I just learned that AnkhSVN now supports Visual Studio 2005. Sweetness.
Ankh is by no means a replacement for TortoiseSVN, but rather a plugin for VS that makes your life a bit easer. Tortoise and Ankh go hand in hand with each other.
Usually I commit my changes, add my files, and call Update directly from Ankh. Sometimes, for example with files outside of VS, I’ll use tortoise.
In the event that something is screwed up, Tortoise is the way to go to get things on the right track again. You just have so much more capability with that tool.