Frequently Asked Questions
-
The recovery from ankle sprains will depend essentially on the severity and the treatment received. Assuming that the correct treatment has been implemented quickly the estimated time to recovery
-
Absolutely yes but not before achieving full recovery and under the guidance of the physiotherapists. A supportive ankle brace is temporarily recommended when returning to impact sports during the first 3 months. There are multiple options of braces and this is one of them – www.tengengb.com/
-
Yes, full recovery is the norm in ankle sprains without surgery, even in those cases of grade 3 sprains.
Only in a small minority of patients sustaining severe sprains (1 in 5 cases) a full recovery may not be achieved despite non-surgical attempts of treatment and surgery may become necessary.
-
Surgery is rarely ever necessary immediately after a simple sprain.
Only in cases when, despite a course of physiotherapy of about 3 months, there are still lingering symptoms that surgery may be indicated. The most common symptoms experienced months after a sprain are pain and a feeling of the ankle giving way (chronic ankle instability).
-
During surgery the ankle is inspected with a miniature arthroscope (camera) through 2 keyhole incisions. Any associated injuries seen with the camera can be addressed there and then. Finally the ruptured ligament will be repaired using a tiny anchor and surgical thread using an arthroscopic (keyhole) technique.
-
Pain is generally very well controlled after keyhole ligament surgery and this is an advantage compared to open ligament surgery. From our own research pain levels at 24h from surgery are at a level of .. out of 10. We will advise you on the best way to keep pain under control and minimize it.
-
Absolutely, this surgery is routinely done as a day case without the need for overnight stays or admission in hospital. From beginning to end the time spent in hospital to undergo ligament repair surgery may range from 4 to 6 hours, including preparation, anaesthetic time, surgery time, observation and recovery.
-
Yes, walking is allowed immediately after surgery with the use of a boot. Contrary to cases of open ligament repair where non-weight bearing is required for the first 2 weeks either in a cast or in a boot
-
No, casts are not necessary nor advised for a fast recovery from ankle ligament surgery. A boot will be applied after surgery for the first 2 weeks but it can be removed occasionally for periods of breaks.
-
Following surgery the wound is covered with a sticky plaster and thin soft bandage. It is important that the bandage remains dry and on for the 2 weeks after surgery to avoid wound infection. There are various strategies but possibly the most convenient is covering the ankle with a purpose-made waterproof plastic bag to get under the shower safely. This is a type of bag that can serve as an option – www.tengengb.com/
-
The scientifically proven advantages include faster recovery, less pain, smaller scars, and less complications
-
One of the main advantages from keyhole (arthroscopic) ankle ligament repair surgery is the faster recovery and return to sports. With this technique walking is allowed from day 1, upper body exercises after 3 days from surgery, non-impact sports such as cycling or swimming can recommence at 2 weeks from surgery, and impacts such as gentle jogging on a treadmill as soon as 3 weeks from surgery.
1. Medical Management
-
If you think you have sprained your ankle stop any sport or strenuous activities you were taking part on.
Try to rest the ankle and follow the RICE protocol, with special focus on Elevation
Take a pain killer or anti-inflammatory if required depending on pain levels.
Use crutches only if necessary. Attend A&E or an Urgent Care Centre to rule out any fractures or more severe injuries.
Follow-up with a Foot & Ankle Orthopaedic Specialist for the best treatment and advice.
-
Crutches are a method of support, but they are not absolutely necessary to help healing an ankle sprain. During the first few days after the injury, it is common to struggle with weight bearing and hence crutches can then be beneficial.
Ultimately the scientific literature supports a functional treatment based on returning to full weight bearing unaided as soon as comfortably possible.
-
Ankle sprains are classified depending on severity between grade 1 and 3, being 3 the most severe.
From an anatomical point of view, a grade 1 corresponds to a stretch to the ligament; a grade 2 a partial tear; and a grade 3 a complete tear.
Clinically, a grade 1 will show lesser amounts of swelling and bruising than a grade 3 and these also tend to be more painful.
-
An X-ray may not always be necessary but it will help to rule out other more severe injuries that require urgent treatment. There are guidelines published to assist with the need for X- rays (such as the Ontario Criteria), but as a rule of thumb these would be required when there is tenderness in bony prominences or inability to bear weight. Given the dramatic consequences of missing a fractured ankle, when in doubt it’s sensible to err on the safe side and obtain an X-ray.
