Treating Ankle Instability With A Tendon Graft

If you are dealing with ankle instability that is not responding to conservative care, your foot and ankle specialist may talk with you about your surgical options. When it comes to surgically addressing lateral ankle instability, doctors usually perform the operation in one of two ways – either by tightening the existing ligaments or by reconstructing the ligament through a tendon graft. While ligament tightening may be the more common of the two, plenty of patients have their instability corrected through a reconstruction procedure. Below, we take a closer look at the lateral ankle ligament reconstruction process.

Lateral Ankle Ligament Reconstruction – Who Needs It?

As we noted in the introduction, it is more common to have your lateral ankle ligament instability addressed with an operation like the Brostrom procedure, which tightens the existing ligaments. However, lateral ankle ligament reconstruction with a tendon graft is starting to become more popular, especially for patients dealing with significant ligament weakness and scar tissue formation after their initial injury. These factors can make it less likely that a tightening procedure will prove successful in the long term. This is also one of the reasons why ligament reconstruction with a tendon graft is more common if a previous ankle ligament stabilization procedure has failed.

Procedure And Recovery

During your procedure, the surgeon works to stabilize the injured lateral ankle ligaments by carefully threading a tendon graft through small tunnels that have been drilled in the ankle. Think of it like when you cross your shoelaces in order to provide some stability and support to the top of your foot. A few small holes are drilled on the side of your ankle and the tendon graft is threaded through these openings and then pulled tight before being anchored to the bone. This ensures that there is enough tension on the tendon to provide adequate support to the lateral ankle ligaments and the entire joint complex.

In most cases, the patient’s own tendon is harvested from somewhere else in the body, oftentimes the foot or leg (autograft), or it may be taken from a cadaver or artificially created (allograft).

After surgery is complete, you will be sent off to a recovery room until anesthesia wears off. Although specific recovery guidelines will vary based on the individual, you can expect to be non-weight bearing for about two weeks after the procedure. During this time, your leg will likely be immobilized in a cast or boot. After about two weeks, you will be transitioned to a walking boot and allowed to bear a limited amount of weight on the area. This is also when physical therapy typically begins, which you’ll pursue for a number of weeks. You may ditch the walking boot after a couple of weeks, but recovery will be a slow and steady process. Expect weeks of physical therapy even after your boot is removed, as complete recovery can take anywhere from 6-12 months. That said, you may be able to return to certain activities like driving or work well before six months post-op. You’ll want to follow the specific advice of your treating surgeon.

Ankle ligament reconstruction has a high rate of success and can help to restore confidence and function in your ankle, so don’t put up with unstable ankle ligaments any longer. If you are dealing with recurrent ankle sprains or haven’t found success with conservative treatments, consider talking with a specialist about your surgical options. In the greater Hartford area, we hope you’ll consider connecting with Dr. McDonald and his team. Give them a call today at (860) 244-8889.

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