Operative indications and cases to be wary of

The cases in which to use an augmented lateral ligament reconstruction are patients with ligamentous hypermobility, stabilising an ankle replacement and considered for revision instability cases. One might also give consideration to such a procedure in those of very heavy build with extreme requirements (eg weight lifters).

Broadly speaking the two forms of augmented reconstruction are anatomical (using additional soft tissue (tendon) to remake soft tissue retraints in the previous positions of the ATFL and CFL ligaments) or non-anatomical (using additional soft tissue to stabilise the joint but not attached across the joint in the position of the ligaments. The tissue used can be the patients own, often the peroneus brevis tendon (unfortunately also a lateral ankle stabilising force), or allograft material such as the Wright Graftjacket.