-
Unless a scan is performed a sprain cannot be diagnosed. X-rays are only able to visualize bone structures, and as a soft-tissue (ligament) injury a sprain will not be represented. By obtaining a scan a sprain cannot only be diagnosed but also classified according to the grade to fine tune the treatment. In addition other associated injuries will also be diagnosed when doing a scan, such as tendon injuries, cartilage damage, minor fractures or
-
Both options will be able to accurately diagnose an ankle sprain and soft-tissue injuries. The decision at times depends on the type of sprain, suspected associated injuries or availability in clinic. The sensibility and specificity of both scans is very similar ranging from …
-
Some ligaments in the ankle are possibly able to heal naturally and by doing so they tend to create some scar tissue that may or may not be symptomatic in the long term. Other ligaments are unlikely to heal and this discrepancy has to do with the anatomic position of ligaments. Those that are intra-articular (inside the joint) such as the ATFL’s superior fascicle or deep deltoid are bathed in synovial fluid which interferes with ligament healing and therefore are unlikely to heal. Others such as the CFL or superficial deltoid ligament are extra-articular and demonstrate some healing potential. In any case, a non-healed ruptured ligament does not always mean that the ankle will remain symptomatic and can instead enable full function with the right treatment in place.
-
Physiotherapy is the best and most scientifically proven modality to improve the healing of a sprained ankle.
There are also available innovative nutraceuticals specifically designed to help with the recovery from these injuries and ensure the adequate nutrients are provided for enhanced healing potential. Link to a type of injury-specific nutraceuticals and supplements – www.tengengb.com/
-
When done arthroscopically driving is generally possible from 2 weeks after surgery. If the repair is done with open surgery, it will be 4 weeks after surgery.
-
No. There are two main techniques to repair the ligament, being open or arthroscopic surgery. In open surgery a large incision is made over the ligament to stitch it up in addition to doing an arthroscopy first to look at the joint. In arthroscopic surgery the ligament is repaired and stitched internally using only miniature keyholes (of less than 5 millimeters). In addition to the smaller scar, there are more substantial benefits from arthroscopic surgery including less pain, faster recovery and return to sports with fewer complications. As a modern and technically demanding technique, only a handful of surgeons in the UK are prepared and are routinely performing the arthroscopic technique safely.
-
The cost of this surgery starts from … and this includes surgeon fees (£. ), anaesthetic fees (£. ), and hospital/material fees (£. ). Despite being a much more modern and specialised surgery, the cost is not higher than that of the open technique performed by some surgeons. Costs may vary depending on complexity and hospital, but in all cases the final cost will be agreed prior to surgery and a quote provided pre-operatively. Ask the office for a personalised quote.
-
Yes, packages that include pre- and post-operative consultations can be offered for a reduced cost. Please ask the office if you are interested in such packages.
-
Yes, please ask the office if you wish to explore fractioned payment options in instalments.
2. Clinic administration and fees
-
Absolutely, by contacting our office you can be seen on the day at one of our clinics where an XR can be done and you can leave the appointment with the right treatment and advice.
You will be seen by an Orthopaedic Foot & Ankle specialist near me.
-
Yes, during your clinic consultation any boots or crutches that are recommended can be obtained on site. These may need to be purchased prior to discussing cost cover by the insurers.
Ultimately the scientific literature supports a functional treatment based on returning to full weight bearing unaided as soon as comfortably possible.
-
These can be obtained either in clinic or online and delivered to your address. See the link below for online purchase TenGen GB
-
Not at all, you can self-refer to our clinic for a first consultation with the foot & ankle Orthopaedic specialist. Many insurers may want you to see a GP or their staff first but this only delays specialist treatment and is not necessary nor mandatory. The best way to obtain authorization to see our Orthopaedic specialists is to ask for it directly and insist you wish to see the chosen specialist by name. Our specialists are fee-assured with all major UK insurers and therefore they can’t deny you a consultation as per their policies.
-
Yes, surgery costs are fully covered by insurers as Mr Malagelada is fully recognised and adheres to all the insurers fees. Only in cases of special policies a shortfall may need to be covered by the patient but this is outside of our control. Please contact your insurer prior to surgery to obtain authorization. We will help you with the necessary surgical codes and assist you through this process.