Ankle Ligament Repair / Ankle Sprain

Ankle ligament injury is characterized in following grades:

• GRADE 1: This is mild grade and often referred to as a sprain to ligament in MRI reports. The fibers of the ligament are stretched, but continuity is present.
• GRADE 2: This is a moderate injury where a partial tear means a significant number of fibers are torn, but continuity is maintained.
• GRADE 3: This is the most severe type in which complete ligament rupture or tear and continuity are absent.

The ankle sprain/ ankle ligament includes of following symptoms: 

• Pain
• Swelling in the ankle joint
• Not able to maintain balance at the ankle joint
• In the Initial period, the patient will not be able to keep weight on the affected leg.
• Bruise or discoloration of skin at the ankle joint

Diagnosis includes detailed medical history, physical examination, x-ray, and MRI of the ankle joint.

GRADE 1/ GRADE 2 ankle sprain/ ankle ligament injury is treated with:

• Rest
• Physiotherapy to strengthen muscles around the knee joint
• Ice packing
• Pain medication
• Braces/ plaster for a few days helps.

GRADE 1 AND GRADE 2 are usually treated without surgery, and recovery is relatively fast.

In Grade 3 ankle sprain/ ankle ligament cases, the treatment of ankle sprain/ligament injury remains the same as in grade 1 and grade 2. But the duration of braces or plaster application increases.

As discussed in detail in the treatment of ankle sprain/ ankle ligament injury it depends on the grade of injury, age of patients and activity level of patients. In cases of GRADE 1 and GRADE 2, with some instances of GRADE 3, it can be managed without surgery.

In ankle ligament deficient/absent ankles if the surgery is not done following will happen:

• Damage to cartilage or early-onset osteoarthritis may occur
• Chronic ankle pain and
• Difficulty in maintaining balance may occur at the ankle joint

Yes, most cases of ankle sprain/ ankle ligament tear and up to 80% of these injuries can heal on their own.

Immediately after having an ankle sprain/ ankle ligament injury, there will be

• Pain in the ankle joint
• Swelling of the ankle joint
• Loss of stability or patient will not be able to maintain balance at the ankle joint

But usually, the swelling will subside after 3-6 weeks, and the pain will decrease. After 6 weeks, you will be able to walk, but in severe cases, pain, stability and difficulty in maintaining balance at the ankle joint will remain.

Surgery is done for injuries which:

• Doesn’t get better with nonsurgical treatment
• Patients with ankle instability or difficulty in maintaining balance at the ankle joint
• Continuous pain after months of treatment
• Surgery is done if a severe ankle sprain/ ankle ligament injury also has ankle cartilage injury or tendon rupture.

Following are some of the best ankle ligament tear/ ankle sprain surgeries.

A) Lateral Ankle Ligament Repair of Ankle Sprain/ Ankle Ligament Injury.

It involves:

• repair of torn or stretched ligament or
• repair of ligament if it is disconnected from fibula
• extensor retinaculum is used to provide strength to repair.

We preserve previously torn ankle ligaments as it helps make post-surgical healing natural and results in complete natural recovery.

B) Lateral Ankle Ligament Reconstruction of Ankle Sprain/ Ankle Ligament Injury

It involves:

• Use of graft which is harvested/ taken from the patient's own body and used to reconstruct the ligament.
• Drilling of holes in bones to fix the graft to the bones
• Use of very small bio-composite/hydroxyapatite-coated screws to fix the graft in drilled holes.

It depends on:

• How severe was an injury to the ankle, which resulted in ligament rupture
• How much ligament is left
• If pieces of ligament can be repaired or sutured back, then repair is done, but if pieces of ligament can’t be sutured back, then reconstruction is done.

This is one of the latest techniques to repair lateral ankle ligaments. This fiber tape is used to strengthen the construction after repair.

• The use of fiber tape acts as a seat belt, which provides extra support to the repair.
• This reduces recovery time, and the patient recovers faster than earlier surgical techniques.
• Since it is a new technique, more studies are required to prove the fact.
• But ankle surgeries show promising results and reduce the time to return to daily activities.

We use this technique with proper indication. Kindly consult your surgeon before undergoing surgery about internal bracing.

Usually, it depends on the patient's medical condition; if the patient is not suffering from any disease before surgery, hospital stay is for 1-2 days.

You can shower after 2 weeks of ankle ligament repair/ reconstruction surgery. Usually, waterproof dressing is applied to the wound, after which the patient can shower. But to take a bath or swim a patient will require 4-6 weeks. The patient has to keep the wound dry and avoid using hot water as it increases swelling.

You can usually drive after ankle ligament reconstruction surgery after 6- 8 weeks. But it has to be first consulted with the surgeon and physiotherapist.

A patient will be given a non-weight bearing cast for 4-6 weeks. Until then, the patient will have to use crutches or a walker. The cast is removed after 4-6 weeks, and physiotherapy is started. The physiotherapy will continue for 4-5 months. The patient will fully recover in 4-5 months after surgery.

Usually, if the patient’s office work involves a desk job and no heavy work activities, he can join the office in 4- 6 weeks. In case it’s a field job and requires heavy work activities, it may take 12-16 weeks.

Usually, if there was only ankle ligament reconstruction/ repair done, the patient can run after 4-5 months of proper physical therapy. But it depends on the amount of cartilage damage and the strength of the muscle; otherwise, chances of developing swelling in the ankle joint and cartilage damage increase. Proper consultation with a surgeon and physiotherapist is required.

It depends on the recovery course of the patient after ankle repair/ reconstruction surgery, but usually, patients can get back to sports in 4-5 months. Initially, some surgeons started to decrease recovery duration to 3-4 months, but it was observed in various studies that chances of failure have increased. We follow international standards of proper rehabilitation and advise our patients to return to sports after 4-5 months after appropriate physical training. We believe we should follow the latest, best and thoroughly studied techniques and provide results comparable to international standards.

It depends on the hospital category chosen by patients and the type of implant discussed. At Simpainortho.com, we have tried to reduce the cost of surgery and hospital expenses and included complete after-surgery services, which patients require after surgery because we know treatment doesn’t end at the discharge of the patient. To ensure the quick recovery of patients in simpainortho.com, we believe that a patient requires expert care within the most comfortable surroundings until he can join routine activities. So, we have made different packages for different patients according to need, and that too at the most affordable prices.

Yes, most insurances have included ankle ligament reconstruction/ repair surgery.