Cochrane Summaries

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Chronic lateral ankle instability may be treated with or without surgery

de Vries JS, Krips R, Sierevelt IN, Blankevoort L, van Dijk CN
Published Online: 
10 August 2011

Chronic ankle instability is common after an acute lateral ankle sprain. Initial treatment is conservative, either with bracing or neuromuscular training. However, if symptoms persist and the ligaments on the outside of the ankle are elongated or torn, surgery is usually considered.

This review includes 10 small and flawed trials that recruited a total of 388 people with chronic ankle instability. Limitations in the design, conduct and reporting of these trials meant that it was difficult to be certain that their results were valid.

Three trials compared neuromuscular training with no training. These found a programme of neuromuscular training appears to provide short term improvement in functional stability. One trial testing the use of a special cycle pedal found that it did not make an important difference to function. However, none of these four trials followed-up patients after the end of treatment.

Four trials compared different types of surgical intervention. There was insufficient evidence to strongly support any specific surgical procedure for treating chronic ankle instability. Two trials found that, after surgical reconstruction, early functional rehabilitation enabled patients to return to work and sports quicker than six weeks immobilisation.