What Are the Different Types of Ankle Surgery?

Your ankles carry your body’s weight, stabilize your movement, and allow you to walk, run, and jump freely. But when an ankle injury or chronic condition interferes with this mobility, surgery may become necessary. Understandably, patients often ask:

“What are the different types of ankle surgery, and which one might be right for me?”

At PPSI, our team of orthopedic surgeons, podiatrists, pain management specialists, and sports medicine doctors frequently treat ankle injuries ranging from mild sprains to complex fractures. This guide explains the main types of ankle surgery, when they’re performed, and what you can expect from treatment and recovery.

When Is Ankle Surgery Needed?

Not every ankle injury requires surgery. Many conditions improve with conservative care, such as rest, physical therapy, injections, or bracing. However, surgery may be necessary if:

• Severe fractures or dislocations occur
• Ligaments or tendons are completely torn
• Arthritis leads to chronic pain and instability
• Previous treatments have failed
• The ankle joint becomes unstable or deformed

The Different Types of Ankle Surgery

There are several types of ankle surgeries, depending on the condition and severity of injury. Let’s explore the most common ones:

1. Ankle Arthroscopy

A minimally invasive procedure where tiny incisions are made, and a small camera (arthroscope) is inserted into the ankle joint.

Why it’s done

• To remove loose cartilage or bone fragments
• To repair mild ligament injuries
• To treat early arthritis
• To wash out infection or inflammation

Benefits

• Small incisions
• Faster recovery time
• Less scarring compared to open surgery

2. Ankle Fracture Surgery (Open Reduction and Internal Fixation – ORIF)

Used to repair broken ankle bones. The surgeon repositions the bone fragments and secures them with metal plates, screws, or rods.

Why it’s done

• Severe fractures with bone displacement
• When bones do not heal properly with casting
• Complex multi-bone injuries

Benefits

• Restores stability and alignment
• Reduces the risk of long-term arthritis
• Helps patients regain mobility sooner

3. Ligament Reconstruction Surgery

Also known as the Broström procedure, it is performed to repair or reconstruct damaged ankle ligaments.

Why it’s done

• Chronic ankle instability after repeated sprains
• Severe ligament tears that don’t heal with bracing or therapy

Benefits

• Prevents future sprains
• Improves joint strength and stability
• Restores confidence in movement

4. Tendon Repair Surgery

Involves repairing or reconstructing damaged tendons around the ankle, such as the peroneal tendons or the Achilles tendon.

Why it’s done

• Chronic tendonitis or tendon tears
• Achilles tendon rupture
• Severe sports-related injuries

Benefits

• Restores strength and function
• Prevents tendon degeneration
• Helps athletes return to activity

5. Ankle Fusion Surgery (Arthrodesis)

In this procedure, the ankle bones are fused together using screws, plates, or rods. Over time, the bones grow into one solid piece.

Why it’s done

• Severe arthritis causing constant pain
• Cases where joint replacement isn’t an option
• To stabilize deformities

Benefits

• Provides permanent pain relief
• Restores stability
• High success rate for chronic arthritis

Drawback

• Loss of ankle joint flexibility (though nearby joints compensate over time)

6. Total Ankle Replacement (Ankle Arthroplasty)

A surgical procedure where the damaged ankle joint is replaced with an artificial implant made of metal and plastic.

Why it’s done:

• Advanced ankle arthritis
• Patients who need to maintain joint motion (vs. fusion)
• To reduce pain while preserving mobility

Benefits:

• Maintains ankle motion
• Reduces pain significantly
• Improves quality of life and walking ability

7. Cartilage Repair and Regeneration

Newer techniques such as microfracture surgery, osteochondral grafting, or biologic injections are used to stimulate cartilage regrowth.

Why it’s done

• Localized cartilage injuries
• Early arthritis in young patients
• Athletes who need to preserve joint function

Benefits

• Preserves natural joint
• May delay or prevent need for larger surgery

Recovery After Ankle Surgery

Recovery time varies depending on the type of surgery and the patient’s health:

• Arthroscopy: 2–6 weeks
• Fracture repair (ORIF): 6–12 weeks
• Ligament or tendon repair: 8–12 weeks
• Ankle fusion: 3–6 months
• Total ankle replacement: 3–6 months, with physical therapy

Rehabilitation is essential. At PPSI, we use physical therapy, chiropractic support, podiatry care, and sports medicine rehabilitation to ensure a safe and complete recovery.

Risks and Complications

While ankle surgeries are generally safe, possible risks include:

• Infection
• Nerve injury
• Blood clots
• Non-healing of bones or ligaments
• Stiffness or loss of mobility

Fortunately, with modern minimally invasive techniques, advanced imaging, and experienced surgeons, complication rates are low.

How to Decide Which Ankle Surgery Is Right for You

The choice depends on:

• Type and severity of injury
• Age and activity level
• Presence of arthritis or deformity
• Lifestyle goals (e.g., athletes may prefer joint-preserving options)

At PPSI, we personalize every treatment plan, balancing pain relief, stability, and long-term function.

Conclusion

Ankle surgery is not one-size-fits-all. From minimally invasive arthroscopy to advanced joint replacement, each type serves a different purpose. The good news is that today’s surgical options are safer, more effective, and better tailored to patient needs than ever before.

At PPSI, our board-certified orthopedic surgeons, podiatrists, pain management experts, and rehabilitation specialists work together to create a customized treatment plan for every patient. Whether you are struggling with a severe fracture, chronic arthritis, or tendon injury, we are here to help you get back on your feet—literally.