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Suffering From Pain In Ankle. MRI Done. What Does The Report Says And What Treatment Is Required?

Posted on Fri, 23 Nov 2012

Question: I had an MRI done of my left ankle recently. I have been suffering from pain that has significantly gotten worse over the years. The MRI results read as follows:
Significant degenerative change at the anterior articulation of the medial malleolus and talus, as well as the articulation of the lateral malleolus and talus, with associated old injuries of the deltoid ligament, anterior and posterior talofibular and cacaneofibular ligaments. Moderate tenosynovitis of the posterior tibialis tendon, without evidence of tear. Mild degenerative change of the tibiotalar joint and talonavicular join.

What treatment plan would you suggest in this case?

Answered by Dr. Saurabh Gupta (1 hour later)

Hello,

Thanks for posting your query.

I read through the details of the report. According to it you might have chronic instability of the ankle resulting from old rupture of ligaments. The following are the options of treatment:

1. If you are symptomatic, you should first be treated conservatively. Symptoms may be decreased by broadening and lowering the heel of the shoe.

2. For severe disability and instability, a muscle strengthening program should be tried for several months, and you may improve enough to make a reconstructive operation unnecessary.

3. When disabling pain and instability persist, you may consider reconstruction of lateral ligaments after discussing with your surgeon.

Hope I have answered your query. Let me know if you have any more concerns.

Wishing you good health....

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Saurabh Gupta (20 hours later)

In addition the MRI results, I suffer from Osteoarthritis in the same ankle. I have been in physical therapy for the last two months to strengthen the ankle.

What results can I expect from a reconstruction of the ligaments and what would the recovery period look like (splint, cast, crutches, etc.)

Answered by Dr. Saurabh Gupta (2 hours later)

Hello,
Thanks for posting your query again.

I suggest you to continue muscle strengthening program for few more months before going for surgical options.

You can expect satisfactory results from reconstruction of the ligaments like watson-jones, XXXXXXX and Elmslie operations. These procedures use the peroneus brevis tendon to reconstruct the anterior talofibular and the calcaneofibular ligaments. It is difficult to predict if you even need crutches or splint. A lot of factors contribute to the recovery including the skills, muscle strength and conditioning and post operative physio.

You can discuss the following options with your orthopaedic Surgeon.

Hope I have answered your query. Let me know if you have any more concerns.

Please accept my answer in case you do not have further queries.

Wishing you good health.
Regards.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar