Syndesmotic Reconstruction

This involves restoring the anatomy of the Sydesmosis joint, made up of the Anterior Inferior Syndesmotic ligament and Posterior Syndesmosis. 

Surgery is indicated in acute cases if there is a significant injury on the MRI, or the Weight Bearing CT shows instability. In chronic cases it is indicated when conservative therapy fails.

Mr Shepherd utilises the most up to date techniques in Syndesmosis surgery and management and has presented Nationally and Internationally on the surgical techniques. A good outcome is achieved in over 90% of cases. 

Using small incisions, A keyhole Arthroscopic assessment is performed.  The Syndesmosis is then stabilised with a ‘tightrope’ device and the AITFL ligament is reinforced.   Evidence based reviews demonstrate improved outcomes with tightrope stabilisation, and it usually avoids the need for removal of devices.

Postoperatively a boot is worn weightbearing as tolerated. After 2 weeks, the boot is removed and physiotherapy with commencement of full range of motion (ROM) of the ankle, cycling and calf raises. At 4 weeks pain free hop dependent jogging commences with progressing to running.   Return to play is allowed at 10 weeks.

Complications

The risks and complications will be assessed and discussed with you. There is a small risk of infection, blood clots, and nerve injury.  Specifically, there is an up to 10% chance that the tightrope device feels to tight and requiring removal beyond 4 months.

Syndesmotic Reconstruction

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