These procedures are performed to tighten, repair or replace the ligaments on the outside or lateral aspect of the ankle. The job of these ligaments is to keep the ankle from rolling when you apply pressure to the outside part of the foot. These ligaments are often injured in ankle sprains and can be pulled or completely torn with severe twisting motions or repetitive injury. Certain foot types, particularly rigid high arch feet, have a tendency for this type of repetitive injury to occur. When these ligaments no longer hold the ankle in place, then repair may be necessary to reduce your ankle sprains and pain.
There are 2 classes of repair. One is a tightening of the anterior talofibular ligament (ATF) that is located just in front of the fibula, which is the long skinny bone on the outside of your ankle. In this surgery a cut is made over the strained or nonexistent ligament and the capsule of the ankle joint. A small anchor with attached suture is then placed into the end of the fibula. The capsule and ligament are then overlapped and sutured together in a stronger position. The suture attached to the bone acts as a strong rope, preventing you from turning your ankle as far as you normally would, but maintains excellent range of motion. As the entire repair heals and scars down, your body begins to take over and you no longer need the effect of the rope. Recovery requires you to be non-weight bearing in a boot for about 3 weeks, then physical therapy, ankle brace and tennis shoes for 6 weeks. If you have chronic ankle swelling, an ankle scope may be combined with this procedure.
The second surgery to stabilize the lateral ankle is more reconstructive and is performed on patients who have significant instability of their ankle and the subtalar joint which is the joint just below the ankle. In this surgery, the ATF and calcaneal fibular ligament (CFL) are replaced with a tendon graft. During this surgery, a cadaver tendon is looped from the front of the ankle, through the fibula, then attached to the calcaneus (heel bone) basically recreating both ligaments. If you have a torn peroneal tendon, which runs behind the fibula, it may be split and used as the tendon graft. Recovery requires 6 weeks of non-weight bearing, then PT, ankle brace and tennis shoes for 6 weeks.
Both of these procedures will allow you to return to full activity once healed.