InternalBrace for Ligament Repair

Updated 2/7/2024
Internalbrace for Chronic Ankle Instability

An ankle ligament injury is one of the most common sports injuries. Straining, overstretching, partially tearing, or rupturing a ligament are all examples of ankle injuries that can occur from traumatic ankle events or overuse.


Suddenly rolling your ankle or the repetitive side-to-side movements of sports such as basketball put stress on the lateral ankle ligaments. Surgical repair is generally required when conservative treatment doesn't resolve a ligament injury.


While we do have conservative treatment options to resolve pain and let the ankle heal, ankle ligament injuries sometimes require surgical correction.


However, past surgical procedures were often imperfect and could result in permanent lateral ankle instability; simply adhering the soft tissue to bone wasn't always strong enough to fully repair the ligament. Another leading option — using donor tissue to strengthen and stabilize the ankle — also comes with risks such as increasing the chances of arthritis and reducing range of motion in the future.


Fortunately, the InternalBrace ligament augmentation repair helps increase ankle stability and strength and restore function more quickly than past approaches to ankle ligament repair.


What is the InternalBrace? 

The Internal Brace Repair System is a surgical technique used to reinforce standard ligament repairs, providing additional support and stability to the joint. We often add the InternalBrace to traditional surgeries such as Brostrom repairs for additional stability.


InternalBrace is a tiny, thick, rope-like fiber that's stronger than the natural ligament; it is applied to the damaged soft tissue, acting as a sort of seat belt to hold it in place. The fibers are secured by BioComposite SwiveLock suture anchors designed to allow blood and bone marrow to circulate through the device. 


The anchor is knotless, instead relying on suture tape, allowing it to be inserted more quickly than procedures that rely on tying suture knots. Instead, strong fiber tape is used to compress the ligament and InternalBrace against the bone. The InternalBrace tightly joins the torn ligaments and bone together.


Because the sutures, anchors, and tape are biodegradable, they will naturally reabsorb into the body when their job is done — no need for a second procedure to remove the stitches.


Developed by Arthrex — a trusted leader in minimally-invasive orthopedic products — the InternalBrace is a reliable technology for augmenting traditional ligament repair.


Why choose InternalBrace for the treatment of chronic ankle instability symptoms? 

The InternalBrace is not only for initial ligament reconstruction procedures; it can also be used to revise previous repairs that didn't resolve ankle instability satisfactorily.


Chronic ankle instability is when the ankle joint's outer (lateral) side periodically "gives out" while walking, jogging, or even just standing. The ankle may repeatedly and unexpectedly release, especially on uneven surfaces or when playing sports. You may experience swelling and soreness and feel wobbly on your foot, as though you can't always trust your ankle during weight-bearing activities. 


Repeated ankle sprains or poorly rehabilitated injuries can cause permanent ligament damage, leading to chronic lateral ankle instability. It's a common problem for athletes, but there is help available. 


The InternalBrace ligament augmentation procedure has been found to be up to three times stronger in terms of lateral ankle stabilization than traditional repair methods.


How does the InternalBrace improve upon traditional treatments? 

Although the foot and ankle community generally recognizes the Brostrom procedure as the "gold standard" of anterior talofibular (ATFL) ligament repair, augmenting this ankle surgery with an InternalBrace adds stability, decreases recovery times, and has a short postoperative immobilization period. 


You'll spend less time in a cast, start physical therapy sooner, and return to sports much earlier than you would with a traditional repair.


InternalBrace: a faster and stronger recovery 

Typical Brostrom procedure repairs usually require ankle immobilization with a cast for six to eight weeks. The patient usually takes around three to six months to return to normal activities. As many as 10-15% of patients must reduce their activity level to accommodate their ankle.


With the minimally-invasive InternalBrace repair system, patients can expect to be out of their cast and into a walking boot in two to three weeks. You can start physical therapy and rehabilitation after your follow-up appointment to remove the cast. 


Although each case is different, patients generally spend less time in physical therapy thanks to the added stability of the InternalBrace. The sooner you're out of physical therapy, the sooner you can get back on track with your regular training routine.


UFAI doctors have experience with InternalBrace procedures 

The orthopaedic experts at University Foot & Ankle Institute have decades of combined experience treating various acute and chronic ankle injuries. Our highly-trained foot and ankle team uses the latest technologies available to successfully remedy ankle instability and pain, such as ligament repair utilizing the InternalBrace technology. Our physicians are nationally recognized experts in treating chronic ankle instability and are often called upon to train other surgeons on this state-of-the-art procedure. 


For a consultation, please call (877) 736-6001 or make an appointment online now.


University Foot and Ankle Institute is conveniently located throughout Southern California and the Los Angeles area. Our foot and ankle surgeons are available at locations in or near Santa Monica, Beverly Hills, West Los Angeles, Sherman Oaks, the San Fernando Valley, El Segundo, the South Bay, LAX, Calabasas, Agoura Hills, Westlake Village, Valencia, Santa Clarita, and Santa Barbara.



InternalBrace FAQs


What is the recovery time for InternalBrace surgery? 

The standard recovery time for an InternalBrace ankle procedure is 12 weeks. Alternatively, the traditional ankle Brostrom repair without an InternalBrace can take as long as six months. 


What is the difference between InternalBrace and Brostrom procedures?

The InternalBrace uses fibers and anchors to support the tightening and repairs done during a Brostrom procedure, acting like a seatbelt for the ligament for extra stability during healing. The InternalBrace generally allows a faster recovery and return to activity than the Brostrom procedure on its own. 


Can a Brostrom procedure fail? 

Some patients can have continued ankle instability after a Brostrom procedure, making the addition of an InternalBrace an excellent choice for those hoping to avoid a revision.


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