Brostrom Repair (Ankle Ligament Reconstruction)
What is a Brostrom Repair?
The Brostrom repair is a surgical procedure aimed at stabilizing the ankle joint after lateral ligament injury. Patients who need this surgery often have repeated ankle sprains and ongoing issues with performance and balance. This procedure is commonly performed to address chronic (long term) ankle instability resulting from repeated ankle sprains or a single severe sprain that fails to heal properly.
Symptoms
Chronic ankle instability is characterized by recurrent episodes of the ankle giving way, swelling, pain, and discomfort during weight-bearing activities. Patients often report feelings of insecurity or weakness in the ankle, especially on uneven surfaces or during athletic activities. The ankle may feel loose or unstable, leading to a fear of further injury.
Diagnosis
Diagnosing chronic ankle instability involves a thorough physical examination, including assessing the range of motion, stability of the ankle joint, and tenderness over the lateral ligaments. Imaging studies such as X-rays and MRI scans may be ordered to evaluate the extent of ligament damage and assess for associated injuries.
Non-surgical Treatment
Initially, non-surgical treatments may be attempted, including rest, ice, compression, and elevation (RICE protocol), immobilization with a brace or boot, physical therapy to strengthen the ankle muscles and improve proprioception, and orthotics to provide additional support. However, if symptoms persist despite conservative measures, surgical intervention may be recommended.
Surgical Treatment
The Brostrom repair is a commonly performed surgical procedure for chronic ankle instability. During the procedure, the surgeon repairs the damaged lateral ankle ligaments, typically the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL), to restore stability to the ankle joint. This may involve tightening or reinforcing the existing ligaments or using sutures or anchors to repair the ligaments to the bone.
Recovery
Recovery following a Brostrom repair typically involves a period of immobilization in a cast or boot to protect the repaired ligaments. Physical therapy is initiated to regain strength, range of motion, and proprioception in the ankle joint. Patients may gradually return to weight-bearing activities and sports under the guidance of their surgeon and physical therapist.
Is there anything I can do to prevent ankle instability?
Preventing ankle instability involves maintaining good ankle strength and flexibility through regular exercise and conditioning. This includes performing ankle-strengthening exercises, balance training, and proprioceptive exercises to improve joint awareness and stability. Wearing appropriate footwear and using ankle braces or supports during high-risk activities may also help reduce the risk of ankle sprains and instability.
After a Brostrom repair, how likely am I to experience ankle instability again?
The success rate of Brostrom repair surgery is generally high, with most patients experiencing significant improvement in ankle stability and function. However, there is always a risk of recurrent instability, especially with high-impact activities or if the rehabilitation protocol is not followed properly. It is essential to adhere to post-operative guidelines and continue with long-term ankle strengthening and stability exercises to minimize the risk of recurrence.
