A/Prof Kuo operates from the following locations:

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Lisfranc Injury Surgery | Midfoot Injury Surgery

Summary

 

Our Foot and Ankle Orthopaedic Surgeon Specialist

Dr Roderick Kuo

 

Surgery Type:

Open

 

Treatment for:

Ankle sprain

Lisfranc injuries

Midfoot injuries

Foot trauma

 

Duration:

1-2 days in hospital

 

Recovery Time:

12 weeks + Ongoing physiotherapy

 

Time to Return to Work:

2-4 weeks for desk-based jobs

12-24 weeks for manual labour work

 

Surgery locations:

Norwest Private Hospital, Norwest

Sydney Adventist Hospital. Wahroonga

 

Foot and Ankle Orthopaedic Specialist clinic locations:

Specialty Orthopaedics Parramatta

Specialty Orthopaedics Norwest Private Hospital

Specialty Orthopaedics SAH Wahroonga

 

Lisfranc injuries or midfoot injuries may be overlooked as a simple sprain that will heal over a few days. However, if not diagnosed and treated properly, Lisfranc injuries may lead to serious long-term health effects such as arthritis or issues walking.Lisfranc injuries vary in severity from mild to severe. In cases where the joints are not affected by abnormal positioning and there are no fractures of the midfoot bones, non-surgical treatments such as a cast or boot may be used to manage the midfoot injury.

However, if there is abnormal positioning of the joints of the midfoot together with fractures of the bones and completely torn ligaments, then surgical options are recommended to treat Lisfranc or midfoot injuries.

You should seek professional medical advice if you suspect you have sustained a Lisfranc injury.

Please read our article on Lisfranc Injuries for more information about this condition.

 

How is the surgery performed?

Lisfranc surgery aims to realign the bones of the midfoot joints and/or repair damaged ligaments that usually hold the midfoot bones together. The surgery is usually done under general anaesthesia and the surgeon will make incisions on the top face of the foot.

The two most common techniques used to surgically repair Lisfranc injuries are open reduction and internal fixation (ORIF) and fusion.

In internal fixation (ORIF), the orthopaedic specialist surgeon will restore the position of the joints and bones by using medical-grade metal screws and plates. These screws and plates remain in place until the bones and ligaments heal and gain enough strength to hold the midfoot in its proper position. They can then be removed about 3-5 months after the surgery is complete.

If the joints of the midfoot are severely damaged and cannot be repaired, surgery for midfoot injuries involves fusing the bones together. The goal of this surgery is to fuse the bones together, so they heal in as a single structure.

 

How long will I be in hospital?

Lisfranc injury surgery is an open-type surgery which requires the orthopaedic specialist surgeon to make incisions on the outside of the foot to access the damaged joint. You can expect to remain in hospital for about 1-2 days after surgery.

 

Will there be pain involved?

Prior to surgery, you will be given general anaesthesia and a local injection around the foot area, so you remain pain-free during and after the surgery. During the recovery period, you may be prescribed some stronger painkillers to reduce any discomforts. In the recovery and rehabilitation period, you may experience some discomforts, but this can be managed with painkillers.

 

What happens after the surgery?

After the surgery is complete, your foot will be placed in cast. Afterwards you will be sent to the recovery unit and monitored for a period of time to allow the general anaesthesia to wear off and your body vitals to normalise. It is important at this time to report any discomfort, pain, or nausea you may have to the doctors as they can assess your need for painkillers or anti-nausea drugs when you are discharged.

You will be referred to a physiotherapist who will start you on a recovery programme. It is recommended that you follow the guidance of the physiotherapy programme as it will speed up your recovery drastically and allow you to get back on your feet sooner.

 

What should I do in the first week after surgery?

In the first week after the surgery, you should attempt to minimalize moving around unless necessary. You should avoid weight-bearing on the operated foot and use non weight bearing mobility aids such as a knee scooter or crutches to move around.

Attempt to elevate your foot to the level of your heart to reduce swelling and take painkillers whenever you experience pain.

You may find some blood ooze at the site of the surgery which is normal. However, if you notice bleed does not stop, please contact the specialist urgently.

 

When will I be able to walk?

