Chronic and recurrent ankle sprains.
Persistent symptoms such as pain, swelling, or giving way after lateral ligament injuries of the ankle are not uncommon. The treating orthopedist must first decide whether the symptoms are related to the ankle instability. Intra-articular or extra-articular injury may occur concomitantly with either a stable or unstable ankle, and careful diagnostic evaluation must be undertaken. Arthroscopy of the unstable ankle in which there is significant pain without demonstrable intra-articular injury by bone scans, CT scans, and MRI studies is indicated, as intra-articular lesions do occur that may result in chronic pain after the ankle has been rendered stable. An arthroscopic lateral ankle capsulodesis procedure has been described with promising early results. Arthroscopic management of an intra-articular pathologic condition in the stable ankle involves removal or excision of offending bone and/or soft tissue. Patients' symptoms can be improved significantly by these approaches, after which there can be a return to a more normal level of function.