Sprained left ankle for a year and a half. Ligament injury, synovitis with effusion?

Condition summary:
Sprained left ankle for a year and a half. Ligament injury, synovitis with effusion

Condition Description:
Female, 34 years old. Left ankle sprain nearly a year and a half (in September 2015 when walking) has not healed yet. Applied bandage for a week after the injury but continued commuting without no long-term rest. Now I can still feel pain and instability inside the ankle. My latest MRI test indicates ligament injury, synovitis with effusion etc. (see the uploaded MR films please) Have taken anti-inflammatory medicine and several external use of ointment, feeling no significant effect.

I Hope the doctor could help me in:
My condition dragged on for a long time. Both internal and external use have been tried. So far there are still discomfort walking, let alone doing sports. Some physicians I visited in person recommend taking glucosamine sulfate capsules, while some recommend of physiotherapy, even arthroscopy surgery, making it hard to decide which one to follow. Therefore, I would truly appreciate your opinion on the optimal treatment for this situation.
sprained left ankle

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Masr Fawzy
4:43 pm

Ankle brace, and putting the ankle in the intial range of movement gradually with strengthening exercises – by physiotherapy- will do a great job,
Also antiinflammatory drugs with ice packs. For the effusiom will be efficient ,
Wearning special footwear should be put in consideration…

Masr Fawzy
4:44 pm

I do not believe surgery would be beneficial in cases of ankle sprains or even neglected ones…

Ahmed Fawzy
5:28 pm

Optimal treatment will be physical therapy + 6 month calcium and vit d supplement , i know it may seem not convincing but you will be cured within 3 to 6 month , i have personally treated many similar cases within 1 to 3 month with physical therapy , notice that even after surgery you will need physical therapy (pick a good physical therapist )
Good Luck

Ayman Darrag
6:20 pm

In my clinical practice I have seen many conditions complicated like this and not getting better with medications..
The only successful treatment is a full course of 2months physiotherapy and focus on proprioceptive training …
Ultra sound and strengthening exercises are great ..
Keep your ankle taped with kinediotsping from session to session with a professional practioner.

4:53 am

if the ligament tear is grade to 3,then it indicates complete tear and will never heal with conservative management.
In fact,it will damage the synovial cartilage in long term.
Best treatment is a arthoscopic repair of the torn ligament followed by aggressive physio and ankle strengthening exercises.