Ankle Ligament and Cartilage Surgery in Singapore

Written by Dr Gowreeson Thevendran, MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed (Trauma & Ortho. ), FAMS (Singapore)

What Is Ankle Ligament Surgery

Ankle ligament surgery, formally known as ligament reconstruction, is a surgical procedure aimed at repairing or strengthening damaged ligaments within the ankle to restore stability and function. This operation is typically performed by an orthopaedic surgeon, a specialist in diagnosing and addressing injuries and disorders involving the musculoskeletal system.

Ankle Ligament and Cartilage - OrthofootMD Singapore

When is Ankle Ligament Surgery Needed

Ankle ligament surgery is typically considered when individuals experience persistent ankle instability, even after receiving proper sprained ankle treatments, such as physical therapy, bracing, and rest. This situation often arises in cases where the ligaments have been severely stretched or torn, leading to frequent sprains and a feeling of the ankle "giving way" during everyday activities or sports.

Additionally, surgery may be necessary if there is significant damage to the ligament that cannot heal properly on its own, or if the injury has led to the development of secondary issues, such as arthritis or cartilage damage, that could further impair ankle function. In these cases, your doctor may suggest an ankle ligament reconstruction surgery to prevent further damage.

Can the Ankle Ligament/Cartilage Heal Without Surgery?

Aside from ligament issues within the ankle joint, it is important to note that pain in the area may also stem from damaged cartilage. If you are experiencing ankle pain and instability, it is crucial to first determine whether it is due to a ligament or cartilage injury, as this will influence the type of management strategies needed.

Ultimately, only a qualified healthcare professional, such as an orthopaedic specialist, can determine if ankle ligament surgery is required. This is done through a series of clinical evaluations such as:

  1. Physical examinations to assess the stability, range of motion, and points of tenderness around the ankle.
  2. Imaging tests, such as MRI scans or X-rays, provide a clearer picture of the extent of the damage and to offer a comprehensive view of both the ligaments and cartilage.

These diagnostic steps are essential in developing a tailored support plan that addresses the specific nature and severity of the injury.

What Happens During Ankle Ligament Surgery

During this procedure, the surgeon will usually put the patient under general anaesthesia prior to the surgery. Following that, they will proceed to make a small incision through the skin and muscle of your ankle.

The surgeon may either shorten your ligament, remove it or re-attach the ankle using stitches. In some cases, the repair may involve a replacement with a tissue graft taken from other ligaments around the foot area.

Recovery Period for Ankle Ligament Surgery

After an ankle ligament surgery, some individuals may require the support of crutches for several weeks, depending on their recovery time and rehabilitation progress.

The recovery period following the ligament reconstruction involves several stages, starting with rest and protection of the ankle, followed by gradually increasing mobility with the aid of physical therapy. During the initial period after the surgery, swelling and discomfort are typically managed with medication, elevation, and ice.

Once the incisions have healed, special strength and flexibility exercises are gradually introduced as part of the rehabilitation programme. These exercises are designed to help with the ankle's range of motion, strengthen the muscles around the joint, and facilitate the return to pre-injury levels of function and stability.

It is important to note that the time taken for full recovery varies depending on the individual's condition and the surgery's extent. However, most patients should observe some improvements over time and with the help of diligent rest, post-surgery rehabilitation exercises and good foot and ankle care.

Dr Gowreeson Thevendran

MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed ( Trauma & Ortho. ), FAMS (Singapore)

Dr Gowreeson Thevendran is an orthopaedic surgeon who specialises in lower limb orthopaedic conditions, trauma, and fracture surgeries of both the 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, Department of Orthopaedics at Tan Tock Seng Hospital, Singapore.

Dr Gowreeson Thevendran’s Qualifications and Awards:

  • Bachelor of Medicine and Surgery, University of Bristol, England
  • Fellow of the Royal College of Surgeons, Edinburgh
  • Diplomate Faculty of Sports and Exercise Medicine, Royal College of Surgeons Edinburgh
  • Fellow of the Academy of Medicine, Singapore
  • SICOT PIONEER Founders Award 2020
  • 2015 European Foot & Ankle Society ‘Best Podium Presentation’ Award
  • 2013 Singapore Orthopaedic Association Junior Travelling Fellowship
  • 2012 NHG Critical Talent Special Recognition Award
  • 1998 Enid Lindt Prize in Clinical Surgery
  • 1995 Public Services Department Full Medical Scholarship

Frequently Asked Questions about Ankle Ligament Surgery

1How do I know if my ankle ligaments are torn?

Symptoms of a torn ankle ligament will usually include:

  • Hearing or feeling a pop at the time of injury
  • Bruising and swelling around your heel and/or toe area
  • Pain and/or difficulty putting weight on your ankle

Depending on the severity of your torn ligament, you might need ankle ligament reconstruction surgery to restore the stability of your ankle.

2Can you walk with a torn ligament?
You may still be able to walk, but not without experiencing pain. That being said, this is not advisable as it will prolong recovery.
3What happens if a torn ligament in the ankle goes untreated?
Without timely treatment, you are more likely to experience chronic pain and instability in your ankle. This could lead to further tearing of the ligaments, which would require surgery before you can fully recover from this injury. An untreated ankle ligament tear may also leave you susceptible to more injuries in the long run.
4What are the risks or complications of ankle ligament surgery?
The risks or complications associated with ankle ligament surgery can include excessive blood loss, infection, nerve damage, blood clots, and anaesthesia-induced complications. Additionally, there's a possibility of stiffness and reduced range of motion in the ankle. These outcomes underscore the importance of discussing potential risks with a healthcare provider before proceeding with surgery.
5Does insurance and MediSave cover ankle ligament surgery?
Yes, insurance and MediSave can cover ankle ligament surgery. However, the coverage will depend on the extent of your injury and your insurance plan. Hence, patients are recommended to visit the clinic and confirm the eligibility of their treatment for MediSave claims and the level of coverage offered by their insurance plan.
6Can I return to sports after ankle ligament surgery?
Yes, many individuals are able to return to sports after ligament reconstruction. However, the timeline and safety of doing so depend on the extent of the ankle surgery and your recovery progress, as every individual will heal differently. To determine when you can resume sporting activities, you should consult your attending healthcare provider.
Dr Gowreeson Thevendran is currently an orthopaedic surgeon with Island Orthopaedic, a one-stop care centre for orthopaedic health under Healthway Medical Group. He specialises in treating lower limb orthopaedic conditions, as well as trauma and fracture surgery of both the upper and lower limbs. Prior to establishing his private practice, Dr Gowreeson was Chief of Foot & Ankle Surgery at the Department of Orthopaedics at Tan Tock Seng Hospital (TTSH). Today, he continues to serve the Orthopaedic Department at TTSH as a visiting consultant.

About Dr. Gowreeson Thevendran