Ankle ligament repair

Ankle instability develops in case of chronic, recurring dislocations of the lateral ankle. Ankle stability cannot bear the loads of everyday life or sport most commonly due to insufficient lateral ankle ligaments.

What are the main symptoms of the disease?

• Pain, which increases to load.
• Feeling of instability, recurring ankle twists.
• Swelling, limping.
• The ankle cannot be loaded in the usual manner.

What are the treatment options?

Non surgical (conservative) treatment

Aim:

• Pain reduction

Methods:

• Pharmacological treatment:
  • Anti-inflammatory drugs
  • Painkillers
  • Treatment for cartilage repair and healing
• Physical therapy, medical spa treatment (balneotherapy)
• Physiotherapy, increasing the joint’s stability, proprioceptive exercises
• Increasing muscle strength
• Exercising the muscles responsible for stability, restoring their previous flexibility, and strength.

Surgical treatment

The physician may recommend surgery if the results achieved by physiotherapy are not adequate, the non surgical treatment methods are no longer effective, and the diagnosis is confirmed by clinical test and imaging scans. It is important to select the time of the surgery, which mostly depends on the patient’s symptoms, the expected level of activity, and the condition of the stabilizing musculature.

• During the procedure, the thinned ligament of connective tissue, which runs in front of the lateral ankle, is fixated to itself in a doubled manner, or to the lateral ankle with an anchor screw.  Stability could be increased further by supporting the fascia (a casing of connective tissue).

What happens to you during surgery?

• The surgery is performed in regional, spinal anesthesia, or general anesthesia (narcosis).

Preparations in the operation room:

• The patient is laid on the surgical table, and local or general anesthesia is induced.
• A urinary catheter is inserted in the urinary bladder – based on individual evaluation.
• Shaving the surgical site – if necessary.
• The skin of the surgical site is washed multiple times with an antiseptic fluid.
  • (Please let us know in advance if you are sensitive to iodine!)
• The patient is covered with sterile sheets, only the surgical site remains uncovered (isolation).

The surgical process:

• The ligaments are explored in front of the lateral ankle.
• The above described surgery is performed (please refer to ’Surgical treatment’).
• Rarely, a silicone drain is placed in the surgical site due to the bleeding following surgery.
• The wound is closed after thorough surgical hemostasis.
• Cover dressing and elastic bandage are applied, followed by a plaster cast or plastic boots.

What happens if the justified surgical treatment is not performed?

• The pain is expected to increase further.
• The movement disability may aggravate.
• The quality of life keeps deteriorating.
• The effectiveness of a surgery performed later may decrease.