Ankle Reconstruction Surgery

Initial consultation

Before ankle reconstruction surgery, you will need to see one of our orthopaedic surgeons, who will start by reviewing your medical history and asking about previous injuries, symptoms, and activity level. A physical exam will be performed to assess ankle stability, motion, and strength.

Imaging tests, such as X-rays or an MRI, are often used to better understand the extent of ligament damage and rule out other issues. If non-surgical treatments like physical therapy or bracing haven’t worked, surgery may be recommended.

During the consultation, the surgeon will explain the procedure, including whether the ligaments will be repaired or replaced, and discuss the risks, benefits, and expected outcomes. Recovery plans, including time off your feet and physical therapy, will also be outlined.

This is your chance to ask questions and make sure you understand the process before moving forward with surgery.

Pre-surgery preparations

Pre-surgery preparations include several key steps to ensure a successful outcome and minimise risks. Blood tests, X-rays, or EKGs may be required based on your overall health and age to assess your readiness for surgery.

You might be advised to discontinue certain medications, such as NSAIDs and blood thinners, before surgery to reduce swelling and the risk of excessive bleeding. You are also advised to quit smoking well in advance to enhance healing and minimise postoperative complications.

Preparing for ankle reconstruction surgery includes arranging for help at home during the recovery period. Having someone take you home after surgery is also necessary, as you will not be able to drive yourself.

Ankle ligament reconstruction surgery is typically performed under general anaesthesia, meaning you’ll be asleep and won’t feel pain during the procedure. You will have the opportunity to discuss anaesthesia options with your anaesthesiologist beforehand.

In many cases, the modified Broström procedure is used. This common technique tightens and reinforces the lateral ankle ligaments, typically through a C- or J-shaped incision near the outer ankle. The surgeon may use sutures to repair the native ligaments directly or reinforce them with local tissue.

In cases where the native ligaments are too damaged, a tendon graft (either autograft from your own body or allograft from a donor) may be used to reconstruct the ligaments. When tendon grafting is involved, especially with allografts, the surgery can take approximately 1.5 to 2 hours.

Ankle arthroscopy, a minimally invasive technique using a small camera and instruments inserted through tiny incisions, may be used before or during the procedure to assess and treat associated intra-articular issues, such as loose bodies or cartilage damage.

Immediate post-surgery care

You will begin the recovery process in the postoperative care area, where your vital signs will be monitored. Pain management begins immediately following surgery with medications prescribed by the healthcare team to ensure your comfort.

After discharge, your ankle will usually be placed in a splint or cast to protect the surgical repair and limit movement. You will be instructed to keep your leg elevated as much as possible for the first few days to reduce swelling and promote healing. Ice may also be recommended to help manage pain and inflammation.

You will likely need to avoid putting weight on the affected foot, using crutches or a walker for mobility. Your healthcare team will provide guidance on how to safely move around and care for the surgical site. It’s important to keep the area clean and dry, and you will be given instructions on when and how to follow up for dressing changes or a switch to a walking boot, depending on your surgeon’s protocol.

Some mild bruising, swelling, and discomfort are normal in the initial days. Contact your healthcare provider if you experience increasing pain, redness, fever, or drainage from the incision site, as these could indicate infection or complications.

Physical therapy

Physical therapy plays a crucial role in regaining mobility and rebuilding strength after ankle reconstruction. Rehabilitation typically begins around six weeks after surgery, once healing has progressed sufficiently. Most patients continue therapy for 2–4 weeks, often attending sessions twice per week.

When movement is comfortable and pain-free, low-impact exercises such as using an elliptical machine or walking on a treadmill may be introduced. A physiotherapist will guide the process and demonstrate proper walking technique, which may include using a walking aid at first. These tailored exercises are designed to support recovery by gradually improving ankle strength, stability, and range of motion.

Potential complications and risks

As with any surgical procedure, there are risks associated with ankle reconstruction. It is important to monitor the surgical site closely for signs of infection so that any concerns can be addressed early. Nerve injury is a possible complication, which in some cases may result in lasting numbness or weakness in the foot.

There is also a risk of developing blood clots following surgery. To help reduce this risk, early mobilisation is encouraged, and additional preventative measures may be taken based on individual health factors.