From the Guidelines
The post-operative protocol following lateral ankle stabilization should prioritize early mobilization and rehabilitation, with a focus on functional exercises and bracing, as evidenced by the most recent guidelines 1. The goal of this approach is to minimize morbidity, mortality, and improve quality of life by promoting optimal healing and preventing chronic instability. Key components of the protocol include:
- Immobilization for a short period, if necessary, to relieve pain and swelling
- Use of a brace or tape in combination with an exercise program to promote stability and strength
- Progressive weight-bearing and range of motion exercises, avoiding inversion that could stress the repair
- Physical therapy for strengthening, proprioception, and balance exercises The specific details of the protocol may vary depending on the individual patient's needs and the surgeon's preferences, but the overall emphasis should be on early mobilization and functional rehabilitation, as supported by the evidence 1. In terms of specific interventions, the use of a brace or tape in combination with an exercise program has been shown to be effective in promoting stability and strength, and should be considered a key component of the post-operative protocol 1. Overall, the post-operative protocol following lateral ankle stabilization should be tailored to the individual patient's needs, with a focus on promoting optimal healing, preventing chronic instability, and improving quality of life.
From the Research
Post-Operative Protocol Following Lateral Ankle Stabilization
The post-operative protocol following lateral ankle stabilization is a crucial aspect of the recovery process. Several studies have investigated the optimal post-operative rehabilitation protocol, including the timing of mobilization and weight-bearing.
- Mobilization Timing: A systematic review and meta-analysis 2 found that the timing of post-operative mobilization made no difference in functional outcomes or post-operative stability for patients undergoing lateral ankle ligament reconstruction. However, another study 3 found that early mobilization resulted in earlier regain of plantar flexion strength compared to immobilization.
- Weight-Bearing: A review of variability in rehabilitation protocols after lateral ankle ligament surgery 4 found that weight-bearing was consistent between most protocols, with 86% of repair and 78% of reconstruction protocols recommending no weight-bearing immediately after surgery. However, a study on early mobilization following elective ankle lateral collateral ligament reconstruction 5 suggested that controlled early weight-bearing is advisable in patients undergoing surgery for chronic lateral collateral ligament instability.
- Rehabilitation Protocols: A consensus opinion from the ESSKA-AFAS Ankle Instability Group 6 presented a best-evidence approach to rehabilitation after ankle ligament surgery, including recommendations for the initial post-operative period, early recovery phase, and goal-orientated late rehabilitation and return-to-sport phase. However, a review of rehabilitation protocols after lateral ankle ligament surgery 4 found significant variability in post-operative protocols, highlighting the need for standardization.
- Complications: A study on early mobilization following elective ankle lateral collateral ligament reconstruction 5 found that there may be an increased risk of postoperative complications, mainly wound-related, with early mobilization compared to delayed mobilization. Another study 3 found that one patient had a superficial wound infection, but there were no other complications reported.
Key Findings
- Early mobilization may result in earlier regain of plantar flexion strength compared to immobilization 3.
- Controlled early weight-bearing is advisable in patients undergoing surgery for chronic lateral collateral ligament instability 5.
- There is significant variability in post-operative protocols after lateral ankle ligament surgery, highlighting the need for standardization 4.
- The timing of post-operative mobilization may not affect functional outcomes or post-operative stability 2.