Ankle instability is generally associated with rupture of the ligaments of the ankle. This commonly occurs after a sprained ankle. An ankle ligament reconstruction is used to improve stability following this injury.
Symptoms and signs
The usual injury is rolling your ankle. The severity of injury ranges from low grade strains to high grade rupture of multiple ligaments. In cases of chronic ankle instability you may notice multiple ankle sprains or a feeling of not trusting your ankle when playing sport. Chronic ankle instability can lead to cartilage injury within the ankle, which can present as pain and swelling.
Investigations
A plain x-ray should be taken in an acute injury if you are unable to weight bear to exclude fracture. Ultrasound or MRI scanning will differentiate between ligament sprain versus rupture and provide a prognostic guide for your return to sport. Chronic cases should receive an MRI scan to assess the ligaments, tendons and cartilage of the ankle.
Treatment
Acute injuries should receive Rest, Ice, Compression, Elevation (RICE) therapy for the first 72 hours. Most acute injuries (even if the ligament is ruptured) can be treated in a rigid or semi rigid brace with early physiotherapy leading to good results. If you continue to experience ankle sprains after an appropriate physiotherapy program, surgical repair of the ligament provides excellent results for most patients.
Surgery
Surgical repair of the ligaments is often combined with ankle arthroscopy to address problems within the ankle. The ligaments are repaired with anchors to the bone. A structured rehabilitation protocol is used post surgery, which involves using a moon boot for 6 weeks.
After your surgery
You will be in a moonboot for the first 6 weeks with weight bearing and Physiotherapy guided by your treating surgeon
You may leave hospital when you are fully awake and can choose to stay overnight if you prefer.
The dressing on your ankle should remain in place for approximately 5 days. If the dressing becomes moist then it should be changed. A waterproof dressing should be used for showering and you should not soak in the bath, pool or at the beach.
If you do not have an appointment for review in the rooms within 10 days after your surgery please phone the rooms to arrange this.
Risks of ankle ligament reconstruction
Infection
Damage to nerves / blood vessels
Blood clots (DVT/ PE)
Ongoing pain, stiffness, swelling
Instability (risk of re-rupture of your repair is 10% with return to sport)
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