Persistent Ankle Swelling After Ligament Reconstruction: What to Do?

Persistent swelling after ankle ligament reconstruction?

Hello, doctor.
About a month and a half ago, I underwent minimally invasive surgery for ankle ligament reconstruction.
Since the surgery, my ankle has remained swollen and has not reduced at all.
The surgeon mentioned that it would naturally subside over time, but the physical therapist indicated that this is not edema, but rather more like bone marrow swelling.

1.
What can I do to promote the reduction of swelling?
2.
Should I wear an ankle brace to stabilize the ankle, or should I use compression bandages?
3.
I previously read an article stating that if the ankle is not stabilized, excessive scar tissue could lead to permanent swelling.
Is this true?
I appreciate your clarification on these matters.
Thank you very much!

Tina, 20~29 year old female. Ask Date: 2021/12/13

Dr. Shi Guozheng reply Orthopedics

1.
Elevate the feet to perform ankle joint exercises.

2.
Both methods can be used.

3.
Incorrect.
For rehabilitation, if swelling occurs, elevate the feet.
The swelling will gradually subside after three months.

Reply Date: 2021/12/13

More Info

After undergoing ankle ligament reconstruction surgery, persistent swelling can be a common concern for many patients. It is essential to understand the underlying reasons for this swelling and the appropriate steps to manage it effectively.
1. What to Do to Promote Swelling Reduction?
Post-surgical swelling can be attributed to several factors, including inflammation, fluid accumulation, and tissue healing. To promote swelling reduction, consider the following strategies:
- Elevation: Keep your ankle elevated above the level of your heart as much as possible, especially during the first few weeks post-surgery. This helps reduce fluid accumulation in the area.

- Ice Therapy: Applying ice packs to the swollen area for 15-20 minutes several times a day can help reduce inflammation and numb the area, providing relief.

- Compression: Using a compression bandage or an ankle brace can help control swelling by applying gentle pressure to the area. However, ensure that the compression is not too tight, as this can impede circulation.

- Gentle Movement: Engaging in gentle range-of-motion exercises, as advised by your physical therapist, can help promote circulation and reduce stiffness, which may contribute to swelling.

- Hydration and Diet: Staying well-hydrated and maintaining a balanced diet can also support the healing process and reduce swelling.

2. Should I Wear an Ankle Brace or Compression Bandage?
Wearing an ankle brace or using a compression bandage can be beneficial, especially in the early stages of recovery. An ankle brace can provide stability and support to the healing ligaments, while a compression bandage can help manage swelling. It is crucial to follow your surgeon's or physical therapist's recommendations regarding the duration and type of support needed, as they will tailor their advice based on your specific condition and recovery progress.

3. Is Permanent Swelling Possible Due to Excessive Tissue Growth?
Yes, it is possible for excessive tissue growth, known as fibrosis, to occur if the ankle is not adequately stabilized during the healing process. If the ligaments are not properly supported, the body may respond by producing excess scar tissue, which can lead to chronic swelling and stiffness. This is why it is essential to follow post-operative care instructions closely, including wearing braces or supports as recommended.
In summary, persistent swelling after ankle ligament reconstruction can be managed through elevation, ice therapy, compression, and gentle movement. Wearing an ankle brace or compression bandage can provide additional support and help control swelling. It is crucial to adhere to your healthcare provider's recommendations to prevent complications such as excessive tissue growth, which could lead to long-term swelling and functional limitations. If swelling persists despite these measures, or if you experience increased pain or changes in sensation, it is essential to consult your healthcare provider for further evaluation and management.

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