27696 Repair, primary, disrupted ligament, ankle; both collateral ligaments

Name of the Procedure:

• Repair, primary, disrupted ligament, ankle; both collateral ligaments
• Common name(s): Double ligament repair, Ankle ligament reconstruction
• Medical term(s): Bilateral collateral ligament repair

Summary

This surgical procedure fixes ligaments on both sides of the ankle, which are essential for joint stability. When these ligaments are disrupted or torn, they are repaired or reconstructed to restore normal function and prevent future instability.

Purpose

• Conditions addressed: Ankle instability, severe ankle sprains, chronic ligament damage
• Goals: To restore stability, reduce pain, and improve ankle function to enable a return to normal activities or sports.

Indications

• Chronic ankle instability
• Recurrent ankle sprains
• Severe ligament injury not responsive to conservative treatments such as physical therapy
• Patients often experience pain, swelling, and a feeling of weakness or giving way in the ankle.

Preparation

• Pre-procedure instructions: Patients may need to fast for several hours before surgery. They should adjust medications as advised by their healthcare provider.
• Diagnostic tests: MRI or ultrasound to assess ligament damage, X-rays to check for any associated bone injuries.

Procedure Description

1. Anesthesia: General anesthesia or regional (spinal) anesthesia is administered.
2. Incision: Small incisions are made around the ankle.
3. Access the Ligaments: The surgeon locates and assesses the damaged collateral ligaments.
4. Repair: Torn ligaments are sutured back together; if required, grafts from other tendons or synthetic materials may be used.
5. Close Incisions: The incisions are closed with sutures.
6. Support: The ankle is usually supported with a cast or brace to allow proper healing.

Duration

• The procedure typically takes 1-2 hours.

Setting

• Location: Hospital operating room or surgical center.

Personnel

• Healthcare professionals involved: Orthopedic surgeon, anesthesiologist, surgical nurse, and operating room technician.

Risks and Complications

• Common Risks: Infection, bleeding, swelling, and pain.
• Rare Complications: Nerve damage, blood clots, prolonged stiffness, and incomplete healing of the ligaments.

Benefits

• Expected outcomes: Improved ankle stability, reduced pain, and a return to normal or enhanced activity levels.
• Timeline: Benefits are often realized within a few months post-surgery, following rehabilitation.

Recovery

• Post-procedure care: Pain management with medications, icing, and elevation. Follow a physical therapy program for several weeks to months.
• Expected recovery time: Full recovery typically takes 6-12 months, with gradual return to weight-bearing and activity.
• Restrictions: Limited weight-bearing initially, avoiding strenuous activities until cleared by the surgeon.
• Follow-up: Regular follow-up appointments to monitor healing progress.

Alternatives

• Non-surgical options: Physical therapy, bracing, anti-inflammatory medications.
• Surgical alternatives: Less complex ligament repair for only one side, arthroscopic surgery.
• Pros and cons: Non-surgical treatments may be less invasive but may not provide complete stability for severe cases. Arthroscopic surgery may be less invasive but may not be suitable for extensive repairs.

Patient Experience

• During the procedure: Patients will be under anesthesia and feel no pain.
• After the procedure: Expect discomfort and swelling, managed with prescribed pain relief. Early use of crutches or a walker is common.
• Pain management: Medications, ice, and elevating the ankle to reduce swelling and discomfort.
• Comfort measures: Physical therapy and gradual activity increase guided by a healthcare provider will help ease recovery.