When is surgery necessary to repair a torn ankle ligament that is causing prolonged ankle pain? (photo)

Thank you for your question. Unfortunately I can only see half the report, and hence it is difficult to advise you fully without all the information.

As Dr Sean mentions, the two important symptoms following an ligament injury are pain and instability.

Often, pain can be due to a cartilage injury, a loose body in the joint, or recurrent sprains. Depending on the number of ligaments injured, options include:

1. Seeing a Physiotherapist to rehabilitate the ankle.

2. Seeing a Podiatrist, who can provide orthoses to help stabilise the ankle.

3. Seeing a Sports/MSK Physician to discuss options such as prolotherapy, cortisone or PRP injections.

4. Seeing an Orthopaedic surgeon for ankle ligament reconstructions.

If pain is the issue, and there are not problems inside the joint, then perhaps if this symptom can be settled, it will allow rehabilitation to be undertaken. Sometimes, however, simply offloading and giving the ankle a chance to settle down itself is also an option!

Good luck to your mum! And if you can share with us the other half of the report, including the images, that would be most useful.

Bw

Dr Dinesh

Hi,

Thank you for your email. I see plenty of torn ankle ligaments, and that is something that is extremely common. Often it starts from a simple sprain.

If not taken care of properly, this may lead to either prolonged pain, or instability. These are the two most common complaints that patients have.

For your mum, whether or not she requires surgery depends on what the exact problem is. For example:

• How many ligaments are torn, and to what extent they are torn
• Are there also any other pathology within the ankle joint? Such as a talar osteochondral lesion or loose body? These can come about from the constant increased pressues on the ankle (as a result of the torn ligaments and subsequent instability)

I would recommend having a thorough physicial examination of your mum's ankle to assess its stability. Going through the MRI scans properly with the surgeon would also be helpful to see that the scans and physical signs correlate.

If she is very symptomatic, surgery is a treatment option that is definitely possible.

Do let me know if there are any other questions or concerns.

Best regards

Dr Sean Ng