Treatment of chronic anterolateral ankle instability in athletes

An inversion trauma with damage to the anterolateral ankle ligaments is one of the most common injuries in athletes, especially in high risk sports like volleyball, basketball and soccer. Treatment is functional, leading to full recovery in the majority of athletes. Approximately 20% suffer from recurrent instability and require further treatment. Chronic anterolateral ankle instability is often caused by disturbed proprioception of ankle joint. Increased ligament laxity is present in a number of patients. Initial treatment of chronic anterolateral ankle instability in athletes is functional, consisting of proprioceptive training and prevention of recurrent sprains by taping or bracing of the ankle. When functional treatment fails and increased laxity of the ligaments is present, surgical treatment is warranted. Surgical treatment can be divided in anatomical and non-anatomical reconstructions. Recent literature has shown that an anatomical reconstruction leads to better long-term results in athletes than non-anatomical reconstructions. Anatomical reconstruction is therefore the surgical treatment of choice in patients with chronic anterolateral ankle instability.