Ankle Ligament Reconstruction – Questions & Answers
A Patient’s Guide:

Mr Troy Keith MBBS (Hons), FRACS (Orth), FAOrthA
Orthopaedic Foot and Ankle Surgeon

Learn more about Mr Keith’s approach to your care:


GP/Specialist referral

Patient consultation & assessment

Additional testing if required


Pain management


Exercise / Nutrition

(If necessary)

Surgical process

Hospital administration

Surgery preparation – What do you need


Early mobilisation

Pain management


Follow up appointments – Next 12 months


What is ankle ligament reconstruction surgery?

Ankle ligament instability may result from a single severe injury or repeated minor sprains of the ankle. The goal of ankle ligament reconstruction surgery is to tighten and firm up one or more of the ankle ligaments.

The surgery involves tightening up the ligaments by peeling the ligament off bone and reattaching it. The ligament is then placed in a tightened position by using stitches and anchors through the bone itself.

An artificial ligament may be added to strengthen the repair and allow early movement. It may be necessary to explore nearby tendons and repair any tears at the same time. Mr Keith will discuss the surgical approach with you before surgery.


What are the most commonly injured ligaments in your ankle?

Ankle ligaments are strong, movable tissues that connect the foot bones with the lower leg bones. These ligaments help stabilise the ankle joint and prevent it from twisting or rolling.

The major ankle lateral ligaments (the most commonly injured) are:

(1) Anterior talofibular ligament (ATFL)  and/or
(2) Calcaneofibular ligament (CFL)
(3) Posterior talofibular ligament (PFL)

It is usually the front and sometimes middle bands that are injured when you sprain your ankle
(See Figure 1 below).

Ankle ligament anatomy

Figure 1.


Mr Keith’s approach to your ankle injury:

Immediately following an ankle injury, you should apply ice packs and keep the foot elevated to minimise pain and swelling.

The treatment of an ankle ligament injury depends upon the type and severity of injury, stability of the ankle and condition of the surrounding tissues.

Treatment starts with non-surgical methods which aim to reduce pain and improve ankle strength and mobility as well as address underlying conditions, deformities and instability.

In cases where the ligament/s remain unstable and do not respond to treatment, surgical methods may be recommended.


What can lead to ankle instability?

If one or more of the ligaments in your ankle has loosened, stretched or torn, it may lead to a condition called chronic ankle instability. It can cause ankle weakness, continual pain and lead to repeated ankle sprains when performing daily activities such as walking or jogging.

An ankle sprain may stretch and/or partially tear one or more of the ligament/s in your ankle. Without adequate healing time, treatment and strengthening you may be more prone to future ankle injuries.

Certain mechanical problems with your foot can make you more likely to develop an unstable ankle.

Ankle Instability


Assessing your ankle injury

Diagnosing your ankle injury may include:

  • A physical exam – It is important to identify whether an ankle fracture, sprain, or another condition is present.
  • X-ray – An X-ray of the ankle is may help determine a fracture, arthritis, or other problems.
  • Stress X-ray – Pressure is applied to the injured ankle during an X-ray film. This may uncover ankle problems unseen on regular X-rays.
  • CT scan – Uses computers and rotating X-ray machines to create cross-sectional images of the ankle
  • MRI scan – An MRI scan is a computer generated high-resolution image of the ankle.

Mr Troy Keith MBBS (Hons), FRACS (Orth), FAOrthA
Orthopaedic Foot and Ankle Surgeon.

“It can be difficult to differentiate ankle injuries such as fractures, sprains, dislocations or tendon injury without an X-ray. In complex cases, an MRI scan may be required to evaluate the ligaments.”


Mr Keith will usually exhaust all treatment options before advising for surgical intervention.

Ankle ligament surgery is usually a final option after non-operative treatments are exhausted.

The type of operation depends on:

  1. Goals of the patient.
  2. Patient specific circumstances of the injury/deformity.

Mr Kieth will discuss the options available to your specific situation.

Ankle Injury Treatment


Mr Troy Keith MBBS (Hons), FRACS (Orth), FAOrthA
Orthopaedic Foot and Ankle Surgeon

Ankle ligament surgery approaches

Ankle surgery may be required for serious ankle injuries and conditions. In general, ankle surgery is performed in order to make the ankle more stable and to relieve pain. Various surgical approaches may include:

Ankle arthroscopic surgery – Arthroscopic surgery uses an endoscope (small video camera) that allows a surgeon to view the inside of the ankle joint to assist in diagnosis and/or surgical repair.

Ankle ligament reconstruction – It is usually a day surgery procedure with patients put under a general anaesthetic. Mr Keith may conduct an initial arthroscopic examination of the ligament. 

