Foot and ankle ligament repair is a procedure typically done to treat serious sprains or instability in the ankle.
The ligaments in your foot and ankle consist of the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL). These ligaments are instrumental in keeping your ankle and foot strong, stable and steady when you walk, jog or run.
When sprains occur, the ligaments stretch beyond normal capacity and tear. Ankle sprains range from mild to severe and in most cases do not require surgery. Sprains of the midfoot — called a Lisfranc injury — can often be treated successfully with non-surgical techniques as well. But in more serious cases, ligament repair surgery may be recommended.
You may be a good candidate for ligament surgery if you:
- Experience chronic pain in your foot and ankle
- Suffer from repeated ankle sprains
- Have an ankle that gives way when walking, running or exercising
Meet the team of experts who specialize in foot and ankle ligament surgery
How to Diagnose Foot and Ankle Ligament Sprains and Tears
Penn orthopaedic surgeons use a musculoskeletal ultrasound, an advanced imaging technology, to accurately diagnose conditions that may not be found during a standard MRI.
A musculoskeletal ultrasound uses sound waves to create images of soft tissues in the foot and ankle such as ligaments, tendons, muscles and nerves. These images are extremely detailed and can reveal the extent of damage and exact cause of all types of foot and ankle ligament conditions.
Your physician will determine the severity of your sprain by assigning a "grade" to it:
- Grade 1: Minimal stretching and tiny microscopic tears in the fibers of the ligaments accompanied by mild swelling, redness and pain.
- Grade 2: Partial to moderate tear of the ligaments accompanied by swelling, redness and pain.
- Grade 3: Completely torn ligament accompanied by swelling, redness, pain and total ankle instability.
Once we assess how severe your sprain is, we can develop a treatment plan.
Treatment Options for Foot and Ankle Sprains
Before jumping to surgery, we treat foot and ankle sprains using the most effective conservative therapies. These include:
- Modifying daily activities
- Anti-inflammatory medications
- Compression: bracing, ankle wrapping, casting
- Corticosteroid injection
- Icing the area
- Physical therapy
Types of Foot and Ankle Ligament Surgeries
If you have severe ligament damage caused by an ankle sprain, overuse or injury, your doctor will likely recommend ankle ligament reconstruction surgery. Penn orthopaedic surgeons perform the latest minimally invasive techniques to repair loose and torn ligaments due to injury or overuse.
Arthroscopy
Arthroscopy is a minimally invasive surgical technique that enables surgeons to view the structures inside the joint. During arthroscopic surgery, we make a small incision in the skin and insert a tiny camera attached to a thin, flexible tube to view the damaged tissues. Visualizing the damaged ligaments this way allows us to determine the extent of damage and what type of surgery needs to be performed.
Lateral Ankle Ligament Reconstruction
Lateral ankle ligament reconstruction can be done using two techniques: the Brostrom-Gould technique and tendon transfer. Both techniques are minimally invasive and use small incisions through the ankle. The Brostrom-Gould technique involves tightening ligaments with sutures. Tendon transfer involves replacing the weakened ligament with a tendon, either from another part of the body or a cadaver, and holding it in place with sutures and hardware such as screws and pins.
Foot and Ankle Ligament Surgery Recovery
After surgery, you will have a cast or boot to help protect the newly repaired ligament and will be expected to go to physical therapy. Penn physical therapists create personalized recovery plans depending upon the severity of your condition.
Recovery is different for everyone and can take anywhere from several weeks to months. You should speak to your doctor about what recovery might mean for you.