What is ankle surgery?

By Cristiano Antonino On Mar 29, 2023

Surgery may be not be necessary for many ankle problems; therapy and medications may be enough to resolve the issue

But when ankles are badly broken, deformed, unstable or cause constant pain, surgery may be the only answer.

Why is ankle surgery done?

Surgery on an ankle may be needed to treat fracture (broken bone), arthritis, tendonitis and problems that can’t be resolved with therapy and medications.

Surgery for an ankle fracture is done if the bones in the ankle are unstable and need more support to heal.

Milder fractures, when the ankle is stable and the broken bone isn’t out of place, may not need to be surgically repaired.

Different types of ankle surgery treat different injuries or medical conditions affecting your ankle.

Ankle problems that may need surgery include:

Fractured ankle.
Arthritis that causes pain and immobility.
Chronic ankle instability from multiple sprains or other causes.
Deformity of the ankle.
Chronic tendonitis/synovitis of the ankle.

What are the types of ankle surgery?

Surgeries can range from minimally invasive arthroscopy to ankle replacement surgery.

You will need local (below the waist) anesthesia or general anesthesia, so you sleep through the procedure.

Recovery times vary depending on the surgery.

However, you should expect time on crutches followed by a period wearing a cast or walking boot.

Ankle arthroscopy (for arthritis and ankle injuries): This minimally invasive surgery involves several small incisions in your ankle. Surgeons use special instruments to remove bits of bone or cartilage from the ankle.

Tendon surgery. With chronic tendonitis/synovitis of the ankle, surgery can be as simple as taking out diseased tendon tissue or repairing a tear. Or it can be complex as Achilles repair/reconstruction and tendon transfer, where a diseased tendon is removed and/or replaced with another tendon from the foot.

Ankle fracture surgery: If you have fractured bones in your ankle (a broken ankle), surgery can stabilize the breaks and help the bone heal. Screws, metal plates, and small metal wires may hold the broken bone in place during healing. There are several types of surgeries depending on the type of fracture, and your surgeon will talk with you about your specific procedure.

Ankle fusion (to treat arthritis): During this procedure, surgeons debride (remove damaged tissue) the surfaces of the ankle joint affected by arthritis. Then, surgeons fuse, or join, ankle bones together permanently with screws and metal plates.

Ankle replacement: During ankle replacement surgery, doctors carefully remove the damaged ankle joint. They replace the damaged joint with a replacement joint made of plastic or metal. In most cases, surgeons attach the replacement joint to existing bone using special surgical glue. Your surgeon may also use screws to help stabilize the ankle replacement.

Lateral ankle ligament reconstruction (for chronic ankle instability or foot deformities): Also known as the Brostrom procedure. The surgeon makes a small cut on the outside of your ankle, then tightens loose and weakened ligaments that cause instability in your ankle.

What are the benefits of ankle surgery?

For many people, ankle surgery lets you use the ankle again. It also relieves pain caused by conditions like arthritis.

What are the risks of ankle surgery?

Ankle surgery may cause complications, including:

Bleeding and blood clots (deep vein thrombosis).
Damage to nerves or blood vessels in the ankle.
Infection.
Joint stiffness or weakness.
Reactions to anesthesia.

What is the prognosis (outlook) for people who have ankle surgery?

Immediately after your procedure, your ankle is immobilized (kept from moving) for several weeks.

A cast or medical boot can allow your ankle to begin healing.

It also helps protect it from further damage or injury.

After surgery, most people return to their normal activities within six to eight weeks.

References

American Academy of Orthopaedic Surgeons. Ankle Fractures (Broken Ankle). (https://orthoinfo.aaos.org/en/diseases–conditions/ankle-fractures-broken-ankle/) Accessed 2/24/2020.
American Orthopaedic Foot & Ankle Society. Ankle Fracture Surgery. (https://www.footcaremd.org/conditions-treatments/ankle/ankle-fracture-surgery) Accessed 2/24/2020.
Arthritis Foundation. Surgery Options for Ankle Arthritis. (https://www.arthritis.org/health-wellness/treatment/joint-surgery/preplanning/surgery-options-for-ankle-arthritis) Accessed 2/24/2020.
Shakked RJ, Karnovsky S, Drakos MC. Operative treatment of lateral ligament instability. Curr Rev Musculoskelet Med. 2017;10(1):113–121. doi:10.1007/s12178-017-9391-x