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Georgetown Ankle Ligament Reconstruction Protocol 2017

Dr. Christopher Lu MBchB FRCSC / Darryl Yardley M.Sc.PT Ankle ligament reconstruction post-op protocol

PRE-OPERATIVE PHYSIOTHERAPY:

- Gait training, advice on edema control and pain management: rest, elevation, cold therapy - Ankle strengthening; Proprioception - Assess with AOFAS Ankle/Hindfoot Scale
- Learn how to use - crutches, knee scooter, cast protector, cast boot and cold therapy unit
- Please Call Restore Physiotherapy Georgetown - 905-702-1840 to book your pre-operative physiotherapy appointment.
- Post-operative physiotherapy can be completed either at Restore Physio Georgetown or a reputable physiotherapy clinic near your home.
- Post-operative in home physiotherapy is also available with: www.therapia.com

0 - 2 WEEKS:

- Non-weight wearing in cast boot locked with fiberglass and integrated cold therapy
- Leg elevation and cold therapy for edema control
- Mobilize with crutches, knee walker or iWalk 2.0
- Keep cast boot and dry - use cast protector in shower - Wound check at 2 weeks post…

Top athletes who have had ankle arthroscopy

Top athletes who have undergone ankle ligament surgery

Recommended aids to help with post-op recovery

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1) Breg Kodiak Cold Therapy + Ankle / Foot Attachment / Game Ready / Ossur



US Amazon Link:
Ossur Cold Rush Ankle Pad
2) Walking Aids - Crutches / Knee Scooter / iWalk 2.0


US Amazon Link:

Crutches
Knee Scooter
iWalk 2.0

Canada Amazon Link:

Crutches
Knee Scooter
iWalk 2.0

3) Shower Aids

US Amazon Link:

Cast Cover
Bath Stool

Canada Amazon Link:

Cast Cover
Bath Stool

4) Vitamin D drops - 2000 IU / day

Please start this now - in preparation for surgery.



US Amazon Link:

Vitamin D drops

Canada Amazon Link:

Vitamin D drops

5) Aspirin 81 mg / day

If you do not have a contraindication for taking aspirin.  I would recommend you take an Aspirin 81 mg / day for each day that you are in the cast.


US Amazon Link:
Aspirin 81 mg
Canada Amazon Link:
Aspirin 81 mg
6) Foam Bed Wedge to elevate feet


US Amazon Link:

Foam Bed Wedge

Canada Amazon Link:

Foam Bed Wedge

7) Advanced healing waterproof band-aids


US Amazon Link:
Advanced Healing Band-aids

Canada Amazon Link:

Advanced Healing Band-Aids


8) Diet.  Make sure you are eati…

The Brostrum Procedure

The Brostrum Procedure is the standard procedure used to correct ankle instability.

It has been performed for over 50 years.

Brostrum's original paper was written in 1966.

Below are some links about the procedure.

Recovery is generally 3 to 6 months.

Brostrum Procedure / Wikipedia

Brostrum Procedure / Wheeless

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC164377/pdf/attr_37_04_0458.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC164377/


PXB - Percutaneous X-ray Guided Internal Brace

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Ankle instability treated using PXB technique - Percutaneous X-ray Guided Internal Brace.


Pre and post-op stress X-rays:

Case 1:


Case 2:


Case 3:


Case 4:


Case 5:


Case 6:


Tracking Outcomes - AOFAS Ankle-Hindfoot Scale

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In an effort to track outcomes for our patients we will be using the AOFAS Ankle/Hindfoot Scale.  I have attached the AOFAS Ankle/Hindfoot scoring sheet.  If you are a patient it would be appreciated if you could fill out this form on your first and subsequent visits.

AOFAS Ankle-Hindfoot Scale PDF