Ankle instability is a chronic condition characterized by a recurrent slipping of the outer side of the ankle. The following are symptoms of ankle instability:
- Pain, tenderness, and swelling is present in the ankle joint.
- The ankle turns while walking on uneven surfaces or during a sporting activity.
- The ankle feels unstable
Ankle Instability usually results from repeated ankle sprains. Recurrent injury to the ligaments further weakens them and aggravates the instability which predisposes to the development of additional ankle problems.
Ankle instability surgery is performed to treat an unstable ankle and involves the repair or replacement of a torn or stretched ligament.
There are two types of ankle instability surgery:
- Anatomic repair: This surgery involves shortening and tightening the stretched ligament; and
- Non-anatomic repair: This surgery uses a tendon as a graft to replace the damaged ligament.
Surgery is recommended in patients with a high degree of ankle instability and in those who have failed to respond to non-surgical treatments.
Ankle instability surgery involves the repair or reconstruction of the injured ankle ligaments. Ankle-instability surgeries can be categorized into either anatomic repair or non-anatomic repair, also called reconstructive tenodesis.
- Anatomic repair involves reconstruction of stretched or torn ligaments. The surgery is performed under epidural anesthesia. An incision on the ankle is made to expose the damaged joint and ligaments. The edges of the torn ligament are shortened and repaired with sutures. The ends may be overlapped and then sutured to strengthen the ligament. The surgeon then covers the repaired ligament with a dense band of connective tissue, to reinforce the ligament.
- Reconstructive tenodesis is a tendon transfer procedure that uses the patient’s tendon or a cadaver tendon as a graft to replace the damaged tendon. The surgery is performed under epidural anesthesia. An incision is made on the ankle. Drill holes are created where the damaged ligament normally attaches to the lower end of the fibula (calf bone) on one side and the talus (anklebone) on the other end. The surgeon then harvests the peroneus brevis muscle tendon, found on the outer edge of the small toe, and weaves it through the drill holes to form a ligament complex.
Postoperatively, the foot will be immobilized with a cast or splint. Crutches will be prescribed to avoid bearing weight on the repaired ankle. The physician will may provide a removable boot to be worn for 2 to 4 weeks. Physical therapy will be initiated to strengthen your joint and improve range of motion. Complete recovery may take 10 to 12 weeks.