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Old 08-20-2012, 10:22 PM   #1
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Ankle Lateral Ligament Reconstruction Over Tightening?

I had an ankle lateral ligament reconstruction (ATFL and CFL) this past December 2011. The reconstruction on the ATFL was done using a tendon graft. I have been through months and months of exhaustive physical therapy. I still can not walk or stand without severe pain. My ankle feels compressed and extremely tight since the surgery....like someone has wrapped my ankle as tight as possible with a roll of duck tape! My surgeon has had no answers to my lack of progress. So, I recently consulted a very well respected internationally known biomechanical expert and PT. He thoroughly evaluated my ankle and rear foot (sub talar joint specifically). And concluded that I now have NO motion in my ankle or my sub talar joint! He was mortified and shocked at how bad my ankle and foot is now after my surgery. He said that both joints are now functionally fused.

It appears that my surgeon has over corrected by over tightening these ligaments. The anterior talar fibular ligament (ATFL) connects the fibular to the talas. And the calcaneal fibular ligament (CFL) connects the fibular to the calcaneous (crossing over both the ankle and sub talar joints). It seems that the surgeon's goal was to stabilize the ankle joint to the extreme, but in doing so, he has left me with absolutely no motion! So, now I can not walk!

Has anyone experienced an over tightening situation in a lateral ligament reconstruction?

I am now facing a very risky and radical surgery to "undo" what this surgeon has done, or, perhaps a total ankle replacement.

 
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Old 08-21-2012, 06:53 AM   #2
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Re: Ankle Lateral Ligament Reconstruction Over Tightening?

That is not a common complication. I'm very sorry that this happened!

Find an orthopedic doctor who is a board-certified foot and ankle surgeon, the best you can get to. A faculty member at a teaching hospital is a good bet. Talk to him before you let anyone else cut you.

 
Old 08-27-2012, 02:20 AM   #3
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Re: Ankle Lateral Ligament Reconstruction Over Tightening?

Hmmm...you said your repair was done with a tendon graft. Is this the first time you've had this done? What was your injury? I ask because I just had my 2nd lateral ankle stabilization surgery (among other repairs) done in Feb. My surgeon contemplated doing the Evans procedure (I think it was called) which involved a tendon graft since mine was a re-do or 2nd surgery. He decided against it because it does prevent almost no subtalar movement. It does generally work well at preventing sprains though. I read up on it and saw what he meant and was glad he chose to not do this as I am still relatively young and active. He just did another Brostrom-Gould (cutting the frayed ends of the ligaments and sewing them together with suture anchors into the fibula and reinforcing with thr retinaculum in a pants over vest type fashion). Again, I had other repairs like a peroneal tendon repair and a fibular osteotomy for groove deepening so the peroneal tendons won't pop out. Even with my surgery (after both), they feel very tight, but somewhat work themselves out. I don't know if that's true for thr tendon graft kind. Again, not sure this is what happened with you, it just triggered my memory of conversations with my surgeon on how he chose how to fix my ankle. Good luck with figuring it out! I'm so sorry!
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Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
Old 08-27-2012, 08:48 AM   #4
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Re: Ankle Lateral Ligament Reconstruction Over Tightening?

Thanks for the replies! Yes, it was done with a tendon graft from the peroneus longus muscle. The ATFL ligament was replaced with this PL tendon graft, while the existing CFL was tightened.

 
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