Ligament Surgery

If one or several ligaments on the outer part of the ankle has stretched or loosened, you may need this surgery. Loosened or stretched ligaments can lead to a condition known as persistent instability of the ankle. It can induce repeated ankle sprains, chronic pain, and your ankle can often give way when you are walking or performing other activities.

First, an ankle sprain may extend and cause a partial tear in your ankle ligaments. One sprain makes your ankle more susceptible to subsequent sprains. This happens primarily when your first sprain is not appropriately treated. As more sprains occur, they further loosen your ligaments.

Several mechanical foot problems can also make you susceptible to an unstable ankle. They include:

• Midfoot cavus (high arches)
• First ray plantar flexion
• Hindfoot varus
• General ligament looseness due to medical conditions such as the Ehlers-Danlos syndrome

You may have been treated using special foot inserts or physical therapy, but if other kinds of treatment have not worked, your physician may recommend surgery.

LALR is done under general anesthesia, and can be done using two techniques:

• Brostom-Gould technique — often used for athletes who have experienced several years of hyperextension and ankle instability
• Tendon Reconstruction

Both methods begin with a small incision along the outer part of the ankle. The Brostom-Gould method fastens the ankle ligaments using anchors and stitches fixed into the fibula bone. During the reconstruction, ligaments are replaced by tendons by holding the tendon (either from your hamstring or a cadaver) in place using stitches, or occasionally a screw in the bone.