Ankle instability

With ankle instability, you have the feeling of sinking through your foot. This feeling can occur during sports activities but can also occur in everyday life. Abnormalities in the ankle or a (frequent) injury that has not healed properly can damage cartilage and cause instability.

Symptoms

The symptoms below may occur:

  • Swelling
  • Pain
  • Frequent twisting of the unstable ankle

The foot may feel stiff after a period of rest. With an ankle sprain, the ankle often immediately becomes thick and blue and is very painful.

Diagnosis

The doctor makes a diagnosis based on the patient's symptoms and on physical examination. Imaging is also performed to rule out that there is no fracture in the ankle or to see if the cartilage is damaged and which ligaments are damaged. This is usually done with a standard X-ray and/or an NMR scan (MRI).
RX skeleton

Treatment

We always try to first increase the stability of the ankle without surgery. For this, an intensive exercise schedule is drawn up with a physical therapist to train the stability and especially to improve the control of the muscles around the ankle (propriocepsis). This intensive exercise therapy is usually combined with wearing a brace.

Intervention

When the previous treatment is not effective enough, surgery will be necessary. Depending on the tissue and/or cartilage affected, either keyhole surgery or open surgery is chosen. The recovery period is the same for both procedures.

For an ankle instability with good tissue, the standard procedure is sufficient. This involves making an incision across the outer ankle forward. The ankle ligament is exposed, passed through and sutured back onto the outer ankle with an anchor (small screw from which solid sutures come out) to make it shorter and firmer again. Next, the capsule that runs across the entire ankle (the retinaculum) is exposed and sutured over the ankle ligament for added stability. The wound is sutured with soluble sutures.

The surgeon can only really see if the tissue of the ankle ligament is strong enough to suture during the procedure. If there is insufficient tissue strength, an internal brace is placed. This is a type of lace band that the doctor can attach like a new ankle ligament with two anchors in the places where the ankle ligament normally attaches.

Arthroscopy (keyhole surgery)

Recovery

The ankle is immobilized with a cast and walker boot to allow everything to heal properly. This must stay on day and night for six weeks. For the first two weeks, you should not put any weight on the joint and may have to walk with crutches. After six weeks, you must wear a brace for another six weeks throughout the day. The first year after surgery, you should not play sports without a brace. For more intense sports such as soccer, basketball, volleyball or field hockey, among others, it is usually advised to play sports with the brace even longer.

Departments

For more information, contact the orthopaedics department.

Telephone 011 33 42 86