Ankle Ligament Repair

This technique involves suturing torn or stretched ligaments back to their original attachment points on the bone. Non-absorbable sutures or anchors are often used to reinforce the repair and provide additional stability. Direct ligament repair is particularly effective for injuries to the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL), making it a standard option for patients with acute ligament tears.

When ligaments are severely damaged or insufficient for repair, reconstruction using a tendon graft is performed. This technique is ideal for cases of chronic ankle instability or when previous repairs have failed. By reconstructing the damaged ligaments, this method provides long-term stability and function.

Arthroscopic techniques allow for a minimally invasive approach to assess and repair ligament damage. This method involves smaller incisions, reduced soft tissue trauma, and faster recovery times compared to open surgery. Arthroscopic-assisted repair is suitable for certain types of ligament injuries and is increasingly utilised due to its advantages in recovery and outcomes.

Anaesthesia is administered as either general anaesthesia or a regional nerve block, depending on the patient and procedure. Vital signs are continuously monitored throughout the surgery to maintain safety and comfort.

The ankle area is cleansed and sterilised, and the leg is positioned appropriately. Surgical draping is applied to ensure a sterile field is maintained throughout the procedure.

Small incisions are made to access the damaged ligaments, with careful dissection to expose the torn structures while preserving surrounding tissues. Arthroscopy may be used in minimally invasive approaches to evaluate and prepare the ligaments.

Depending on the extent of ligament damage, the procedure involves direct repair or reconstruction. In direct repair, torn ligaments are sutured to their original positions with strong sutures or anchors. For severe damage, reconstruction uses a tendon graft, such as the gracilis or peroneus longus, to restore stability. Arthroscopic-assisted techniques may be used to minimise tissue trauma and ensure precise repair.

The incisions are closed using sutures or surgical staples, followed by the application of a sterile dressing and compression bandage to protect the surgical site. A splint or boot is applied to immobilise the ankle and support healing during the initial recovery period.

The first 24-48 hours focus on pain management, swelling control, and wound care. Patients keep the ankle elevated and apply ice packs according to specific guidelines.

Physical therapy begins within 2-4 weeks post-surgery. Patients learn gentle range-of-motion exercises and gradually progress to weight-bearing activities as directed by their surgeon.

Between 6-12 weeks, rehabilitation advances to strength training and balance exercises. Most patients return to normal activities within 4-6 months, depending on individual healing progress.