Chronic Ankle Instability Surgery: A Foot and Ankle Surgeon's Complete Guide

The Ankle That Won't Stop Giving Way

You sprained your ankle months ago — maybe even years ago. The initial swelling went down. The bruising faded. But something never went back to normal.

Your ankle rolls on uneven ground. It gives way when you cut in basketball. You don't trust it on the tennis court anymore. You've started wearing a brace just to walk the dog. And every few months, it happens again — another sprain, more swelling, more time on the couch.

If this sounds familiar, you probably have chronic ankle instability. And you're not alone.

I'm Dr. Sarang Desai, a fellowship-trained orthopedic foot and ankle surgeon in McKinney and Flower Mound, Texas. I serve as a professional sports team physician, and chronic ankle instability is one of the conditions I treat most frequently — in professional athletes, high school soccer players, weekend pickleball warriors, and everyone in between.

Here's what I want you to understand right from the start: chronic ankle instability is not just "weak ankles." It's a real structural problem with real consequences — and if it's not addressed, it leads to cartilage damage and arthritis inside the ankle joint. The good news is that when treated properly, the results are excellent. A meta-analysis of over 1,300 patients found that 95% return to sport after surgical stabilization.

This guide is going to explain everything — what's actually happening inside your ankle, why physical therapy alone sometimes isn't enough, what surgery involves, and what recovery looks like week by week.

Related guides:

- A Pro Sports Team Physician's Guide to Foot and Ankle Sports Injuries →

- Achilles Tendon Rupture Surgery →

- Jones Fracture Surgery →

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What Is Chronic Ankle Instability?

Chronic ankle instability (CAI) is a condition where the ankle repeatedly gives way, feels unstable, or sprains — typically after an initial ankle sprain that never fully healed.

Here's the basic anatomy: the outside of your ankle is stabilized by two main ligaments — the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL). When you sprain your ankle, one or both of these ligaments tear. In most people, they heal with appropriate treatment. But in about 20-40% of people, they don't heal properly — they heal in a stretched-out, elongated position, or they don't heal at all.

The result is an ankle that is mechanically loose. The talus (the bone that sits inside the ankle joint) has too much play. It shifts and tilts in ways it shouldn't. And every time it does, it damages the cartilage inside the joint a little more.

Research suggests that up to 40% of individuals who experience a first-time lateral ankle sprain will develop chronic ankle instability. The condition is characterized by recurrent sprains, episodes of giving way, persistent pain, swelling, weakness, and diminished function.

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Why Did This Happen to Me?

This is one of the most common questions I hear. "I sprained my ankle playing basketball five years ago. My buddy sprained his the same way. He's fine. Why am I still dealing with this?"

The honest answer is that we don't fully understand why some people develop chronic instability and others don't. But we do know several risk factors:

Severity of the initial sprain. A Grade III sprain (complete ligament tear) is more likely to lead to instability than a Grade I sprain (stretch without tear). MRI studies have shown that talar osteochondral lesions and talonavicular ligament injuries at the time of the initial sprain are independent predictors of developing chronic instability.

Inadequate rehabilitation. This is the biggest modifiable risk factor. Athletes who return to sport before completing a proper rehabilitation program — particularly balance and proprioception training — are significantly more likely to develop chronic instability.

Early functional deficits. A prospective study found that patients who couldn't complete a single-leg drop landing or drop vertical jump within 2 weeks of their initial sprain were significantly more likely to develop chronic instability at 12 months. At 6 months, deficits in dynamic balance (Star Excursion Balance Test) and lower self-reported function predicted eventual chronic instability with 85% accuracy.

Generalized joint laxity. People who are naturally "loose-jointed" (hypermobile) have a higher failure rate after ligament repair — 11.4% versus 1.8% in one study — and may need augmentation or reconstruction rather than simple repair.

Anatomy. A cavovarus foot (high arch with the heel turned inward) places more stress on the lateral ankle ligaments and predisposes to recurrent sprains. This same foot type is a risk factor for Jones fractures and peroneal tendon injuries — these conditions frequently coexist.

