the bones in the correct position. If you sprain your ankle by twisting or turning the joint in an awkward way, this can stretch and tear the ligaments.
Chronic ankle instability usually occurs after repeated ankle sprains. If an ankle sprain does not heal properly or is not treated correctly, there is a risk of spraining the ankle again. With each sprain, the ligaments are stretched more and become weaker. This can make the ankle joint unstable and damage the bones and cartilage (connective tissue) over time.
Many athletes develop chronic ankle instability because a lot of pressure is put on their ankle joint during sport.
How is chronic ankle instability diagnosed?
If your ankle feels unstable or has been repeatedly sprained, you can have a full assessment at Parkside Orthopaedics and Sports Medicine Centre. A specialist orthopaedic consultant asks you some questions about your symptoms and any previous ankle injuries.
Your consultant then carefully examines your ankle for any signs of tenderness, swelling or instability. They may gently stretch your ankle in different directions or observe you while you walk. This helps the consultant to find out whether your ankle ligaments are weak.
To make an accurate diagnosis, your consultant may arrange for you to have a digital X-ray, MRI, CT or ultrasound scan. Our Diagnostic Imaging Suite has advanced equipment and performs high quality scans in a relaxed, comfortable environment.
Can chronic ankle instability be treated without surgery?
Your treatment depends on whether the condition is severe and whether you have an active lifestyle. Non-surgical options are usually recommended first and may include:
• Physiotherapy: You can work closely with one of our physiotherapy team, who offer various rehabilitation therapies. Your physiotherapist teaches you exercises to strengthen and retrain the muscles around the outside of the ankle. These exercises are also intended to improve your balance and range of movement. We give you practical guidance about resuming your normal activities or specific sport. After having physiotherapy, you may find that your ankle joint is much more comfortable and stable.
• Moulded insoles (orthotics) in your shoes: Your consultant examines the shape of your feet. If this shape puts extra pressure on your ankle ligaments, you can wear moulded insoles in your shoes to reduce the pressure. The shoe inserts are called orthotic devices.
• Ankle brace: Your consultant may recommend that you wear an ankle brace. This helps to support your ankle, prevent the joint from turning inwards and avoid more sprains.
• Medicines: Your consultant may prescribe anti-inflammatory medicines, such as aspirin or Ibuprofen, to reduce the swelling and pain in your ankle.
Can chronic ankle instability be treated with surgery?
If your ankle ligaments are weak and your condition does not improve after other treatment, your consultant may recommend an operation. This involves tightening or replacing the weak ankle ligaments.
The type of ankle ligament repair surgery that you have depends on your individual case. At Parkside Orthopaedics and Sports Medicine Centre, we have leading foot and ankle surgeons and four modern operating theatres. You typically have a general anaesthetic. This means that you are asleep during the operation and do not feel any pain.
Your surgeon may initially perform a keyhole procedure called an ankle arthroscopy. This allows them to inspect the inside of your ankle joint with a camera and assess the damage. The surgeon then carries out one of these minimally invasive procedures:
• Broström procedure: To tighten the weak ankle ligaments, your surgeon reattaches them to the bone with stitches or small metal screws in the bone. The surgeon also stitches the layer of surrounding tissue in place to give extra support.
• Tendon transfer procedure: Your surgeon replaces your damaged ankle ligaments with a tendon (a band of connective tissue). The tendon is held in place with stitches and sometimes small metal screws in the bone.
What happens after ankle ligament repair surgery?
After ankle ligament repair surgery, your foot and ankle are put in a plaster cast for two to six weeks. This protects your newly repaired ankle joint. Before you leave the hospital, a physiotherapist teaches you how to move with crutches or a walking frame. You normally go home on the same day or after staying in hospital for one night.
We may replace your plaster cast with a special boot. You can then start to put some weight on the ankle. Most people recover well from ankle ligament repair. We offer a physiotherapy programme to suit your needs and our team are here to support you. Surgery is very effective at making your ankle more stable and less likely to ‘give way’.
If you suffer from chronic ankle instability, Parkside Orthopaedic and Sports Medicine Centre provides first-class independent healthcare. To make an appointment with a specialist orthopaedic consultant, please call 020 3944 0568 or complete this form online. Appointments are available six days a week.
Ankle instability and ligament repair Consultants