Ankle ligament reconstruction

Ligament reconstruction of the ankle is indicated when there is functional instability or repeated episodes of the ankle giving way. This typically occurs after a severe ankle sprain and symptoms persisting greater than 3 months.

The ankle ligaments are reconstructed using bone anchors and then reinforced with a synthetic (collagen) ligament to provide extra support. This is typically combined with a keyhole operation of the ankle (arthroscopy) to explore the joint and address any problems inside the ankle joint itself.

Figure 1: repair of the ankle ligaments on the outside of the ankle (lateral ligaments)

Figure 2: graft may need to be used to reconstruct the ligaments on the inside of the ankle (medial deltoid ligament)

Success rates: up to 95% of patients have a good result from this operation.

 

Post-operative plan:

  • Surgery is typically a day case or overnight stay

  • Local anaesthetic or a nerve block is administered to help with pain

  • 0-2 weeks: elevation at home, but weight bearing in a CAMboot is allowed

  • 2-6 weeks: full weight bearing and weaning out of the CAMboot, ongoing physiotherapy required.

  • 6 weeks onwards: continued rehabilitation, symptoms can sometimes take up to 6 months or longer to resolve fully.

Download post-operative care guide

Risks of surgery

  • Swelling, stiffness

  • Infection

  • Wound healing problems

  • Scar sensitivity

  • Failure of the procedure (ligament re-injury)

  • Further procedures