Activity level. Athletes in cutting and pivoting sports — basketball, soccer, volleyball, tennis, football — are at highest risk simply because of the demands they place on the ankle.

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The Hidden Danger: Cartilage Damage

This is the part of chronic ankle instability that most patients don't know about — and it's the reason I take this condition seriously even when patients say, "It's just a sprain."

A systematic review and meta-analysis of over 2,100 ankles with chronic lateral ankle instability found that 32% had cartilage or osteochondral lesions inside the ankle joint. That's one in three patients. The most common location was the medial (inside) talar dome — 68% of lesions were found there.

What does this mean practically? Every time your ankle gives way, the talus shifts inside the joint and impacts the tibial plafond (the ceiling of the ankle joint) or the edges of the talar dome. Over time, this repetitive abnormal contact damages the cartilage surface. Once cartilage is damaged, it doesn't regenerate on its own. And damaged cartilage is the first step toward ankle arthritis.

This is why I tell patients: chronic ankle instability isn't just about the inconvenience of a wobbly ankle. It's about protecting the cartilage inside your joint. Every additional sprain is doing damage you can't see on an X-ray.

When I take patients with chronic instability to the operating room, I routinely perform an ankle arthroscopy (camera inside the joint) before the ligament repair. In one study of 87 ankles with chronic instability, intra-articular lesions were found in 91% — including synovitis and impingement in 75, chondral injuries in 33, anterior tibial osteophytes in 23, and loose bodies in 7. Patients with chondral lesions had significantly worse outcomes than those without.

The takeaway: the longer you wait to address instability, the more likely you are to have cartilage damage — and the harder that damage is to fix. I discuss cartilage injuries in more detail in my guide to ankle cartilage injuries (osteochondral lesions).

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When Is It Time to See a Specialist?

Not every ankle sprain needs surgery. Most don't. But here are the signs that it's time to see a foot and ankle specialist:

- Recurrent sprains — two or more sprains in the same ankle, especially if they happen with minimal provocation (stepping off a curb, walking on uneven ground)

- Giving way — the sensation that your ankle is going to buckle, even if it doesn't actually sprain

- Persistent pain — lateral (outside) ankle pain that hasn't resolved after 3-6 months

- Failed physical therapy — you've done a legitimate course of balance and strengthening exercises (not just "ankle circles") and the ankle is still unstable

- Activity limitation — you've stopped playing your sport, hiking, or exercising because you don't trust your ankle

- Deep ankle pain or catching — this may indicate a cartilage lesion inside the joint, which needs to be evaluated with MRI

If you're not sure whether your injury is chronic instability, a high ankle sprain, or a peroneal tendon problem, that's exactly why a specialist evaluation matters — these conditions can mimic each other and require different treatments.

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How Is Chronic Ankle Instability Diagnosed?

The Physical Exam

The diagnosis of chronic ankle instability is primarily clinical — meaning I can usually make the diagnosis based on your history and physical exam.

Anterior drawer test: I stabilize your lower leg with one hand and pull your foot forward with the other. If the talus slides forward excessively compared to the other side, the ATFL is incompetent. This is the most important test.

Talar tilt test: I invert (tilt inward) the ankle while stabilizing the leg. Excessive tilt compared to the other side indicates CFL incompetence in addition to ATFL damage.

Giving way history: I ask specifically about episodes of giving way — how often, what triggers them, and whether they're getting worse. I also use validated questionnaires like the Cumberland Ankle Instability Tool (CAIT) and the Foot and Ankle Ability Measure (FAAM) to quantify the severity.

Imaging

X-rays: Weight-bearing ankle X-rays are the starting point. They help rule out fractures, arthritis, and malalignment. Stress X-rays (anterior drawer and talar tilt under fluoroscopy) can quantify the degree of mechanical laxity.

MRI: This is essential for surgical planning. MRI shows:

- The condition of the ATFL and CFL (torn, attenuated, or absent)

- Osteochondral lesions (cartilage damage)

- Bone marrow edema

- Peroneal tendon pathology (which can coexist with instability)

- Loose bodies and synovitis

CT scan: Occasionally used for detailed evaluation of osteochondral lesions or bony anatomy.

