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Ankle Sprains: 30 Years Later -- Osteoarthritis

Ankle injuries are common in running and jumping sports, especially soccer. Ligament sprains and bone fractures are the most common traumatic injuries. Poor alignment of the ankle and an unstable joint occur in up to 30 percent of adults with previous ankle injuries. The results of a new study show that ankle osteoarthritis is common 30 years later.

Patients going to an ankle arthritis center over a period of seven years were included in this study. There were 261 cases of post-traumatic ankle sprains. Of these, 185 led to painful ankle arthritis. Thirteen percent of the 185 ankles were from ligament sprains. Over half were from sports activities. The rest occurred during daily activities.

Using measures of ankle pain, motion, alignment, and joint stability, the authors found the following results:

  • Most of the sprains were of the lateral (outer side) ankle ligaments.
  • Single ankle sprains had worse results than chronic, recurring ankle sprains
  • Two-thirds of the patients had conservative treatment without surgery; one-third had a repair of the ligament
  • Post-traumatic osteoarthritis developed sooner in the single ankle sprains
  • Medial ankle sprains (inside edge) had worse results than lateral ankle sprains
  • Two-thirds of the athletes returned to sports but not at their full level
  • Ankle arthritis occurred 10 years later in the group treated conservatively compared to the patients who had a surgical repair of the torn ligament

    This report presents results of the longest study of ankle ligament sprains leading to posttraumatic ankle osteoarthritis. Sports athletes and especially soccer players seem to be at greatest risk. Doctors should be aware that ankle instability occurs in over half these cases.

    Victor Valderrabano, MD, et al. Ligamentous Posttraumatic Ankle Osteoarthritis. In The American Journal of Sports Medicine. April 2006. Vol. 34. No. 4. Pp. 612-620.

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