Lisfranc injuries takes more time to heal than most foot procedures. You should allow up to 6 to 8 weeks before attempting to weight-bear on the operated. This is to ensure that the joints have time to heal and are kept in their proper place. Avoid all high-impact activities such as jumping or running until at least 3-5 months after surgery. Consult your orthopaedic specialist surgeon before attempting to weight-bear on the operated foot.

 

When can I return to work?

Healing and recovery times are different for each individual person. In general, you should be able to return to work in 2-4 weeks if you mostly sit at work. You should allow for up to 12-24 weeks to recover if your work involves manual labour.

 

What are some risk and complications of Lisfranc injury surgery?

Before undergoing any surgery, an orthopaedic specialist surgeon will discuss risks and potential complications with you and answer any questions you might have.

Some risks include:

  • Wound infection: this occurs in less than 1% of all procedures and can be treated with antibiotics
  • Nerve damage: there is a small risk to losing sensation of the skin in area surrounding the surgical site, but this is very rare.
  • Blood clots: with any surgical procedure, there is a small risk of the blood clotting in the vessels causing pain and swelling. If you have known risk factors associated blood clots, the specialist may prescribe you with some blood-thinners during the recovery period. The risks are present but small. If you experience abnormal swelling and pain of the leg, please contact the specialist urgently.
  • Hardware failure: as with weight-bearing hardware, the metal screws and plates used to hold the midfoot joint together can fail after repeated stress. In most cases, failure of the metal screws or plates do not affect the surgery’s effect in keeping the joints in their proper place. However, you should attend the follow-up appointments consistently to ensure that the hardware remains in place.

 

Follow-up appointments

The typical follow-up appoints after you have been discharged is as following:

10-14 days after surgery

At the first appointment, the orthopaedic specialist surgeon will remove your cast or boot and remove the sutures.

Six weeks after surgery

At this appointment, you will undergo an X-ray of your foot. Your cast or boot will be removed at this appointment and you may be able to weight-bear

Three months after surgery

Your progress will be evaluated at this appointment. You will undergo a weight-bearing X-ray, your foot will be examined, and the orthopaedic specialist surgeon may see how you are progressing with your posture and walking gait.

Six to twelve months after surgery

This is the final appointment, your progress will be evaluated and if all is well, you will be discharged.

 

Important: Information is provided for guidance only. Individual circumstances may differ and the best way to approach a condition is by individual medical consultation where a specialist can tailor a treatment plan to suit your needs.

Edited by Dr Roderick Kuo
Last updated: 12/11/2019

Flatfoot Reconstruction Surgery

Summary

 

Our Foot and Ankle Orthopaedic Surgeon Specialist

Dr Roderick Kuo

 

Surgery Type:

Open

 

Treatment for:

Flatfoot deformities

Flatfeet issues

Feet pain

Foot arch repair

 

Duration:

1-2 days in hospital

 

Recovery Time:

12 weeks + Ongoing physiotherapy

 

Time to Return to Work:

2 weeks for desk-based jobs

3-6 months for manual labour work

 

Surgery locations:

Norwest Private Hospital, Norwest

Sydney Adventist Hospital. Wahroonga

 

Foot and Ankle Orthopaedic Specialist clinic locations:

Specialty Orthopaedics Parramatta

Specialty Orthopaedics Norwest Private Hospital

Specialty Orthopaedics SAH Wahroonga
 
 

Flatfoot reconstruction surgery is an umbrella terms used for a variety of surgical procedures to repair the bones and tendons of the foot to restore the foot arch and reduce pain, correct deformities, and restore function. 

Flatfoot reconstruction surgery is used for people that have a low foot arch and are experiencing symptoms such as pain and posture problems that are limiting their ability to function in daily life. In most cases, non-surgical methods have been tried but failed to help reduce symptoms

 

Please read our article on Flatfoot for more information about this condition.

 

How is the surgery performed?

Depending on the cause of flatfoot, a combination of surgical techniques is used to restore the foot shape. Your orthopaedic specialist surgeon will discuss surgical options with you prior to undergoing any procedure.

