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Foot + Ankle Problems + Treatments

Ankle Instability

Type of Procedure: Outpatient
Length of Procedure: 45 minutes
Anesthesia: General anesthesia with a popliteal block

Ankle Ligament Reconstruction: What is it?

With twisting injuries of the ankle, the ligaments may be torn and may not heal sufficiently to provide adequate stability in the ankle. Instability of the ankle may show itself in the form of pain or repetitive twisting injuries of the ankle. When bracing or taping and physical therapy have not been successful, the ankle ligaments may be repaired or reconstructed to help prevent further twisting injuries, instability, and joint damage. In the setting of chronic ankle instability, repetitive twisting injuries may lead to other associated injuries, including Ankle Cartilage (Osteochondral) Defect, ankle impingement: loose bodies, and peroneal tendon tears. Because these associated injuries have been reported to be as high as 93% (Komenda and Ferkel), we recommend ankle arthroscopy at the time of lateral ligament reconstruction.

You can also book an appointment by calling Dr. Carreira’s office at 404-355-0743. Learn more at www.peachtreeorthopedics.com.

Lateral Ankle Ligaments

These two ligaments of the lateral ankle are the most frequently injured in the human body. The modified Brostrom technique includes direct anatomic repair of these ligaments. Very small anchors may be drilled into the bone as needed for additional strength. The retinaculum also is incorporated into the repair for additional repair strength.

There are several procedures to reconstruct the ankle ligaments. These techniques are typically performed  with allograft or cadaver tendon to anatomically recreate the lateral ligaments that have been torn. Reasons to consider reconstruction over repair include generalized laxity, increased body weight, high demand level of activity, and previous surgery. These factors are considered on a case by case basis to optimize surgical outcomes. More recently, Dr Carreira is one of the very surgeons internationally who performs an all arthroscopic cadaver ligament reconstruction of the lateral ligaments of the ATFL and CFL.

Recovery:

  • Following surgery, you will need to use crutches for about two weeks.
  • The boot is worn for 6 weeks, and then an ankle stirrup brace in a shoe is worn for an additional 6 weeks.

Post Operative Course:

Day 1

  • The foot is wrapped in a bulky plaster splint
  • Ice, elevate, and take pain medication
  • Expect numbness in the foot for 12-24 hours because of the anesthesia block
  • Bloody drainage through the splint is expected
  • Do not remove the splint but you may add additional ACE wrap bandage

Days 3-5

  • First visit to the office
  • Change dressings and place in a short leg cast
  • Elevate the leg regularly to prevent excessive swelling and wound problems

Weeks 2-3

  • Sutures removed
  • CAM Boot is applied
  • Weight-bearing in the boot as tolerated
  • The boot may be removed for showering. There is no bathing until the wound is completely healed
  • Start ankle up and down motions (dorsiflexion and plantarflexion only) while avoiding heel side to side motions

6 Weeks

  • Start physical therapy
  • The CAM boot is weaned to a sneaker like shoe
  • Air cast stirrup is worn for support for 6 weeks

Return to sport typically occurs between 6 weeks and 6 months after surgery, depending on the procedure and any associated injuries treated at the time of surgery.

If you have any questions about the information on this page about Ankle Stability, please contact Dr. Dominic Carreira.