What Is Ankle Ligament Reconstruction Surgery?
Ankle ligament reconstruction surgery is used to repair, reinforce or reconstruct damaged ligaments that are causing ongoing ankle instability.
Depending on the condition of the ligaments, treatment may involve direct repair, repair with reinforcement or reconstruction using a tendon graft. The most appropriate approach depends on ligament quality, the pattern of instability, associated injuries, anatomy and whether the procedure is a primary or revision surgery.
What Are the Surgical Approaches for Ankle Ligament Reconstruction?
Open Ligament Repair
Open ligament repair uses an incision to access and repair the damaged ligaments. A Broström-type technique may be considered depending on the injury and the surgeon’s assessment.
Arthroscopic Ligament Repair
Arthroscopic repair uses a camera and specialised instruments through small incisions to assess and repair the ligament. It may also help identify associated problems within the ankle joint.
Percutaneous or Arthroscopic-Assisted Repair
These techniques use smaller incisions and may be performed with arthroscopic guidance. The choice depends on the injury pattern, ligament condition, associated injuries and the surgeon’s assessment.
Ligament Reconstruction With a Graft
A tendon graft from another part of the body or a donor may be used when the native ligaments are unsuitable for direct repair. This may be considered in selected severe, longstanding or revision cases.
What Happens in Ankle Ligament Reconstruction Surgery?
Before surgery
Your surgeon will examine your ankle and assess its stability, range of motion, tenderness and associated symptoms. X-rays or an MRI may be recommended to assess the bones, ligaments, cartilage, tendons and other structures around the ankle.
During surgery
Depending on your injury, the surgeon may:
- Repair or tighten the damaged ligament
- Reinforce the ligament
- Reconstruct the ligament using a tendon graft
- Use open surgery or small-incision techniques with a camera
The selected technique depends on your ankle condition and the extent of the ligament damage.
Anaesthesia
Ankle ligament surgery may be performed under general or regional anaesthesia. Your anaesthesia team will discuss the most suitable option with you before the procedure.
After surgery
Your ankle may be placed in a splint, cast or boot, and you may need crutches for a period of time. Your surgeon will explain how to manage pain and swelling, care for the wound and begin weight-bearing and physiotherapy safely.
Your recovery plan will depend on the type of surgery performed and how your ankle heals.
Recovery After Ankle Ligament Reconstruction Surgery
Recovery varies according to the surgical technique, extent of ligament damage, associated injuries and individual healing.
You may need a period of protection in a splint, cast or boot, followed by gradual weight-bearing. Physiotherapy may focus on restoring movement, strength, balance and ankle stability.
Return to work, exercise and sport should be gradual and guided by your surgeon or physiotherapist. You should follow your post-operative instructions and attend recommended follow-up appointments.
Don’t wait it out
Who May Be Suitable for Ankle Ligament Reconstruction?
An orthopaedic assessment is needed to determine whether surgery is appropriate. The decision depends on your symptoms, examination findings, ligament condition, associated injuries and response to non-surgical treatment.
Ankle ligament reconstruction may be considered for:
- People who have chronic ankle instability or repeated ankle sprains over time.
- Patients whose ankle continues to give way despite physiotherapy, bracing and activity modification.
- Individuals with significantly stretched, loose or damaged ankle ligaments.
- Patients whose ankle instability limits daily activities, exercise or sport.
- Selected patients requiring revision surgery after previous treatment.
- People with associated cartilage or tendon injuries that may contribute to ongoing instability.
About Your Orthopaedic Specialist
Dr. Gowreeson Thevendran
MBChB (Bristol) · MRCS.Ed · Dip. Sports Med.Ed · FRCS.Ed (Trauma & Ortho.) · FAMS (Singapore)
Dr Gowreeson Thevendran is an orthopaedic surgeon in Singapore who specialises in lower limb orthopaedic conditions, trauma and fracture surgery of upper and lower limbs. He received his medical education from the University of Bristol and completed his surgical training in the UK and Canada.
Before establishing his private practice, he served as Chief of Foot & Ankle Surgery in the Department of Orthopaedics at Tan Tock Seng Hospital, Singapore.
Questions patients ask
FAQs
How Do I Know If My Ankle Ligaments Are Torn?
Common symptoms may include pain and tenderness around the outer ankle, swelling, bruising, difficulty bearing weight and a feeling that the ankle is unstable. A medical assessment may be needed to determine the severity of the ligament injury.
Can You Walk With a Torn Ankle Ligament?
Some people can walk with a partial or complete ligament tear, while others cannot. Weight-bearing should follow the advice of a healthcare professional, particularly during the early stages of injury.
What Happens If a Torn Ankle Ligament Goes Untreated?
Persistent instability may contribute to recurrent sprains, ongoing pain, cartilage injury and difficulty returning to normal activities. Surgery may be considered when symptoms and instability continue despite appropriate non-surgical treatment or when the injury pattern warrants it.
What Are the Risks of Ankle Ligament Surgery?
Risks may include infection, wound-healing problems, nerve irritation or numbness, blood clots, stiffness, reduced range of motion, persistent pain, recurrent instability and anaesthesia-related complications.
Can I Return to Sports After Ankle Ligament Surgery?
Many people can return to sport after ankle ligament surgery. The timing depends on the extent of the surgery, ligament healing, strength, stability and progress during rehabilitation.Your surgeon or physiotherapist will advise you when it is safe to resume sporting activities.
Is Ankle Instability Affecting Your Daily Life?
If your ankle continues to give way or remains painful despite treatment, an orthopaedic assessment can help identify the cause and discuss your treatment options.
Is Ankle Instability Affecting Your Daily Life?
If your ankle continues to give way or remains painful despite treatment, an orthopaedic assessment can help identify the cause and discuss your treatment options.