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Nonoperative Treatment: When and How

Surgery is not the first step. For most patients, I start with a structured nonoperative program. The evidence supports this approach — a meta-analysis of 15 randomized controlled trials found that exercise therapy significantly improved function and dynamic balance in patients with chronic ankle instability.

What Effective Rehabilitation Looks Like

The key word is "effective." Doing ankle circles and calf raises at home is not a rehabilitation program. A proper program for chronic ankle instability includes:

1. Balance and proprioception training — This is the most important component. Single-leg stance on unstable surfaces, wobble board exercises, and dynamic balance challenges retrain the neuromuscular system to stabilize the ankle. A network meta-analysis of 44 randomized trials found that balance and strengthening exercises combined with manual therapy were the most effective interventions for improving function and relieving pain.

2. Peroneal strengthening — The peroneal muscles are the dynamic stabilizers of the lateral ankle. Strengthening them with resistance band exercises (eversion against resistance) helps compensate for ligament laxity.

3. Hip and core strengthening — Ankle instability doesn't exist in isolation. Weakness in the hip abductors and core muscles alters lower extremity mechanics and increases ankle injury risk.

4. Joint mobilization — Manual therapy techniques to restore normal ankle dorsiflexion range of motion. Limited dorsiflexion is a risk factor for ankle sprains.

5. Sport-specific training — Cutting, jumping, landing, and agility drills that progressively challenge the ankle in sport-relevant patterns.

A supervised, multimodal rehabilitation program of at least 4 weeks has been shown to be superior to any single intervention alone.

Bracing

Ankle braces — particularly lace-up braces — can reduce the frequency of giving way episodes and are useful as a bridge during rehabilitation or as a long-term management strategy for patients who choose not to have surgery. However, bracing treats the symptom (instability), not the cause (ligament incompetence).

When Nonoperative Treatment Fails

If a patient has completed 3-6 months of structured rehabilitation and still has recurrent instability, giving way, or functional limitation, surgery is indicated. In my experience, the patients who benefit most from surgery are those who:

- Have mechanical laxity on exam (positive anterior drawer)

- Have failed a legitimate physical therapy program

- Want to return to cutting/pivoting sports

- Have evidence of cartilage damage on MRI

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Surgical Treatment: The Options

The Modified Broström Procedure (Gold Standard)

The modified Broström procedure — also called the Broström-Gould repair — is the most widely performed surgery for chronic ankle instability and has been the gold standard for decades.

What it involves: The surgeon makes an incision along the front of the fibula (the outside ankle bone), identifies the stretched-out or torn ATFL (and CFL if involved), and repairs them by shortening and reattaching the ligaments to the fibula using sutures or suture anchors. The Gould modification adds reinforcement by advancing the inferior extensor retinaculum (a band of tissue on the front of the ankle) over the repair.

The results are excellent. A systematic review of 669 Broström-Gould procedures reported a revision rate of only 1.2% at a mean follow-up of 8.4 years. The procedure achieves good to excellent outcomes in 85-95% of patients. A meta-analysis of 1,384 patients found that 95% returned to some sport, 83% returned to their preinjury level, and 87% returned to competitive sport, with a mean time to return of 12.5 weeks.

Failure rates are generally low — around 6-7% in most studies. However, patients with generalized joint laxity have a significantly higher failure rate (11.4% vs. 1.8%), which is why these patients may benefit from augmentation.

Complications are uncommon but include:

- Superficial peroneal nerve injury (numbness on top of the foot) — usually temporary

- Wound infection — rare

- Recurrent instability — 6-7%

- Stiffness — uncommon with proper rehabilitation

Suture Tape Augmentation (Internal Brace)

This is a newer technique that has gained significant popularity. After performing the Broström repair, the surgeon adds a strong suture tape (often called an "InternalBrace") that spans from the fibula to the talus, reinforcing the repair.