 

Posterior Tibial Tendon Dysfunction (PTTD)

Posterior tibial tendon dysfunction (PTTD) is one of most common causes of acquired flatfoot in adults. The posterior tibial tendon connects the calf muscles of the leg to a bone in the foot arch called the navicular and weakening or problems with this tendon causes the foot to lose its shape and results in pain and swelling. The following procedures may be used in flatfoot caused by posterior tibial tendon dysfunction:

 

  • Lengthening of the Achilles Tendon (Gastrocnemius Recession): This is used to lengthen and increase flexibility of the calf muscles. This prevents flatfoot for reoccurring and is useful to help patients that having difficulty lifting their ankles up. It is used in combination with other surgeries to repair flatfoot.
  • Cleaning the tendon (Tenosynovectomy): This surgery involves cleaning up the tendon by removing inflamed or damaged tendon tissue. It is used primarily for early and mild cases of flatfoot to reduce pain and swelling. Unfortunately, it carries the risk of the tendon continuing to degenerate and resurface of pain.Tendon transfer: This procedure removes diseased or damaged tendon and replaces it with healthy tendon from another part of the foot to reform the foot arch. Tendon tissue that is not completely diseased may be preserved and attached to a healthy tendon.
  • Cutting and shifting bones (osteotomy): This procedure involves cutting and reconstructing the heel and midfoot bones to restore the foot arch. In more severe cases of flatfoot, bone from another area may be grafted to improve the structure of foot arch.
  • Subtalar implant: To repair the foot arch, a small titanium device is sometimes implanted into the side of the hindfoot.

 

Rheumatoid Arthritis

Flatfoot may be the result of rheumatoid arthritis which is a chronic inflammatory condition that affects the soft tissue of the foot and ankles. The loss of ligaments and cartilage causes pain and loss of structure in the foot. The following procedures may be used in flatfoot caused by rheumatoid arthritis:

  • Fusion (arthrodesis): This procedure aims to fuse the joints of the foot to realign the bones and restore normal shape. During the surgery, joints affected by arthritis and all cartilage is removed and replaced with bone graft material to create a single solid bone structure. This eliminates any joint movements that causes arthritic pain. In most cases, fusion is used because arthritis has caused the foot to stiffen significantly that other surgical techniques cannot be used.

 

Injury of the foot

Ligaments of the foot provide structure and support to the foot arch. Damage or tear of these ligaments can cause the bones and joints to misalign and result in flattening of the foot arch. The following procedures may be used in flatfoot caused by injuries:

  • Internal fixation: This procedure uses a combination of metal screws and plates to realign the bones of the foot.

 

How long will I be in hospital?

You may be required to stay 1-2 days in hospital.

 

Will there be pain involved?

Prior to surgery, you will be given general anaesthesia and a local injection around the foot area, so you remain pain-free during and after the surgery. During the recovery period, you may be prescribed some stronger painkillers to reduce any discomforts. In the recovery and rehabilitation period, you may experience some discomforts, but this can be managed with painkillers.

 

What happens after the surgery?

After the surgery is complete, a plaster cast will be placed from foot to knee. Afterwards you will be sent to the recovery unit and monitored for a period of time to allow the general anaesthesia to wear off and your body vitals to normalise. It is important at this time to report any discomfort, pain, or nausea you may have to the doctors as they can assess your need for painkillers or anti-nausea drugs when you are discharged.

You will be referred to a physiotherapist who will start you on a recovery programme. It is recommended that you follow the guidance of the physiotherapy programme as it will speed up your recovery drastically and allow you to get back on your feet sooner.

 

What should I do in the first week after surgery?

In the first week after the surgery, you should attempt to minimalize moving around unless necessary. This is to ensure the foot structure is kept in place while healing. Avoid wear-bearing on the operated foot.

You should avoid taking any anti-inflammatory medication such as ibuprofen as this may interfere with the bone healing process.

Attempt to elevate your foot to the level of your heart to reduce swelling and take painkillers whenever you experience pain.

You may find some blood ooze at the site of the surgery which is normal. However, if you notice bleed does not stop, please contact the orthopaedic specialist surgeon urgently.

 

When will I be able to walk?

For the first 6 weeks, you will have the foot in a plaster cast or boot, and you should NOT weight bear. You may move around with the use of crutches, frame or knee scooter.

After 6 weeks, if the foot has healed sufficiently, the boot/plaster cast will be removed, and you will be given a brace or footwear insoles. You should be able to weight-bear at this time and regain the ability to walk independently without assistive devices. You should consult with the orthopaedic specialist surgeon prior to removing the boot/plaster cast and attempting to weight-bear on the foot.

 

When can I return to work?

