Publication:

Do we need early ankle arthroscopy for the patients with acute lateral ankle instability

Background Lateral ankle injury is the most frequently encountered trauma in physically active populations. The general approach to acute lateral ankle instabilities is conservative treatment.

Methods We investigated the effects of compliance to conservative treatment on permanent instability and other intra-articular pathologies and the outcomes of insufficiently treated lateral ankle instability. These patients underwent conservative treatment for at least 3 months. At the end of this period, anterior ankle arthroscopy was performed for patients who continued to report ankle problems. The patients were grouped according to compliance and noncompliance with conservative treatment.

Results The rate of compliance for conservative treatment was 41.4%. Arthroscopy revealed that the rate of osteochondral lesions of the talus was 45.3%; 51.6% of the patients had partial or complete lateral ankle ligament injury. The rate of lateral ankle instability was significantly lower in patients who were compliant with conservative treatment (39.6% vs. 60%, p<0.05). Lateral ankle instability was accompanied by osteochondral defects in only 5 patients who were compliant with conservative treatment.

Conclusions For ankle injuries associated with lateral ankle instability, conservative treatment can decrease instability levels and other pathologies, which may become chronic over time. However, arthroscopy may be required due to ankle pathologies accompanying instability and an early decision for arthroscopy may reduce the incidence of permanent lateral ankle instability.