The advantage: It allows earlier, more aggressive rehabilitation because the suture tape protects the healing ligament during the early postoperative period. A 2026 study of 105 patients found that suture tape augmentation achieved the same excellent outcomes as isolated repair at 2 years, with no recurrence of instability, but with significantly earlier return to sport — 12 weeks versus 20 weeks.

A systematic review comparing the two techniques found no major differences in clinical outcomes, radiologic stability, or complication rates. However, return to sport was significantly faster with suture tape augmentation when performed arthroscopically. Irritation of the peroneal nerve and tendons may occur slightly more frequently with suture tape.

My approach: I use suture tape augmentation for:

- Athletes who need to return to sport as quickly as possible

- Patients with generalized joint laxity

- Patients with poor-quality ligament tissue

- Revision cases

- Patients in high-demand pivoting sports

Anatomic Reconstruction (Tendon Graft)

When the native ligament tissue is too damaged or insufficient to repair — which can happen in revision cases, patients with severe laxity, or long-standing instability — a reconstruction using a tendon graft is performed.

Options include:

- Autograft (patient's own tissue) — gracilis tendon or split peroneus brevis tendon

- Allograft (donor tissue) — typically a semitendinosus or peroneus longus allograft

A study of high-risk patients who underwent anatomic reconstruction with tendon autograft found that 96% returned to sport at a mean of 8.3 months, and 100% returned to work. A separate study of 44 patients who underwent arthroscopic allograft reconstruction found that all patients achieved the minimal clinically important difference in every outcome measure, with return to work at 3.3 months and return to sport at 6.5 months.

Reconstruction is a bigger operation with a longer recovery, but it's the right choice when repair isn't going to hold.

Open vs. Arthroscopic

Both open and arthroscopic techniques produce excellent results. The meta-analysis of 1,384 patients found no significant difference in return-to-sport rates between open and arthroscopic approaches.

The advantages of arthroscopic surgery include:

- Smaller incisions

- Ability to evaluate and treat intra-articular pathology (cartilage lesions, loose bodies, impingement) at the same time

- Potentially lower wound complication rates

- Shorter recovery in some studies

A prospective study of 286 patients who underwent arthroscopic ankle stabilization reported an overall satisfaction score of 8.5/10, with significant improvements in AOFAS and Karlsson scores. Neurological complications (mostly transient numbness) occurred in 10%, and wound complications requiring revision occurred in 4.2%.

The disadvantage is that arthroscopic techniques are more technically demanding and require specialized training.

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What Happens During Surgery: A Step-by-Step Overview

Here's what a typical Broström-Gould repair looks like in my operating room:

1. Anesthesia and positioning. The surgery is performed under general anesthesia or regional anesthesia (a nerve block that numbs the leg). The patient is positioned on their back with a bump under the hip to internally rotate the leg.

2. Ankle arthroscopy (when indicated). Before the ligament repair, I insert a small camera into the ankle joint through two tiny incisions. This allows me to:

- Inspect the cartilage surfaces for damage

- Remove loose bodies

- Treat osteochondral lesions (microfracture if needed)

- Remove inflamed synovial tissue

- Address anterior or posterior impingement

3. Incision. A 4-6 cm incision is made along the front border of the fibula, curving toward the sinus tarsi (the soft spot on the outside of the ankle).

4. Nerve identification. The superficial peroneal nerve runs through this area and must be identified and protected. Nerve injury is the most common complication of this surgery.

5. Ligament identification and repair. The stretched-out ATFL and CFL are identified. The ligaments are released from the fibula, and the bone surface is prepared (roughened) to promote healing. The ligaments are then shortened and reattached to the fibula using heavy sutures in a "box stitch" pattern or with suture anchors. The ankle is held in dorsiflexion and eversion (foot up and turned outward) while the sutures are tied — this is critical for proper tensioning.

6. Gould modification. The inferior extensor retinaculum is advanced over the repair and sutured down, creating a "pants-over-vest" reinforcement.

7. Suture tape augmentation (if used). A suture tape is passed from an anchor in the fibula to an anchor in the talus, spanning the ATFL repair and providing additional stability.

