Treatment of Chronic Ankle Instability in the Military Population

CATEGORY: Ankle; Sports INTRODUCTION/PURPOSE: The high incidence of ankle sprain within the military sets the stage for prevalent chronic ankle instability. The purpose of this review was to compare and evaluate chronic ankle instability treatment strategies in the military population. METHODS: Electronic databases were systematically searched for English-language, human studies with a military patient population that had been diagnosed with and treated for chronic ankle instability. Exclusion criteria were animal, cadaver, and review studies and case reports. RESULTS: Eight studies met inclusion criteria and represented 695 military service members-625 males (89.9%) and 70 females (10.1%). The four treatment strategies included were Broström-related procedures, modified Watson-Jones procedure, Colville's technique, and anatomic lateral ligament reconstruction using semitendinosus tendon allograft. The percentage of subjective satisfactory outcomes ranged from 80 to 94.7%, and the percentage of objective satisfactory outcomes ranged from 72 to 100%. The range for Broström-related procedures was 73.2% (objective) to 94.7% (subjective). The modified Watson-Jones procedure had a subjective satisfactory outcome of 80% and objective satisfactory outcome of 72%. Colville's technique had an objective satisfactory outcome of 100%. No satisfaction outcome was available for the study utilizing the anatomic lateral ligament reconstruction with semitendinosus tendon allograft. Mean American Orthopaedic Foot & Ankle Society (AOFAS) scores, anterior drawer displacement, talar tilt, and visual analogue scale (VAS) scores were also reported. CONCLUSION: This review demonstrates that the Bröstrom procedure has consistently satisfactory outcomes within the military population, and Colville's technique is another promising option for this patient population, but would require future studies to fully support this claim.