Healing and recovery times are different for each individual person. In general, you should be able to return to work in 2 weeks if you mostly sit at work. You should allow for 3-6 months to recover if your work involves manual labour.

 

What are some risk and complications of flatfoot surgery?

Before undergoing any surgery, an orthopaedic specialist surgeon will discuss risks and potential complications with you and answer any questions you might have.

Some risks include:

  • Wound infection: this occurs in less than 1% of all procedures and can be treated with antibiotics
  • Nerve damage: there is a small risk to losing sensation of the skin in area surrounding the surgical site, but this is very rare.
  • Blood clots: with any surgical procedure, there is a small risk of the blood clotting in the vessels causing pain and swelling. If you have known risk factors associated blood clots, the specialist may prescribe you with some blood-thinners during the recovery period. The risks are present but small. If you experience abnormal swelling and pain of the leg, please contact the specialist urgently.
  • Reappearance of symptoms: Although symptoms rarely continue after surgery, a small number of people may find that their pain and discomforts return. In this case, your specialist will discuss further treatment options with you. You may also have to use footwear insoles long-term.

 

Follow-up appointments

The typical follow-up appoints after you have been discharged is as following:

10-14 days after surgery

At the first appointment, the orthopaedic specialist surgeon will remove your plaster casts and wound sutures. An X-ray will be ordered to check the progress of bone healing then you will be fitted with a new plaster cast or a boot.

Six weeks after surgery

At this appointment, the foot will be X-rayed, and the plaster casts or boot removed. You will be given insoles for your footwear and at this time you should be able to weight-bear on the foot.

Three months after surgery

The orthopaedic specialist surgeon will review your progress at this appointment. It is important to report how if you have any more pain or discomforts in your foot.

Six to twelve months after surgery

This will be the final appointment to review your progress. If all is well, you will be discharged. Occasionally you may require removal of any metal implants.

 

Important: Information is provided for guidance only. Individual circumstances may differ and the best way to approach a condition is by individual medical consultation where a specialist can tailor a treatment plan to suit your needs.

Edited by Dr Roderick Kuo
Last updated: 12/11/2019

Bunion surgery

Summary

 

Our Foot and Ankle Orthopaedic Surgeon Specialist

Dr Roderick Kuo

Surgery Type:

Open

Treatment for:

Bunions
Foot deformities
Drifting big toes
Big toe bumps

Duration:

Overnight stay in hospital

Recovery Time:

12 weeks + Ongoing physiotherapy

Time to Return to Work:

2-4 weeks for desk-based jobs
12 weeks for manual labour work

Surgery locations:

Norwest Private Hospital, Norwest
Sydney Adventist Hospital, Wahroonga

Foot and Ankle Orthopaedic Specialist clinic locations:

Specialty Orthopaedics Parramatta
Specialty Orthopaedics Norwest Private Hospital
Specialty Orthopaedics SAH Wahroonga

 

Bunion surgery is used for people who are experiencing difficulty walking, continuous pain, or bothersome deformities of their great toe. It is usually undertaken after non-surgical methods have been tried and failed or if the foot deformity has reached a point where it is interfering with daily function. Although not all bunions need to be operated on, you may choose to undergo the procedure if you experience the following symptoms:

  • Inflammation of the big toe and swelling of the area that does not improve with rest or medications
  • Toe deformity especially when the big toe begins to overlap the second or third toe
  • Failure of non-surgical options to control pain such as anti-inflammatory drugs (ibuprofen) and changes to footwear
  • Inability to bend or straighten the big toe

Before undergoing any surgical procedure, it is important to discuss your condition and circumstances with an orthopaedic specialist surgeon.

Please read our article on Bunions for more information about this condition.

 

How is the surgery performed?

A combination of surgical techniques is used to correct a bunion depending on how much the bones of the big toe are misaligned. The overall goal is to realign the main joint of the big toe (known as the metatarsophalangeal joint or MTP joint), repair the tendons and ligaments of the big toe and foot, and remove any damaged or inflamed tissue.

In most cases, ligaments need to be corrected by tightening or loosening them, so they do not cause the big toe to drift towards the other toes.

The orthopaedic specialist surgeon may also remove some of the bone of the big toe to correct its shape with a procedure called an osteotomy. In most cases, only a small wedge is removed and then the bone is fixed in place with pins, screws, or plates. Osteotomy is done in combination with ligament correction to maintain the big toe shape and alignment.

