Ankle Instability

Ankle Instability

Ankle instability means repeated ankle sprains and no longer being able to “trust” your ankle. Only 15 to 20% of patients go on to have chronic or long-lasting ankle instability after a severe ankle sprain. Many patients have attempted multiple courses of physical therapy, ankle braces, and changes in their activities, but continue to have ongoing issues with their ankle “giving-out.”

Dr. Kohring recommends patients attempt conservative management before considering surgery to fix their torn ligaments. Every patient has a different activity-level, thus surgery is dependent on many factors. Dr. Kohring will be happy to discuss your specific situation in the office. She will evaluate your ankle in the office and order an MRI to further evaluate your ligaments, tendons, and the cartilage in your joint.

Surgery

Surgery to repair your ankle ligaments is called a lateral ligament reconstruction or “Brostrom-Gould” procedure. This involves rebuilding and tightening your lateral ligaments with your previously torn tissue. Additionally, Dr. Kohring will perform an ankle arthroscopy where she makes two small incisions on either side of your ankle joint to look inside to assess for any cartilage injuries or other torn ligaments. Many patients will also injure the peroneal tendons, which are on the outside of the ankle. She will assess and repair these tendons as needed based on the results of your MRI and surgical findings.

After surgery, patients are in a splint (like a cast) for 2 weeks. She then will take out your sutures and put you into a walking boot and allow you to put as much weight as you are able on your foot. You will also start physical therapy at this time. Once you are walking pain-free in the boot, you will go into a regular shoe with an ankle brace. She requires you to wear the ankle brace for 3 months after surgery to protect the ligament repairs and allow your ankle to strengthen. By 5 months, most patients are back to all the sporting activities they enjoy doing without restriction or pain. The success rate for surgery is around 90%. 

Revision Surgery

Although success rates are high after a lateral ligament reconstruction, some patients may fail their surgery and continue to have ongoing issues with ankle instability. Ongoing ankle instability can lead to chronic pain, early arthritis, and limitations in daily activities and sports. Dr. Kohring has extensive experience in treating patients and athletes with these complex cases. She will be happy to review your specific case in the office to determine the treatment option best for you.