The surgery usually involves:

  • Two to three small incisions close to the damaged ligament/s in the ankle
  • The ligament/s are tightened up by peeling the ligament off bone and reattaching it
  • The existing ligament may be be repaired using stitches or the repair may require strengthening using support from other tissues, or a tendon may be used to take the place of torn or damaged ligament/s
  • The ligament/s are placed in a tightened position by using stitches and anchors through the bone itself
  • An artificial ligament may be added to strengthen the repair and allow early movement.

It may be necessary to explore nearby tendons and repair any tears at the same time. Mr Keith will discuss and confirm the surgical approach with you prior to surgery.


A typical recovery timeline for ankle surgery is as follows:

Timeline – After surgery Description
0 to 2 weeks Your foot will be in a plaster to help protect and heal your ankle.
2 to 6 weeks You will start physiotherapy to help regain ankle mobility and strength. You will most likely wear a moon boot during the day and ankle brace at night.
6 to 9 weeks Most patients can return to low impact activities such as walking.
10 to 12 weeks  Depending on ankle strength and flexibility you may be able to return to higher impact activities and driving.


The ankle surgery complications which may occur after an operation may include:

  • Ankle pain
  • Ankle swelling
  • Ankle stiffness and restricted movement
  • Infection
  • Numbness or tingling down the side of your foot
  • In 5% – 10% of cases the surgery may not work.

Mr Keith will discuss with you in detail the potential complications and risks in relation to your ankle surgery.

Mr Troy Keith MBBS (Hons), FRACS (Orth), FAOrthA
Orthopaedic Foot and Ankle Surgeon.

If you have any questions please contact my team:


Helpful information and frequently asked questions (FAQ’s)

Post surgery and rehabilitation

Depending on the specifics of your ankle ligament surgery, most patients usually spend at least two or more weeks off their feet. Rehabilitation and a gradual return to your previous activity levels is the goal.

These tips are designed to help you heal as safely and quickly as possible:

  1. Prepare your living spaces for your decreased mobility after surgery:
    • Removal any items you could trip over in your living spaces
    • Preparation of meals during your rehabilitation
  2. Follow your post-surgical care instructions given to you by Mr Keith
  3. Organise your support network to help you after surgery
    • Transport home from hospital
    • The first few weeks of home care after your surgery.

Rest – Give your body the chance to perform its natural healing processes after the surgery.

Medication – Make sure you manage your pain levels and monitor your medication to help assist with your recovery.

Rehabilitation – Follow the directions of Mr Keith and your physiotherapist in relation to your recovery and use of protective devices such as casts and braces. Ease back into physical activity and your stretching and strengthening exercises.

Hygienic practices – The potential for infection is one of the risks of surgery. Keep surgical areas clean to reduce your infection risk.

Follow-up appointments – You’re not on your own after the surgery! Mr Keith will schedule follow-up appointments to monitor your progress and ensure everything is on track for your rehabilitation.

Ankle surgery recovery

The recovery time following ankle surgery varies depending on a number of factors including:

  • Complexity of surgery
  • Your age
  • General health
  • Compliance and commitment to rehabilitation instructions

For most ankle ligament operations, tenderness and swelling can take 2-3 months to resolve, while for more complicated procedures, the recovery may take 4 months or more.

How long will I need physical therapy for after ankle surgery?

Physical therapy usually starts two weeks after ankle ligament surgery and can continue for the next 6 months depending on:

  • Commitment to the rehabilitation program
  • Ankle swelling and pain management
  • Level of activity you wish to return to
  • Foot, ankle and leg response to your physiotherapy exercise program.

Will my ankle ever be the same after ligament surgery?

Full recovery after ankle ligament surgery is highly dependant on the severity of the damage as well as:

  • Your age
  • Activity level you wish to return to
  • Complexity of the surgery
  • Commitment to your rehabilitation program

There may be some difference in flexibility and appearance during the rehabilitation period.

Mr Keith can help give you a more accurate idea as to the potential of your ankle recovery timeline and overall progress and results.

Protecting your ankle after foot surgery

After ankle surgery, your foot will be in either a cast or a splint for at least two weeks. This is to ensure your ankle is protected and gives your foot time to heal after the surgery.

You may be advised to wear the removable splint or brace for up to 6 weeks after your surgery.

 Ankle Ligament Surgery Melbourne:
Mr Troy Keith – Foot & Ankle Surgeon

If you have any questions or would like to make an appointment, please feel free to contact my team:

Ankle Ligament Reconstruction Surgery Melbourne

Mr Keith consults with patients from all over Melbourne in relation to ankle ligament surgery. Mr Keith consults at the following practice locations in Melbourne including Armadale, Malvern, Richmond, Heidelberg and in Shepparton, country Victoria.