8. Closure and splinting. The wound is closed in layers, and a posterior splint is applied with the ankle in neutral position.

The entire procedure takes approximately 45-60 minutes (longer if arthroscopy and cartilage treatment are performed). It's an outpatient surgery — patients go home the same day.

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Recovery: Week by Week

Recovery after a Broström repair follows a predictable timeline, though individual variation exists. Here's what to expect:

Weeks 0-2: Protection Phase

- Posterior splint, non-weight-bearing

- Elevation and ice to control swelling

- Pain management (typically managed with nerve block + oral medications)

- Gentle toe and knee range of motion exercises

Weeks 2-4: Early Motion Phase

- Transition to a walking boot

- Begin protected weight-bearing (partial to full, depending on the technique used)

- Start gentle ankle range of motion exercises — dorsiflexion and plantarflexion

- No inversion or eversion yet

- Sutures or staples removed at 2 weeks

Weeks 4-6: Progressive Weight-Bearing

- Full weight-bearing in the boot

- Progressive ankle range of motion including gentle inversion/eversion

- Begin peroneal and calf strengthening (isometric initially)

- Stationary bike for cardiovascular fitness

Weeks 6-8: Transition Out of Boot

- Wean from boot to a lace-up ankle brace

- Begin proprioception and balance training (single-leg stance, wobble board)

- Progressive strengthening — resistance bands, heel raises

- Pool walking and swimming

Weeks 8-12: Functional Rehabilitation

- Progressive agility drills — lateral shuffles, carioca, figure-8s

- Sport-specific movements begin

- Jogging progression (typically starting around week 10)

- Continue balance and strengthening program

Weeks 12-16: Return to Sport

- Sport-specific training at full intensity

- Cutting, jumping, landing drills

- Clearance for return to sport when:

  - Full, pain-free range of motion

  - Strength at least 80-90% of the uninjured side

  - Successful completion of sport-specific functional testing

  - Psychological readiness and confidence

With suture tape augmentation, this timeline is often accelerated by 4-8 weeks. Some patients return to sport as early as 12 weeks; without augmentation, 16-20 weeks is more typical.

This recovery timeline is similar in structure to what I describe in my Achilles tendon rupture surgery guide and Jones fracture surgery guide — the phases are the same (protection → motion → strengthening → sport-specific → return), but the timelines differ based on the biology of each injury.

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Return to Sport by Activity

For a broader overview of how foot and ankle injuries affect athletes across all sports, see my Pro Sports Team Physician's Guide to Foot and Ankle Sports Injuries.

Basketball

Basketball players are among the highest-risk patients for chronic ankle instability — and among the most motivated to get back. The combination of cutting, jumping, landing (often on other players' feet), and lateral movement demands a fully stable ankle.

- Timeline: 12-16 weeks (with augmentation), 16-20 weeks (without)

- Key milestone: Ability to perform a single-leg vertical jump and land without giving way

- Recommendation: Wear a lace-up ankle brace for the first full season after surgery

Basketball players are also at high risk for Achilles tendon ruptures and Jones fractures — I often discuss all three injuries with basketball athletes during their initial consultation.

Soccer

Soccer requires cutting, pivoting, sprinting, and kicking — all of which stress the lateral ankle.

- Timeline: 12-16 weeks

- Key milestone: Ability to cut and change direction at full speed on grass/turf

- Recommendation: Ensure proper cleat fit; consider ankle brace for the first 6 months

Football

Position matters. A lineman who needs to anchor and push has different demands than a wide receiver who needs to cut and accelerate.

- Timeline: 12-20 weeks depending on position

- Key milestone: Position-specific functional testing

- Recommendation: Ankle taping or bracing for the remainder of the season

Football players should also be aware of high ankle sprains and Lisfranc injuries, which can mimic or coexist with lateral ankle instability.

Running

Runners need a stable ankle for repetitive loading over distance, but the lateral demands are lower than in cutting sports.

