What is ligament and tendon reconstruction?

Foot and ankle ligament and tendon reconstruction is surgery that repairs damaged ligaments or tendons in the lower extremity. Tendons are long thin bands that attach your muscles to bones. Ligaments connect bones to each other to support a joint. Tendons can tear partially or completely during a joint injury. Ligaments can tear or stretch and become loose after repeated strains. Tendon and ligament reconstruction can restore joint stability and range of motion.

Normal joint movement requires healthy nerves, muscles, ligaments and tendons. Nerves send signals to muscles to tell them to contract. A joint moves when muscles contract and pull on tendons, moving the bones. Ligaments span the joint and limit how far a joint can move. This protects against dislocation and hyperextension.

Ligaments and tendons are both made of connective tissue, but their structure is different. Ligaments are not designed to stretch. This helps them perform their passive function of limiting joint motion. Tendons, on the other hand, are designed to be elastic and stretch to allow active movement.  

Injuries and other problems with ligaments or tendons can cause joint problems. It is difficult for severely damaged ligaments and tendons to heal on their own.

Ligament and tendon reconstruction is major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having ligament and tendon reconstruction. 

Types of ligament and tendon reconstruction

The types of ligament and tendon reconstruction include:

  • Direct primary repair, which involves suture or stitches to perform the repair
  • Secondary repair, which involves a graft or tendon transfer to supplement and support the repair
  • Other procedures that may be performed

Your doctor may perform other procedures in addition to ligament and tendon reconstruction. These include:

  • Bone spur removal, which removes an overgrowth of bone that rubs against a tendon
  • Osteotomy, which is the cutting and shifting of bones to correct deformity or bone misalignment

Why is ligament and tendon reconstruction performed? 

Your doctor may recommend foot and ankle ligament and tendon reconstruction if you have ligament and tendon damage causing severe pain, joint misalignment, joint instability, deformity, or disability. Your doctor may only consider ligament and tendon reconstruction if other treatment options have not relieved your symptoms. Ask your doctor about all of your treatment options and consider getting a second opinion.

Your doctor may recommend foot and ankle ligament and tendon reconstruction to treat damage to ligaments and tendons due to:   

  • Acute injuries, causing strains and partial or complete tears 
  • Bone spurs, which can rub against a tendon
  • Degenerative changes, which weaken the ligament or tendon with age
  • Overuse injuries, which places repetitive stress on the ligament or tendon

Who performs ligament and tendon reconstruction?

Orthopedic surgeons and foot and ankle surgeons perform ligament and tendon reconstruction. Orthopedic surgeons are specially trained to treat problems of the bones and joints. They perform surgery and prescribe other treatments. Foot and ankle surgeons are orthopedic surgeons or podiatrists who further specialize in surgery of the foot, ankle, and lower leg. 

How is ligament and tendon reconstruction performed?

Your foot and ankle ligament and tendon reconstruction will be performed in a hospital or outpatient surgery setting. Ligament and tendon reconstruction is an open surgery involving at least one incision. Procedures vary depending on your diagnosis and the ligaments and tendons that need repair. The number of incisions and the use of hardware to secure the repair will vary depending on your condition.

Types of anesthesia 

Your surgeon will perform your ligament and tendon reconstruction using either general anesthesia or regional anesthesia.