Hyperlife Medical Centre

010 020 5050 | 80 Van Bergen St,
Brackenhurst, Alberton

Morningside Mediclinic

011 883 1719 | Rivonia Rd, Hill Rd,
Sandton, 2057

ANKLE LIGAMENT RECONSTRUCTION

What is it?

You have torn the ankle ligaments and a repair of the ligaments is necessary to tighten up the ankle and prevent further episodes of twisting.

There are two main ligaments which will be repaired and tightened.

There are two methods that I use to reconstruct the ankle ligaments. The one operation is called the modified Brostrum procedure, and is made with a cut on the ankle and the two ligaments are re-attached and tightened using a tiny metallic anchor to which the stitches are attached onto the bone (the fibula). The second type of ankle ligament reconstruction uses a tendon taken from the tissue bank, and is inserted through a “mini-incision” technique. This is called the “percutaneous mini-incision ankle reconstruction” and serves to add support to the already repaired ligament in cases where increased stability is required

General Recovery Facts

Following surgery, you will need to use crutches for about ten days to two weeks.

 

The cast is worn for 4 weeks, and then you are able to wear a shoe with an ankle stirrup brace which is worn for 4 more weeks.

 

You can start excercising at 6 weeks after surgery with the ankle brace on at all times under the guidance of a physiotherapist.

 

Physical therapy is an important part of your recovery.

 

Running, cutting, ball and racket sports are not permitted for 3-4 months after the surgery unless rehab is complete biomechanical ratios are restored.

 

An orthotic arch support MAY be helpful but not NECESSARY to your recovery and will be made for you with a computer gait analysis of your walking should the need arise.

 

You may experience a variety of sensations whilst in the cast consisting of sharp shooting, dull aches, electric shocks, throbbing, sensation of itching and these are all normal and you should not panic.

You will also be placed on DVT prophylaxis as there is a risk of blood clots shooting to the lungs with this procedure for a period of 6 weeks.

Specific post-operative recovery

  • Foot is wrapped in a below knee cast.
  • Elevate the leg on some pillows when awake however when sleeping elevate the base of the bed with 2 bricks or thick books so that the limb does not fall of the pillow at night and you wake up swollen.
  • Take pain and DVT prophylaxis medication as prescribed.
  • Expect numbness in foot 4-12 hours, followed by pain for usually one more day.
  • Do not allow foot to hang down.
  • If you are travelling, move the toes as much as possible to stimulate the calf muscle however travel during this time is not advisable.
  • First follow-up in the office.
  • Cast inspection for any possible complications or irritable areas +- adjustment of cast.
  • Start full weight-bearing in cast with post-operative shoe and crutches initially to pain and swelling.
  • Can allow foot to hang down at 3 weeks provided no pain and swelling occurs.

CAST REMOVED

  • Cast is removed by my dressing Sister and wound inspected.
  • If incision is dry and completely healed, swimming is permitted for rehabilitation purposes taking care to not jump in the pool or apply any unnecessary force.
  • Gentle exercise on bicycle permitted preferably guided by physiotherapist.
  • At this stage ankle stirrup is fitted and foot is prevented from inverting or everting and must be used for 6 weeks for any form of walking however patient does not need to sleep with this brace.
  • If swelling is problematic you may require the use of a compression sock.
  • Start physical therapy under supervision with my protocols and this will focus on scar desensitisation and tendon glide mostly.
  • More vigorous exercise with Biokineticist for the next 8-12 weeks in order to achieve strength within 10% of the unaffected side hence clearing you for return to sport.
  • Can discontinue boot at this stage and use a shoe with a supportive sole and a slight heel lift (heel cup) inside the sole of the shoe .
  • Flat running on treadmill by 3 months.
  • Followup in my consultation rooms.
  • Photographs and video taken of range of motion and strength.
  • Cutting sports by 4-6 months.
  • May require gait analysis and custom orthotics to be made on an individual basis.
  • Final followup in my consultation rooms.
  • Photographs are taken of range of motion and strength.
  • Patient outcome score taken.
  • Patient is usually discharged at this stage.