Our foot is the most integral part of our life as it inspires us to chase our dreams without stopping. One portion of the foot that plays an important role in the movement is the ankle as it attaches the leg to the foot. The ankle is a hinge type of synovial joint and is layered with various ligaments on both the inner and outer side of the ankle and cartilage to improve the stability of the joint and allows a smoother movement of the ankle. But there are many occasions when the ankle ligament can get injured and may not heal properly thus needing expert medical help. In some complex and severe cases, surgery may also be suggested to repair the ankle ligament. Today we will be discussing the complete surgical procedure for ankle ligament repair.

When does the ankle need surgery for a cure?

Sometimes, after a twisting injury to the ankle, the ligament present on the outer side of the ankle (most commonly anterior talofibular and calcaneofibular ligaments) can be injured causing an ankle sprain. This strain may range from mild to severe. An acute ankle sprain can be treated through a non-surgical method, but a grade 2 or 3 ankle sprain may need surgical treatment if the repeated sprain occurs on the same ankle and the patient is suffering from intense pain and instability. This chronic ankle problem can even affect the ability to walk.

How to diagnose the severity of the ankle problem?

Your foot and ankle surgeon will, first of all, examine your ankle and evaluate the possible causes of pain. The pain may arise from ligaments or joints due to impingement and instability may happen if the ligaments are not healed/ healed in a stretched position. He will suggest you undergo an MRI that can help in identifying the status of ligaments and any other joint pathology that might not be seen on  X-rays.

Type of surgical methods for ankle ligament repair

The surgical approach is decided after analysis of the injury as well as the present health condition of the patient. The prime objective of the surgery is to repair the torn or loose ligament and remove all the possible sources of pain but the approach may be different according to the condition.

• Ankle Arthroscopy

This approach helps to perform the surgery without making large slits on the leg as an arthroscope ( a tiny device with a camera and thin pipe) is used to view the internal images of the joint. Visualizing the condition with the help of the arthroscope helps in performing the surgery with minimal invasion. Ankle arthroscopy helps in the assessment of the joint to look for possible associated problems like thickened synovium causing impingement or damage to the cartilage of the joint like osteochondral lesions. In most cases, lateral ankle ligament reconstruction is preceded by ankle arthroscopic assessment and debridement.

• Lateral Ankle Ligament Reconstruction

There are two methodologies used to perform this surgical treatment. These are:

• Broström -Gould technique operation

This technique is widely used to treat ankle instability and is the anatomic form of reconstruction. It involves reattachment of the torn ligaments back to the distal fibula and reinforcement by another layer of soft tissue called extensor retinaculum.  For this purpose, suture anchors with nonabsorbable sutures are used. The strength of the repair depends on a number of factors like the number of anchors placed for repairing the tendon, their pullout strength, and tissue quality. For those who have a risk of reinjuring like athletes or those with ligament laxity, reinforcing of the ligament with an Internal Brace/ suture tape augmentation is performed which functions as a seat belt to prevent reinjuring during any future twisting injury. According to a study, the reinforcement of repair with suture tape augmentation is one of the strongest forms of repair and even stronger than the native ligament. More and more patients can return to their normal life with this technique.

• Tendon transfer technique

This is a nonanatomic type of reconstruction and refers to the replacement of a weakened ligament with a tendon from other parts of the body and holding it in place with sutures, screws, and pins.

After the surgery- what to expect?

Post-surgery, one needs to protect the newly repaired ligaments in the initial period. Initially, plaster is applied which is changed to a boot in which walking can be started. For faster recovery, your surgeon will advise you to participate in some physical therapy sessions. During this period, one needs to focus on diet as well to pace up the recovery.

In case if you are looking for an experienced foot and ankle surgeon in Gurgaon, consult Dr. Anuj Chawla. He has many years of experience in treating foot or ankle problems. Hopefully, he will be able to cure the problem with the most effective method.