Chronic ankle instability is when ligaments are stretched/torn and the ankle repeatedly “gives way”. If ankle instability has not responded to physiotherapy treatment then ankle ligament reconstruction is recommended.
A small incision is made along the outside of the ankle and the injured ligaments assessed. If a ligament has been stretched but not torn, it is cut and shortened, then the two ends are sewn together. If a ligament is torn but still remains attached to the fibula bone, the ends are repaired and sewn together. If a ligament is found to have pulled away from the fibula, it must be reattached. Stitches are used to attach the ligament to a small hole drilled in the fibula. A band of tissue that crosses the front of the ankle joint is used to reinforce the repair. The surgery will take approx 60 minutes. You will go home the same day. You will be able to walk immediately with the use of crutches for support.
Patients will need physiotherapy for up to 6 months after surgery. Rehabilitation after surgery can be a slow process and you should expect full recovery to take up to six months.
There are a number of risks associated with surgery:
- Excessive stiffness
- Damage to the blood vessels or nerves
- New injury to the ankle causing damage to the repair
- Ongoing instability
Instructions for AFTER the surgery
- It is essential for someone to accompany you home and preferably stay with you for 24 hours.
- You may put full weight on the affected ankle with the boot on at all times.
- Use 2 crutches at all times when walking.
- Leave Boot on at all times, including sleeping. You may take it off for daily shower and gentle exercises. Keep dressings dry when showering.
- Elevate operated ankle as much as possible in the first 3-5 days.
- Move/wriggle toes as much as possible. It will NOT cause harm/damage.
- Swelling. This is to be expected. Elevate operated ankle as much as possible for first 3-5 days
- Pain You will receive a prescription for pain medication on discharge. Pain relief medication works best if taken REGULARLY
- Possible temporary numbness and/or tingling around the foot and toes.
- Excessive persistent pain
- Pus discharge from wound
- Excessive pain AND tenderness AND swelling in the calf.
Should any of these symptoms persist contact Dr Sim’s rooms or after hours emergency.
- Camboot on at all times including sleeping
- OK to come out for daily shower AND daily ankle Range of Motion (ROM) exercises
- Full weight bearing/walk with BOOT and 2 crutches AT ALL TIMES
- Remove boot – boot no longer required
- Continue to use crutches until you can WALK WITHOUT A LIMP. You can stop using crutches once you can walk without a limp.
- Wear ankle brace when walking
- Continue ROM exercises
- Add resistance AND strength training when full symmetrical ROM achieved (i.e. moves as freely as the UNINJURED side).
Proprioceptive training (i.e. learning to sense movement within joints and joint position)
DO NOT start running/jumping until:
- Full symmetrical painless ROM
- Walking WITHOUT a limp
Return to sport? Only when suitably CONDITIONED