If there is arthritis of the joint, the orthopaedic specialist surgeon may use a technique called arthrodesis which involves removing arthritic joint surfaces and fusing the bones of the big toe together. However, this procedure is only reserved for those who have severe cases of bunions affected by arthritis or when bunion surgery has previously failed.

The orthopaedic specialist surgeon may directly remove the offending big toe bump with a procedure called an exostectomy. This procedure may relieve symptoms of pain but does not correct the underlying big toe deformity issue. It may be used in conjunction with other surgical techniques to correct a bunion.

 

How long will I be in hospital?

Bunion surgery is usually done as an overnight surgery. You will expect to spend at least one night in hospital after the surgery.

 

Will there be pain involved?

Prior to surgery, you will be given a local injection around the foot area called ankle block anaesthesia, so you remain pain-free during and after the surgery. Depending on your case, other types of nerve blocking anaesthesia may be used including regional anaesthesia that numb the areas below the knee or spinal anaesthesia that numbs the body below the waist. You may choose to undergo the procedure under general anaesthetic, but your orthopaedic specialist surgeon will discuss these options with you well before the day of surgery.

During the recovery period, you may be prescribed some stronger painkillers to reduce any discomforts. In the recovery and rehabilitation period, you may experience some discomforts, but this can be managed with painkillers.

 

What happens after the surgery?

After the procedure is complete, the orthopaedic specialist surgeon will insert metal pins to hold the toes in alignment and bandage your foot to hold the bones in their newly aligned place and protect the surgical wounds while they are healing.

Afterwards you will be sent to the recovery unit and monitored for a period of time to allow the anaesthesia to wear off and your body vitals to normalise. It is important at this time to report any discomfort, pain, or nausea you may have to the doctors as they can assess your need for painkillers or anti-nausea drugs when you are discharged.

You will be referred to a physiotherapist who will start you on a recovery programme. It is recommended that you follow the guidance of the physiotherapy programme as it will speed up your recovery drastically and allow you to get back on your feet sooner.

 

What should I do in the first week after surgery?

In the first week after the surgery, you should attempt to minimalize moving around unless necessary. This is to ensure the bones are kept in place while healing. You may heel weight-bear on the foot as tolerated but this is not recommended for at least 2 weeks after surgery. You may use assistive devices such as crutches, a knee walker, or a scooter to move around.

Avoid disturbing the bandages and dressings of the foot and follow instructions for the care including keeping them dry during showers.

Attempt to elevate your foot to the level of your heart to reduce swelling and take painkillers whenever you experience pain. This will reduce swelling of the foot, but some swelling may be unavoidable for up to six months.

You may find some blood ooze at the site of the surgery which is normal. However, if you notice bleed does not stop, please contact the orthopaedic specialist surgeon urgently.

 

When will I be able to walk?

For the first 6 weeks, your foot will be bandaged or supported with a special shoe and toe splint. You may heel weight bear as tolerated but do so under advice from your orthopaedic specialist surgeon.

After 6 weeks, you will have an X-ray and if the foot has healed sufficiently, you should be able to fully weight-bear and regain the ability to walk independently without assistive devices. You should consult with the orthopaedic specialist surgeon prior to fully weight-bearing on the foot.

 

When can I return to work?

Healing and recovery times are different for each individual person. In general, you should be able to return to work in 2-4 weeks if you mostly sit at work. You should allow for up to 12 weeks to recover if your work involves manual labour.

 

What are some risk and complications of bunion surgery?

Before undergoing any surgery, an orthopaedic specialist surgeon will discuss risks and potential complications with you and answer any questions you might have.

Some risks include:

  • Wound infection: this occurs in less than 1% of all procedures and can be treated with antibiotics
  • Nerve damage: there is a small risk to losing sensation of the skin in area surrounding the surgical site, but this is very rare.
  • Blood clots: with any surgical procedure, there is a small risk of the blood clotting in the vessels causing pain and swelling. If you have known risk factors associated blood clots, the specialist may prescribe you with some blood-thinners during the recovery period. The risks are present but small. If you experience abnormal swelling and pain of the leg, please contact the specialist urgently.
  • Reappearance of symptoms: Although symptoms rarely reappear after surgery, a small number of people may find that their pain and discomforts return. You may notice a small cosmetic deformity of the foot. If this occurs, please consult with the specialist to discuss further surgical correction.
  • Over-correction: an imbalance of the ligaments may cause the toe to start drifting towards the other foot. This is very rare though and only occurs in less than 1% of cases.

