The procedure depends on the severity of instability and the condition of the ligaments:

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• Ligament Repair (Broström-Gould Procedure)

  • The damaged ligaments (ATFL and CFL) are shortened and reattached to the bone with sutures or anchors.

  • Suitable for patients with good-quality ligament tissue.

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• Ligament Reconstruction (Tendon Graft Procedure)

  • Used when the native ligaments are too weak or previously repaired ligaments have failed.

  • A tendon graft (from the patient or a donor) replaces the torn ligaments.

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• Additional Procedures (if needed)

  • Peroneal tendon repair (if tendon damage is present).

  • Osteotomy (if bone alignment issues contribute to instability).

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The surgery is typically performed under general or regional anesthesia

Before considering surgery, non-operative treatments may be effective, including:

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• Physiotherapy – Balance, strengthening, and proprioception training.

• Bracing – Ankle supports or taping to reduce instability.

• Activity Modification – Avoiding sports or activities that aggravate the condition.

• Injections (PRP or prolotherapy) – Limited evidence supports these treatments in ligament healing.

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If the ankle remains unstable and continues to give way, surgery is recommended to prevent long-term complications.

While ankle instability surgery is highly effective (80–90% success rate), it carries potential risks:

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General Surgical Risks:

• Infection – Uncommon (<1%), but can delay healing; treated with antibiotics if it occurs.

• Blood Clots (DVT/PE) – Rare but possible, especially with prolonged immobilization; prevented with early movement and, in high-risk cases, blood thinners.

• Nerve Injury – The superficial peroneal nerve or sural nerve may be affected, causing temporary or, rarely, permanent numbness, tingling, or burning sensations.

• Wound Healing Issues – More likely in smokers, diabetics, or those with poor circulation.

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Procedure-Specific Risks:

• Persistent Pain or Stiffness – Some patients may experience discomfort or reduced flexibility, requiring extended physiotherapy.

• Recurrent Instability – If the ligament does not heal properly or rehabilitation is not followed, instability may persist.

• Overtightening of Ligaments – Can limit ankle movement, potentially affecting mobility.

• Failure of Repair or Graft Rupture – Rare, but possible with premature return to high-impact activities.

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Long-term research indicates that successful surgery significantly reduces instability, minimizes the risk of arthritis, and improves quality of life.

Time Off Work

• Desk jobs: 2–3 weeks

• Manual labor: 8–12 weeks

 

Return to Driving

• Typically 6–8 weeks, depending on the foot operated and recovery progress.

 

Return to Activities & Sports

• Low-impact activities: 6–8 weeks

• Running: 3–4 months

• Full sports participation: 4–6 months

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Rehabilitation Timeline​

• Weeks 0–4: Immobilization in a boot; minimal weight-bearing.

• Weeks 4–6: Gradual weight-bearing, gentle range-of-motion exercises.

• Weeks 6–12: Strengthening, proprioception training, and functional rehab.

• 3–6 months: Gradual return to sports under physiotherapy supervision.

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Most patients experience significant improvements in stability and function, with a return to pre-injury activity levels.