Surgery improves athletes' ankle stability after sprain

An elderly woman wraps her sprained ankle in a handout photo.

NEW YORK (Reuters Health) - For athletes with chronic ankle instability, surgery may help when conservative therapies fail, a new study suggests.

Ankle sprains occur when the ligaments connecting the bones of the joint become overstretched or tear. Ankle sprains are one of the most common injuries in athletes, and in most cases, they heal with conservative treatments like ice, anti-inflammatory painkillers and physical therapy.

But in some cases, the injury leads to lasting instability in the joint, particularly in athletes who have suffered multiple ankle sprains.

In the new study, researchers at the University of Massachusetts Medical Center looked at whether surgical reconstruction of the damaged ligaments was helpful for 62 athletes who'd tried at least six months of conservative therapy.

The patients, who ranged in age from 16 to 26, had chronic lateral ankle instability -- meaning the outer side of the ankle frequently "gave out" when they put weight on it.

All underwent a surgical procedure that uses "suture anchors" to secure the injured ligaments to the bone.

One and two years after surgery, patients reported improved ankle function, and by the second year nearly all -- 94 percent -- had returned to their previous level of activity, Dr.

Xinning Li and colleagues report in the American Journal of Sports Medicine.

In addition, the researchers found, the long-term range of motion in the injured joint was similar to that of the uninjured ankle in all but three patients.

In all, three patients suffered a repeat rupture in the repaired ligament.

Athletes in high-demand sports put much more stress on their ankles than the average person, Li's team writes, which makes it "imperative" to reconstruct a chronically unstable joint.

The current findings, they write, suggest that doing so can return athletes to their original activity levels, with both flexibility and stability in the ankle joint.

SOURCE: American Journal of Sports Medicine, March 2009.