Ankle Ligament Reconstruction
What is an Ankle Sprain?
A sprain is the stretching or tearing of a ligament. Ligaments connect adjacent bones in a joint and provide stability to the joint.
An ankle sprain is a common injury and occurs when you fall or suddenly twist the ankle joint or when you land your foot in an awkward position after a jump. It most commonly occurs when you participate in sports or when you jump or run on a surface that is irregular.
Ankle sprains can cause pain, swelling, tenderness, bruising, and stiffness, numbness in the toes, and inability to walk or bear weight on the ankle accompanied by persistent discomfort.
Inadequate healing of a sprained ligament or incomplete rehabilitation of the affected ligament can result in instability of the ankle.
A complete medical history, including a history of any previous ankle injuries, and a physical examination is essential for an accurate diagnosis of the condition. An X-ray may be ordered to confirm the diagnosis.
What are the Treatment Options for an Ankle Sprain?
Acute injuries can be managed with conservative treatment measures such as RICE method (rest, ice, compression and elevation), medications, bracing, and physical therapy.
Surgical intervention to reconstruct the injured ligament may be considered in patients with a high degree of instability and in those who have failed to respond to non-surgical treatments.
How is an Ankle Ligament Reconstruction Procedure Performed?
Ankle ligament reconstruction may be performed arthroscopically under general anesthesia. Your surgeon will make small incisions in your ankle. A tiny camera and a few special instruments are inserted through the incisions to repair and strengthen the ligaments. Stretched or torn ligaments will be shortened and stitched as needed. Sometimes, a weakened ligament is reconstructed with a section of tendon derived from the foot and around the ankle.
The recovery time after ankle ligament reconstruction depends on the extent of injury and the procedure performed. For the first few weeks after surgery, you will be instructed to use crutches or a wheelchair and avoid bearing any weight on the reconstructed ankle joint.
What are the Risks and Complications of Ankle Ligament Reconstruction?
Specific complications of ankle ligament reconstruction include infection, nerve damage, ankle joint stiffness, and recurrent instability.
Reconstructive tenodesis is a tendon transfer procedure that uses your own tendon or a cadaver tendon as a graft to replace a damaged ligament. The surgery is performed under epidural anesthesia. Your surgeon makes an incision on your ankle. Drill holes are created where the damaged tendon normally attaches to the lower end of the fibula (calf bone) on one side and the talus (anklebone) on the other end. Your surgeon then harvests the peroneus brevis muscle tendon, found on the outer edge of the small toe, and weaves it through the drill holes to form a ligament complex. Range of motion is evaluated; the incision is closed and a sterile bandage is applied.