What is it?
When the ligaments on the outside of the ankle have been stretched or torn by repeated sprains, the ankle can keep giving way. Ankle ligament reconstruction tightens and repairs these ligaments (often called a Broström-type repair). If the ligament tissue is poor, it may be reinforced with a strong synthetic tape or a tendon graft. Ankle arthroscopy is often carried out at the same time to check and treat the inside of the joint.
Who might it help?
- An ankle that repeatedly gives way, despite a good course of physiotherapy
- Instability that stops you from doing sport or everyday activities with confidence
- Ongoing ankle pain or swelling linked to an unstable ankle
Is it right for you?
Treatment is tailored to your individual needs, symptoms and goals. Surgery is only recommended when it is likely to help, and non-surgical options are always discussed first.
Mr Jeyaseelan will talk you through the benefits, risks and alternatives for your situation at your consultation.
What does it involve?
- It's usually a day-case operation under a general or regional anaesthetic.
- The repair is done through a small incision on the outside of the ankle.
Before your operation
- You'll have a pre-assessment check, usually a week or two before surgery, including blood tests if needed
- Stop smoking, ideally at least six weeks before, as it slows bone and wound healing
- Arrange help at home for the first couple of weeks, and someone to take you home
- Prepare your home: clear walkways, and put everyday things within easy reach
- If you'll use crutches or a knee scooter, practise beforehand
On the day
- You'll be asked not to eat or drink for a few hours beforehand
- The anaesthetist will discuss the anaesthetic with you, often a general anaesthetic with a nerve block to keep the foot numb for several hours afterwards
- Mr Jeyaseelan will see you before the operation to answer any questions and mark the leg
- Before you go home, you'll be shown how to use crutches and given pain relief and written instructions
Recovery
The ankle is usually protected in a plaster or boot for around six weeks. Physiotherapy then rebuilds strength and balance. Return to sport is typically after three to six months, depending on the sport.
Foot raised, in a plaster or boot.
In a boot, increasing weight bearing as advised. Physiotherapy begins.
Out of the boot. Balance and strength exercises, then light jogging.
Sport-specific training and a return to sport, often with a brace at first.
These times are typical only. You'll be given a personal recovery plan.
Getting back to normal
- Driving
- You can usually drive once you're out of a boot and can do an emergency stop safely. After right-foot surgery this is often six to eight weeks or more. Check with your insurer.
- Work
- Desk-based work is often possible after two to six weeks if you can keep the foot raised. Jobs that involve standing or walking take longer.
- Sport
- Low-impact exercise, such as cycling and swimming, usually comes first. Running and contact sport come later, once strength and movement have returned.
- Flying
- Long-haul flights are usually avoided for at least six weeks after foot and ankle surgery because of the risk of blood clots. Ask before booking travel.
Possible risks
As with any operation, there are risks. They include:
- Numbness from nerve irritation
- Infection or wound problems
- Stiffness
- The ankle becoming unstable again
- Blood clots in the leg or lungs
Alternatives
Physiotherapy focused on balance and strength, together with a brace or taping for sport, helps many people and is usually tried first.
Conditions this may treat
Common questions
Where can I have ankle ligament reconstruction in London?
Mr Lucky Jeyaseelan, a consultant orthopaedic surgeon who specialises only in the foot and ankle, sees private and insured patients with problems that may need ankle ligament reconstruction at Align Orthopaedics on Harley Street, The London Clinic on Devonshire Place, HCA London Bridge Hospital, HCA UK at The Shard, HCA UK City of London on Old Broad Street and The Holly Hospital in Buckhurst Hill, Essex. See all clinic locations or request an appointment. If surgery is right for you, he will discuss which hospital suits you best.
How long is recovery after ankle ligament reconstruction?
The ankle is usually protected in a plaster or boot for around six weeks. Physiotherapy then rebuilds strength and balance. Return to sport is typically after three to six months, depending on the sport. Your own recovery plan will be tailored to you.
Is it covered by health insurance?
Mr Jeyaseelan is recognised by major insurers including Bupa, AXA Health, Aviva, Vitality and WPA. Cover depends on your policy, so please get an authorisation code from your insurer before your appointment.
Do I need a GP referral?
Self-funding patients can book directly, though a GP letter is helpful. Most insurers need a GP referral before they authorise your consultation, so check with yours first.
This information is general and is not a substitute for a medical consultation. Your diagnosis and treatment plan will be tailored to you.