What to know about ankle reconstruction surgery

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Ankle reconstruction surgery addresses chronic ankle instability, arthritis, or injuries that have not appropriately healed after 3–6 months of conservative treatments.

Surgery aims to restore the ankle joint’s stability, range of motion, and function by repairing or replacing damaged ligaments and tendons, reshaping bones, and fusing bones to promote healing.

Doctors may recommend ankle reconstruction surgery when conservative treatments have not been effective. Here are some common reasons why ankle reconstruction surgery may be necessary:

• Chronic ankle instability: This is when the ankle feels unstable or gives way during movement. It may happen due to damage to the ligaments and tendons that support the ankle joint, leading to ankle sprains or even fractures. Surgeons may be able to repair or replace these damaged ligaments and tendons, restoring stability to the ankle joint.
• Ankle arthritis: Arthritis causes pain, stiffness, and swelling in the ankle joint. Over time, this can lead to decreased range of motion and difficulty with walking or other physical activities. Ankle reconstruction surgery can remove damaged cartilage and bone or fuse the ankle joint to reduce pain and improve mobility.
• Ankle injuries: Injuries such as fractures, dislocations, and severe sprains can cause long-term problems without treatment. In some cases, ankle reconstruction surgery may repair or replace damaged ligaments and tendons or realign and stabilize the bones in the joint.

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Ankle reconstruction surgery typically involves the following steps:

1. Anesthesia: A person will receive general anesthesia so that they are asleep and pain-free throughout the procedure.
2. Incision: The surgeon makes an incision in the skin over the ankle joint. The length and location of the incision will depend on the specific procedure.
3. Repair or removal of damaged tissue: If there is any damaged tissue in the ankle joint, such as ligaments, tendons, or cartilage, the surgeon will repair or remove it. Sometimes, the surgeon may use donor tissue or synthetic materials to repair or replace damaged ligaments or tendons.
4. Bone reshaping: If the bones in the ankle joint are misaligned or atypically formed, the surgeon may reshape them to improve stability and range of motion. This may involve cutting and repositioning the bones or using screws, plates, or other devices to hold them in place.
5. Fusion: In some cases, the surgeon may fuse the bones in the ankle joint to prevent movement and promote healing. This involves removing the cartilage from the joint surface and placing the bones together to fuse over time.
6. Closure: After the procedure, the surgeon will close the incision with stitches or staples.

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Preparing for ankle reconstruction surgery can help ensure an effective outcome and a smooth recovery. This will likely involve:

Following medical advice

It is best for a person to talk with their orthopedic surgeon about the details of the surgery before the procedure occurs, including any risks or potential complications. The surgeon may also provide specific instructions.

Following preoperative instructions is important. These may include when to stop eating and drinking, which medications to avoid, and what to bring to the hospital.

Before surgery, doctors may advise starting a rehabilitation program to strengthen the muscles around the ankle joint and improve the range of motion. They may also recommend stopping smoking and limiting alcohol consumption, if applicable, and eating a healthy diet.

Planning ahead and arranging help

The person having surgery will need to arrange for someone to take them home afterward. They may also need assistance with daily activities during the early stages of their recovery.

People can prepare their homes for recovery by making certain modifications, such as setting up a comfortable resting area or removing tripping hazards.

Recovery time from ankle reconstruction surgery varies depending on the procedure and other factors. It may take up to a year to regain ankle function.

Recovery typically involves the following:

1. Immobilization: Doctors may immobilize the ankle with a cast or brace to allow the bones and soft tissue to heal.
2. Physical therapy: After cast or brace removal, physical therapy can help restore strength, flexibility, and range of motion to the ankle joint.
3. Rehabilitation: As the ankle continues to heal, rehabilitation exercises are necessary to strengthen the ankle and reduce the risk of future injuries.

A person will need to attend follow-up appointments with their surgeon to monitor their progress and ensure the ankle is healing properly.

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While most people experience successful outcomes and few complications, there are potential risks associated with ankle reconstruction surgery. These include:

• Infection: Any surgery carries a risk of infection. Doctors may prescribe antibiotics before and after surgery to reduce this risk.
• Nerve damage: Damage to the nerves around the ankle joint can happen during surgery, resulting in numbness, weakness, or pain.
• Blood clots: Blood clots can form in the leg veins after surgery. This can be a serious and potentially life threatening complication. Medical staff can advise on steps to help avoid this risk.
• Anesthetic complications: General anesthesia can cause complications such as nausea, vomiting, and allergic reactions.
• Failure to alleviate symptoms: In some cases, ankle reconstruction surgery may not completely alleviate the individual’s symptoms, or the symptoms may return over time.

Ankle reconstruction surgery aims to restore stability, range of motion, and function to the ankle joint. It is typically beneficial for people with chronic ankle instability, arthritis, or injuries that have not healed appropriately.

People will need to follow medical advice when preparing for and recovering from surgery. Recovery time varies but may take up to a year. Although surgery carries some risks, most people experience positive outcomes.