Lateral ligament reconstruction is considered for chronic ankle instability that has not responded to 6 months or more of physiotherapy. The Brostrom-Gould procedure repairs and reinforces the torn ligaments using local tissue, with excellent long-term outcomes.
ℹ️ This appointment takes place 2-4 weeks before surgery. Most patients having this surgery are otherwise fit and well, so the assessment is usually straightforward.
You will have routine pre-operative checks and meet the anaesthetic team. The team will confirm your understanding of the recovery process.
Standard pre-operative checks.
Blood thinners and anti-inflammatory medications may need to be paused before surgery.
Usually performed under general anaesthesia or spinal anaesthesia, with a regional nerve block (popliteal block) for post-operative pain relief.
A structured rehabilitation programme is essential for a successful outcome. Arrangements are made before surgery.
You will be on crutches for the first 2-4 weeks. Arrange help with shopping, cooking, and transport.
ℹ️ You will be given a specific arrival time. Do not eat or drink (other than clear water up to 2 hours before) from midnight the night before. Bring your medication list and any documents sent by the hospital.
You will be admitted to the ward or day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.
Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.
You will meet the anaesthetist in the anaesthetic room. Once anaesthesia is established, the procedure will begin.
After surgery you will wake in the recovery room where nurses monitor your vital signs until you are stable and comfortable.
Most foot and ankle surgery is performed as a day case, meaning you go home the same day. More complex procedures such as ankle replacement or flat foot reconstruction usually require 1-3 nights in hospital. Before discharge, the team will check your pain is controlled, give you wound care instructions, and confirm your follow-up appointment.
You will be given oral pain relief before discharge. Take it regularly for the first 48 hours rather than waiting until pain is severe.
A nurse will check the wound before you leave and explain how to keep it clean and dry.
You will be shown how to use crutches and given clear instructions about weight-bearing on your operated foot.
You will receive a letter for your GP and details of your next outpatient appointment, usually at 2 weeks for a wound check.
Arrange for a family member or friend to collect you. You must not drive after a general anaesthetic or sedation.
⚠️ Important: Do not weight-bear against advice in the first 6 weeks. The repaired ligaments are vulnerable, and early loading can lead to failure of the repair.
Keep the foot elevated above the level of your heart for as much of the day as possible during the first 2 weeks. This significantly reduces swelling and helps healing.
Avoid getting the wound wet until it is fully healed, usually 10-14 days. Use a waterproof cover when showering.
Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, ibuprofen if appropriate) is more effective than taking it only when needed.
This is usually 2 weeks after surgery. Sutures or clips will be removed if used.
Seek urgent advice if you develop increasing redness, warmth, swelling, discharge from the wound, calf pain or swelling (possible DVT), shortness of breath, or a temperature above 38°C.
Non-weight-bearing on crutches. Foot is immobilised to protect the repair.
Gradual transition from non-weight-bearing to full weight-bearing in the boot.
Out of the boot. Structured programme of range of movement, strengthening, and proprioception exercises.
Return to running and sport-specific drills, depending on progress and surgeon advice.
Return to competitive sport, including pivoting and cutting activities. Ankle bracing is often advised for the first 12 months.
Most surgeons use a removable walking boot rather than a cast, but practice varies. A short cast may be used for the first 2 weeks.
Once you are out of the boot and have good control of the foot (typically around 8 weeks). Sooner if it is your left foot and you drive an automatic.
Desk work: 1-2 weeks. Standing work: 6-8 weeks. Heavy manual or sport-related work: 3-4 months.
Around 85-90% of patients have an excellent outcome with stable, pain-free ankles. Recurrence of instability is uncommon when full rehabilitation is completed.
Plain-English answers to the things people most often ask, grounded in published guidance. Tap a question to open it.
This operation is for people with ongoing instability or repeated giving-way of the ankle despite a good course of rehabilitation.
Most sprains never need surgery.
The stretched outer ligaments are tightened and repaired (the Brostrom), and often reinforced with nearby tissue (the Gould modification).
It restores stability to the outer side of the ankle.
Usually a general or spinal anaesthetic with a nerve block, as a day case.
Your anaesthetist will discuss the options.
Expect a boot for several weeks, then balance and strengthening rehabilitation. Return to sport is often around three to six months.
Finishing the rehab is what makes the ankle reliable again.
Arrange crutches, help at home and time off, and complete any pre-operative rehabilitation you are given.
A stronger ankle going in tends to recover better.
Wound redness, discharge or a temperature can signal infection, and calf or chest symptoms can signal a clot.
Seek prompt help if these occur.