LONDON FOOT & ANKLE SURGERY
Mr Andy Roche MSc FRCS (Tr & Orth) Consultant Orthopaedic and Trauma Surgeon specialising
in Foot and Ankle Surgery and Reconstruction

Lateral Ankle Sprain Surgery – Ankle ligament reconstruction

How the surgery is carried out

It is a day-case procedure. The operation is done under a general anaesthesia and an added injection around the ankle to numb it after surgery. Sometimes the ligament repair is performed with a brief ankle arthroscopy procedure first to inspect inside the ankle joint, but your Consultant will explain this prior to the surgery. The operation involves one 5 cm incision on the outside of your ankle. The procedure involves carefully finding the torn ligament scar tissue near the fibula bone, repairing it together with stitches to the bone. Dissolvable skin stitches are used. 

What to expect immediately after surgery

Your foot will be in a plaster below the knee, numb and pain free. You will see a physiotherapist who will advise on walking non-weight bearing. You will be discharged only when comfortable and given a follow-up appointment and pain-killers as required.

Recovery in the first few weeks after surgery 

  • Elevate you foot as often and as much as possible to reduce swelling.
  • Mobilise as instructed, but only for necessity indoors and outdoors.
  • Some blood ooze can be expected in the bandage, if worried contact the Consultants clinic.
  • Take pain-killers as prescribed. 

Post-operative clinic schedule

  • 2 weeks - Wound check and new boot
  • 6 weeks - Remove boot
  • 12 weeks - Clinical examination and discharge

When can I start to walk?

  • 0-2 weeks - Plaster cast, non-weight-bear with crutches
  • 2-4 weeks - Boot, partial weight-bear with crutches
  • 4-6 weeks - Boot, full weight-bear >6 weeks mobilise in own shoes 

Physiotherapy and Rehabilitation

Your physiotherapist will guide you through the stages of rehabilitation on this website including gait re-education, swelling reduction and reducing muscle tightness. It is important to adhere to advice given.

How do I wash and shower?

Keep the plaster cast totally dry. You may shower with a waterproof cover over the plaster or boot. Once the plaster is removed you may shower if the wound is healed but gently dab the wound dry. Be careful not to stumble on the ankle out of the boot.

How can I look after the incision wound?

Once out of cast, do not pull at scabs but let them fall away naturally. If your wound becomes red, swollen or sore you need to see your Consultant to ensure there is no infection present. Your physiotherapist may advise on wound massage when its healed.

When can I start to drive again?

DVLA states it is the responsibility of the driver to ensure they are always in control of the vehicle. A good guide is if you can stamp down hard with the foot to stop the car in an emergency stop. This will take at least 6 weeks. Click here to read DVLA guidance.

When can I work?

This is very individual and job-dependent. Below is a guide:

  • Sedentary 2 weeks
  • Manual labour 8-10 weeks

What long-term outcome can I expect after surgery?

Excellent symptom relief once the wound heals and the rehabilitation is well underway which can take 3 months. Good level of activity expected and return to sports by 4-6 months, to continue to improve up to 12 months. Lateral ligament reconstructions have excellent outcomes in 95%. Mild swelling can persist in the ankle for up to a year.

What are the risks?

Any operation carries a risk. Below is a guide to some risks potentially encountered. It is the surgeons duty to fully inform you of possible risks. Mr Roche will ensure this is always done so patients can make safe and informed choices about their operation. 

Infection

If this happens, it is usually simply treated with antibiotics. Significant consequences from infection are very rare but can be dealt with. Risk is around 1%.

Nerve damage

Nerves that supply sensation to the skin are near the incision site. Damage is rare but if your toe stays numb after surgery, the nerve may be bruised. If so it usually recovers. Risk is around 5%.

Recurrence of instability

Further rehabilitation goals can be set with physiotherapy. Surgery can be repeated if necessary. Risk is around 5%.

Deep Vein Thrombosis

Symptomatic clot formation in the leg is unusual after ankle surgery (<3%). Whether treatment to prevent clot is needed can be discussed with your surgeon. There is no consensus amongst UK Orthopaedic surgeons as to whether preventative medicine is needed.

Important last note

This document is only meant to be a guideline to help you understand your treatment and what to expect. Every person is different and your rehabilitation may be quicker and slower. This will be advised and guided by your doctor and physiotherapist.

  • Chelsea & Westminster Hospital NHS
  • The Lister Hospital, Chelsea
  • Fortius Clinic
  • Bupa Cromwell Road