Evolution in Surgical Management of Ankle Instability in Athletes

Brian C. Lau, MD; Alexej Barg, MD; C. Thomas Haytmanek, MD; Kirk McCullough, MD; Annunziato Amendola, MD


J Am Acad Orthop Surg. 2021;29(1):e5-e13. 

In This Article

Advanced Imaging

Advanced imaging is usually obtained. Stress radiographs may be useful (Figure 1) and have comparable accuracy with MRI in the diagnosis of ankle instability, 74% to 71%, respectively.[4] MRI, however, does provide the added benefit of visualizing concomitant pathology including peroneal tendon tears, osteochondral lesions, deltoid injury, and soft-tissue impingement. It is important to evaluate the patient for concomitant injuries because some reports demonstrate that up to 96.9% of patients with ankle instability have additional pathologies.[5]

Figure 1.

Ankle stress radiographs: stress radiograph demonstrating medial instability with tilting (A) lateral gapping demonstrating instability to lateral ligaments and (B) medially gapping demonstrating instability to deltoid ligament.