Follow-up appointments

The typical follow-up appointments after you have been discharged is as following:

10-14 days after surgery

At the first appointment, the orthopaedic specialist surgeon will remove your bandages and metal pins holding your toes in place. You will be given a toe splint and special supportive shoe.

Six weeks after surgery

At this appointment, the foot will be X-rayed, and the splint and shoe removed. At this time, you should be able to weight-bear on the foot.

Three months after surgery

The orthopaedic specialist surgeon will review your progress at this appointment and if all is well, you will be discharged. It is important to report how if you have any more pain or discomforts in your foot.

 

Important: Information is provided for guidance only. Individual circumstances may differ and the best way to approach a condition is by individual medical consultation where a specialist can tailor a treatment plan to suit your needs.

Edited by Dr Roderick Kuo
Last updated: 12/11/2019

Arthroscopy | Foot and Ankle

Summary

 

Our Foot and Ankle Orthopaedic Surgeon Specialist

Dr Roderick Kuo

 

Surgery Type:

Arthroscopy (Minimally invasive procedure)

 

Treatment for:

Ankle sprain

Ankle instability

Ankle trauma

Ankle ligament damage

Ankle torn ligaments

Osteoarthritis

Joint debridement

 

Duration:

Day surgery (less than 24 hours in hospital)

 

Recovery Time:

12 weeks + Ongoing physiotherapy

 

Time to Return to Work:

2 weeks for desk-based jobs

8-12 weeks for manual labour work

 

Surgery locations:

Norwest Private Hospital, Norwest

Sydney Adventist Hospital. Wahroonga

 

Foot and Ankle Orthopaedic Specialist clinic locations:

Specialty Orthopaedics Parramatta

Specialty Orthopaedics Norwest Private Hospital

Specialty Orthopaedics SAH Wahroonga

Arthroscopy is a minimally invasive technique used by orthopaedic specialist surgeons to diagnose and treat a number of joint issues. It is a keyhole procedure that uses precise tube-like instruments called arthroscopes about the width of writing pen.

An array of instruments such as a camera and miniature surgical tools are attached to arthroscopes allowing an orthopaedic specialist surgeon to complete procedures in the joint without the need for open surgery. They also have the added benefit of a quicker recovery time because the incisions or cuts needed for surgery are much smaller.

Arthroscopy has a number of uses in ankle joint treatment including removing diseased and damaged soft tissue (arthroscopic debridement), removing loose bone fragments, and as adjunctive treatment in ligament and tendon repair. In foot and ankle treatments, it is used commonly to repair the ankle joint for damaged or torn ligaments and restore structure and stability to the ankle and foot.

 

How is the surgery performed?

In most cases, small incisions or cuts will be made on the outside of the ankle. This will allow the orthopaedic specialist surgeon to insert a camera for viewing the joint and also use small surgical instruments needed to complete the joint procedure.

For tidying up or debriding a joint, the orthopaedic specialist surgeon will remove damaged or diseased soft tissue (usually cartilage), smooth out rough joint surfaces, remove free floating bones and growths such as spurs. This a common treatment method for relieving joint pain in osteoarthritis and rheumatoid arthritis.

How long will I be in hospital?

Because it is a minimally invasive procedure, arthroscopy can be done as a day surgery procedure and you should be discharged home within 24 hours of the procedure being complete.

 

Will there be pain involved?

Prior to surgery, you will be given general anaesthesia and a local injection around the foot area, so you remain pain-free during and after the surgery. During the recovery period, you may be prescribed some stronger painkillers to reduce any discomforts. In the recovery and rehabilitation period, you may experience some discomforts, but this can be managed with painkillers.

 

What happens after the surgery?

After the surgery is complete, your foot will be bandaged, and your wounds dressed. Afterwards you will be sent to the recovery unit and monitored for a period of time to allow the general anaesthesia to wear off and your body vitals to normalise. It is important at this time to report any discomfort, pain, or nausea you may have to the doctors as they can assess your need for painkillers or anti-nausea drugs when you are discharged.

