Multidirectional chronic ankle instability: diagnostics and management

Chronic ankle instability (CAI) is a complex condition involving dysfunction of multiple stabilizing structures within the ankle joint. While traditionally associated with lateral ligament involvement, CAI can also affect the medial and syndesmotic complexes, leading to multidirectional CAI (MD-CAI). MD-CAI is characterized by instability in all three ligamentous structures, resulting in rotational and translational talar motion within the ankle mortise. Accurate diagnosis requires a thorough clinical assessment supplemented by advanced imaging modalities such as weight-bearing computed tomography (WBCT) and magnetic resonance imaging (MRI). Arthroscopy plays a critical role in confirming MRI and WBCT findings while also enabling the identification and management of intra-articular pathologies that may contribute to instability. Management of MD-CAI necessitates a tailored surgical approach, often involving reconstruction of multiple ligamentous complexes to restore ankle stability and optimize functional outcomes.

Duke Scholars

Author Cesar de Cesar Netto Orthopaedic Surgery