Ankle ligament reconstruction is a surgery intended to repair and tighten the ligaments at the ankle. There are two different types of this surgery: the first uses a graft to supplement the outside tendons of the ankle and the second, called a modified Brostrum procedure, requires re-attachment and tightening of the two ligaments of the ankle. An ankle ligament reconstruction surgery may be required when the patient has severely injured his ankle, often by twisting it forcefully. Following the operation, most patients should expect a recovery and rehabilitation period of at least 16 weeks.
A person's ankle is supported by two main ligaments. The deltoid ligament is on the inside of the ankle and the lateral ligament, which is made up of three bands of ligaments, is located on the outside of the ankle. These tough fibers can rip or tear when a person twists his foot forcefully, placing excessive weight and pressure on the ligaments. This results in a sprained ankle, and it may also cause small chips of bone to break off.
Not everyone who has a sprained ankle will require an ankle ligament reconstruction. Most sprained ankles can be resolved with compression, elevation, the application of ice and plenty of rest. Patients may require surgery if they have an ankle that appears deformed, that is painful to the point where it cannot bear any weight, or if the pain and swelling continually become worse instead of improving. This can indicate ankle instability, which may result in coordination problems and difficulty walking normally.
To prepare for an ankle ligament reconstruction surgery, patients must disclose their full medical history. They should tell the surgeon about any medications they take and other medical conditions they might have. Certain drugs and supplements may need to be discontinued prior to surgery. Patients should also arrange to have someone drive them home after the operation, as well as to help them around the house for several days or a few weeks.
Depending on the patient's specific injury and the extent of the damage, the surgeon may decide to perform the ankle ligament reconstruction using arthroscopic techniques. This means that several smaller incisions will be used. Otherwise, a larger incision will be needed, which will lengthen the recovery time. If the ligament must be augmented, the surgeon will graft additional tissues. He will also tighten and re-attach the ligaments, if necessary, and check the entire range of motion of the ankle to ensure mobility.
Patients should expect to use crutches for about the first two weeks following the ankle ligament reconstruction. They will then likely wear a special walking boot designed to stabilize the ankle. After about six weeks, patients should begin rehabilitation exercises with a physical therapist while wearing the walking boot. It may take three to four months before patients can resume normal activities.