You will be referred to a physiotherapist who will start you on a recovery programme. It is recommended that you follow the guidance of the physiotherapy programme as it will speed up your recovery drastically and allow you to get back on your feet sooner.

If you are well, you should be discharged from hospital on the same day.

 

What should I do in the first week after surgery?

In the first week after the surgery, you should attempt to minimalize moving around unless necessary. In most cases, you may weight-bear on the operated foot as tolerated and occasionally use mobility aids such as crutches in the first two weeks.

Attempt to elevate your foot to the level of your heart to reduce swelling and take painkillers whenever you experience pain. You may be prescribed some anti-inflammatory medication for six weeks after surgery such as ibuprofen.

You may find some blood ooze at the site of the surgery which is normal. However, if you notice bleed does not stop, please contact the orthopaedic specialist surgeon urgently.

 

When will I be able to walk?

In most arthroscopy cases, you should be able to weight bear on the foot immediately after the procedure. The only exceptions to this would be if the procedure involved fusion of the ankle joints (arthrodesis) or extensive repair of the foot bones or ligaments and under those circumstances, you should avoid wearing bearing for 6-12 weeks after surgery.

 

When can I return to work?

Healing and recovery times are different for each individual person. In general, you should be able to return to work in 2 weeks if you mostly sit at work. You should allow for up to 6 weeks to recover if your work involves manual labour.

 

What are some risk and complications of arthroscopy?

Before undergoing any surgery, an orthopaedic specialist surgeon will discuss risks and potential complications with you and answer any questions you might have.

Some risks include:

  • Wound infection: this occurs in less than 1% of all procedures and can be treated with antibiotics
  • Nerve damage: there is a small risk to losing sensation of the skin in area surrounding the surgical site, but this is very rare.
  • Blood clots: with any surgical procedure, there is a small risk of the blood clotting in the vessels causing pain and swelling. If you have known risk factors associated blood clots, the specialist may prescribe you with some blood-thinners during the recovery period. The risks are present but small. If you experience abnormal swelling and pain of the leg, please contact the specialist urgently.

 

Follow-up appointments

The typical follow-up appoints after you have been discharged is as following:

10-14 days after surgery

At the first appointment, the orthopaedic specialist surgeon will remove your bandages and wound sutures.

Six weeks after surgery

At this appointment, your orthopaedic specialist surgeon will review your progress in terms of ankle functionality and movements. If all is well, you will be discharged.

 

Important: Information is provided for guidance only. Individual circumstances may differ and the best way to approach a condition is by individual medical consultation where a specialist can tailor a treatment plan to suit your needs.

 

Edited by Dr Roderick Kuo
Last updated: 12/11/2019

Ankle Ligament Surgery

Summary

 

Our Foot and Ankle Orthopaedic Surgeon Specialist

Dr Roderick Kuo

 

Surgery Type:

Arthroscopy (Minimally invasive procedure)

 

Treatment for:

Ankle sprain
Ankle instability
Ankle trauma
Ankle ligament damage
Ankle torn ligaments

 

Duration:

Day surgery (less than 24 hours in hospital)

 

Recovery Time:

12 weeks + Ongoing physiotherapy

 

Time to Return to Work:

2 weeks for desk-based jobs
8-12 weeks for manual labour work

 

Surgery locations:

Norwest Private Hospital
Sydney Adventist Hospital

 

Foot and Ankle Orthopaedic Specialist locations:

Specialty Orthopaedics Parramatta
Specialty Orthopaedics Norwest Private Hospital
Specialty Orthopaedics SAH Wahroonga

 

Ankle ligament surgery is used to treat and manage ankle sprains, ankle trauma, ankle ligament damage, and ankle instability where non-surgical methods have not had the desired effect in reducing symptoms. Patients may choose to undergo ankle ligament surgery for their loose, easily sprained ankles that may be causing posture issues or other instabilities of the foot.For more information, please read our article on ankle sprains to learn more about ankle ligament damage or torn ankle ligaments.

 

How is the surgery performed?

Arthroscopy is the preferred method to perform ankle ligament surgery. Arthroscopy is a minimally invasive technique that uses precise tube-like surgical instruments called arthroscopes. The use of arthroscopy allows the orthopaedic specialist surgeon to complete the surgery with small incisions (cut) on the ankle. From there, the orthopaedic specialist surgeon is about to locate the damaged tissue of the ligament and make repairs with stitches to the bone.