- Timeline: 10-14 weeks for road running; longer for trail running (uneven surfaces)

- Key milestone: Ability to run 3 miles without pain or instability

- Recommendation: Gradual mileage progression (10% rule); trail running last

Pickleball and Tennis

Court sports with lateral movement, lunging, and quick direction changes.

- Timeline: 12-16 weeks

- Key milestone: Ability to perform lateral lunges and quick stops without hesitation

- Recommendation: Court-specific shoes (not running shoes); ankle brace for the first 3-6 months

Pickleball players in particular should also read about Achilles tendon ruptures — the lateral lunge on a hard court is the classic mechanism for both ankle sprains and Achilles injuries in this population.

Volleyball

Jumping and landing — particularly at the net — are the primary demands.

- Timeline: 12-16 weeks

- Key milestone: Comfortable landing from a block or spike approach

- Recommendation: Ankle brace during play for at least the first season

CrossFit

Box jumps, rope climbs, pistol squats, and Olympic lifts all challenge ankle stability.

- Timeline: 12-16 weeks for most movements; box jumps and rope climbs last

- Key milestone: Ability to perform a pistol squat without giving way

- Recommendation: Step-downs instead of rebounding box jumps for the first 3 months

Dance and Gymnastics

These sports require extreme ranges of motion — particularly plantarflexion — and place unique demands on the ankle.

- Timeline: 16-20 weeks (longer for pointe work)

- Key milestone: Full plantarflexion range of motion and ability to perform relevé without pain

- Recommendation: Gradual return to pointe; ankle strengthening program ongoing

Golf

Low-impact but the rotational forces of the swing load the lead ankle.

- Timeline: 8-12 weeks

- Key milestone: Ability to complete a full swing without lateral ankle pain

- Recommendation: Supportive golf shoes

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Common Mistakes I See

Mistake #1: Treating Every Ankle Sprain the Same

A Grade I sprain (stretch) and a Grade III sprain (complete tear) are fundamentally different injuries. Treating a Grade III sprain with "rest and ice" and sending someone back to sport in 2 weeks is a recipe for chronic instability.

Mistake #2: Skipping Rehabilitation After the Initial Sprain

This is the single most common reason people develop chronic instability. The ligament may heal, but if the proprioceptive system (the brain's ability to sense ankle position) isn't retrained, the ankle will sprain again. Balance training after a first ankle sprain reduces the risk of recurrence by 30-50%.

Mistake #3: Ignoring Giving Way Episodes

"My ankle just does that" is not a diagnosis. Giving way episodes mean the ligaments are incompetent, and every episode is potentially damaging the cartilage inside the joint.

Mistake #4: Getting Surgery Too Early

Surgery should not be the first option. A legitimate trial of physical therapy — at least 3-6 months of supervised, structured rehabilitation — should be completed before considering surgery. Many patients improve significantly with proper rehab.

Mistake #5: Getting Surgery Too Late

On the other end, waiting years with ongoing instability allows progressive cartilage damage. The longer the instability persists, the more likely there is to be an osteochondral lesion — and the worse the surgical outcomes.

Mistake #6: Not Addressing the Underlying Cause

If a patient has a cavovarus foot (high arch), the foot mechanics are driving the instability. Repairing the ligament without addressing the alignment is like fixing a tire without fixing the alignment of the car — it's going to wear out again. These patients may need a calcaneal osteotomy (heel bone realignment) in addition to the ligament repair. The same cavovarus alignment is a major risk factor for Jones fractures and peroneal tendon injuries — which is why I evaluate the entire foot, not just the ankle.

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Frequently Asked Questions

1. What is chronic ankle instability?

Chronic ankle instability is a condition where the ankle repeatedly gives way, feels unstable, or sprains after an initial ankle sprain. It occurs when the lateral ankle ligaments (ATFL and CFL) don't heal properly and remain stretched out or torn.

2. How common is chronic ankle instability?

Very common. Up to 40% of people who suffer a lateral ankle sprain develop some degree of chronic instability. It's one of the most frequent reasons athletes see a foot and ankle specialist.