 

How long will I be in hospital?

Because it is a minimally invasive procedure, arthroscopy is usually done as a day surgery procedure meaning it should only require you to be in hospital for less than 24 hours.

 

Will there be pain involved?

Prior to surgery, you will be given general anaesthesia and a local injection around the ankle area, so you remain pain-free during and after the surgery. During the recovery period, you may be prescribed some stronger painkillers to reduce any discomforts.

 

What happens after the surgery?

After the surgery is complete, a boot / brace will be applied and will remain in place for 6 weeks after surgery and is needed to ensure the ankle joint stays in place while it is healing. Afterwards you will be sent to the recovery unit and monitored for a period of time to allow the general anaesthesia to wear off and your body vitals to normalise. It is important at this time to report any discomfort, pain, or nausea you may have to the doctors as they can assess your need for painkillers or anti-nausea drugs when you are discharged.

You will be referred to a physiotherapist who will start you on a recovery programme. It is recommended that you follow the guidance of the physiotherapy programme as it will speed up your recovery drastically and allow you to get back on your feet sooner.

If you are well, you should be discharged from hospital on the same day.

 

What should I do in the first week after surgery?

In the first week after the surgery, you should attempt to minimalize moving around unless necessary. This is to ensure the ankle joint is kept in place while healing. Weight-bearing on the foot is allowed in most cases and crutches occasionally required.

Attempt to elevate your foot to the level of your heart to reduce swelling and take painkillers whenever you experience pain.

You may find some blood ooze at the site of the surgery which is normal. However, if you notice bleed does not stop, please contact the orthopaedic specialist surgeon urgently.

 

When will I be able to walk?

You can weight bear as tolerated in the boot / brace for 6 weeks after surgery, in most cases. Occasionally you may use crutches to move around.

Around six weeks after the surgery, you should regain weight-bearing ability of your foot without the need of the boot / brace, but this is different for each individual and you should consult your orthopaedic specialist surgeon before removing the boot / brace.

 

When can I return to work?

Healing and recovery times are different for each individual person. In general, you should be able to return to work in 2 weeks if you mostly sit at work. You should allow for 8 to 12 weeks to recover if your work involves manual labour.

 

What are some risk and complications of ankle ligament reconstruction surgery?

Before undergoing any surgery, an orthopaedic specialist surgeon will discuss risks and potential complications with you and answer any questions you might have.

Some risks include:

  • Wound infection: this occurs in less than 1% of all procedures and can be treated with antibiotics
  • Nerve damage: there is a small risk to losing sensation of the skin in area surrounding the surgical site, but this is very rare.
  • Blood clots: with any surgical procedure, there is a small risk of the blood clotting in the vessels causing pain and swelling. If you have known risk factors associated blood clots, the specialist may prescribe you with some blood-thinners during the recovery period. The risks are present but small (3% or less). If you experience abnormal swelling and pain of the leg, please contact the specialist urgently.
  • Instability: The risks of having further instability after surgery is low and below 5% recurrence. You can further reduce the risks by physiotherapy exercises.

 

Follow-up appointments

The typical follow-up appoints after you have been discharged is as following:

10-14 days after surgery

At the first appointment, orthopaedic specialist surgeon who will remove your brace / boot and examine your wound and ankle and sutures are removed. At this appointment, be sure to discuss any pain and discomforts you may be experience.

Six weeks after surgery

The boot will be removed at this appointment and you will start physiotherapy. You will be able to wear normal shoes.

Twelve weeks after surgery

This is the final appointment you will have with the orthopaedic specialist surgeon. A final examination of your ankle will be performed and if all is well, you will be discharged.

 

Important: Information is provided for guidance only. Individual circumstances may differ and the best way to approach a condition is by individual medical consultation where a specialist can tailor a treatment plan to suit your needs.

 

Edited by Dr Roderick Kuo
Last updated: 12/11/2019

A/Prof Roderick Kuo is associated with Specialty Orthopaedics, a group practice comprised of 10 fellowship trained orthopaedic surgeons with multiple subspecialty interests including hand, shoulder, elbow, hip, knee, foot & ankle, trauma, Paediatric orthopaedic surgery and medicolegal work.

All surgeons are members of the Australian Orthopaedic Association and Fellows of the Royal Australian College of Surgeons.

Visit the Specialty Orthopaedics Website

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