3. Will my ankle instability get better on its own?

Possibly, with proper rehabilitation. But if you've had symptoms for more than 6 months despite physical therapy, it's unlikely to resolve without intervention. And the longer it persists, the more cartilage damage accumulates.

4. Do I need surgery for chronic ankle instability?

Not necessarily. Many patients improve with structured physical therapy focusing on balance, proprioception, and peroneal strengthening. Surgery is recommended when nonoperative treatment fails after 3-6 months, or when there is significant mechanical laxity and cartilage damage.

5. What is the Broström procedure?

The Broström procedure is the gold standard surgery for chronic ankle instability. It involves repairing and tightening the stretched-out lateral ankle ligaments and reattaching them to the fibula. The Gould modification adds reinforcement with the extensor retinaculum.

6. What is an internal brace or suture tape augmentation?

A suture tape (brand name InternalBrace) is a strong synthetic tape that is added to the Broström repair to reinforce it. It allows earlier, more aggressive rehabilitation and faster return to sport — typically 12 weeks versus 20 weeks.

7. How long does the surgery take?

The Broström repair itself takes about 45-60 minutes. If ankle arthroscopy is performed at the same time (to evaluate and treat cartilage lesions), add another 20-30 minutes.

8. Is it outpatient surgery?

Yes. Patients go home the same day.

9. How long will I be non-weight-bearing?

Typically 2 weeks in a splint, then transition to a walking boot with progressive weight-bearing. With suture tape augmentation, some surgeons allow immediate protected weight-bearing.

10. When can I drive?

If it's your left ankle and you drive an automatic, you can usually drive within 1-2 weeks. If it's your right ankle, typically 4-6 weeks (when you're out of the boot and have adequate reaction time).

11. When can I go back to work?

Desk job: 1-2 weeks. Job requiring standing/walking: 4-6 weeks. Job requiring physical labor: 8-12 weeks.

12. When can I run again?

Jogging typically begins around week 10. Full-speed running by week 12-14. Trail running (uneven surfaces) is the last activity to return to.

13. When can I play sports again?

Most athletes return to sport between 12-20 weeks, depending on the sport, the surgical technique, and individual healing. Cutting and pivoting sports take longer than straight-line activities.

14. What is the success rate of Broström surgery?

Excellent. Studies report 85-95% good to excellent outcomes. A meta-analysis of 1,384 patients found 95% returned to some sport, 83% returned to their preinjury level, and the revision rate was only 1.2% at 8.4 years.

15. What are the risks of surgery?

The most common complication is temporary numbness on top of the foot from irritation of the superficial peroneal nerve. Wound infection, recurrent instability (6-7%), and stiffness are uncommon. Serious complications are rare.

16. Can the repair fail?

Yes, but it's uncommon — about 6-7% overall. Risk factors for failure include generalized joint laxity (hypermobility), obesity, older age, and inadequate postoperative rehabilitation. Suture tape augmentation may reduce the failure rate in high-risk patients.

17. What if I have cartilage damage too?

This is common — one in three patients with chronic instability has a cartilage lesion. If a lesion is found during arthroscopy, it can be treated at the same time as the ligament repair. Small lesions are treated with microfracture; larger lesions may need cartilage restoration procedures. Learn more in my guide to ankle cartilage injuries.

18. Is arthroscopic surgery better than open surgery?

Both produce excellent results. Arthroscopic surgery has the advantage of smaller incisions, the ability to treat intra-articular pathology, and potentially faster recovery. Open surgery is more straightforward technically and has a longer track record. The best approach depends on the individual patient and the surgeon's expertise.

19. I'm hypermobile (double-jointed). Does that affect my surgery?

Yes. Patients with generalized joint laxity have a higher failure rate after standard Broström repair (11.4% vs. 1.8%). These patients often benefit from suture tape augmentation or anatomic reconstruction with a tendon graft.

20. My teenager has chronic ankle instability. Is surgery safe for adolescents?

Yes. A study of 111 ankles in patients under 18 who underwent the modified Broström procedure showed significant improvements in all outcome scores at 5-10 year follow-up, with a 97.3% satisfaction rate.