There are many surgical techniques, but they basically fall into two groups. One is anatomic reconstruction. With this technique, surgeons use the original ankle ligaments to repair the ankle. The other technique is called tenodesis. In this procedure, surgeons reconstruct the ankle ligament using tendon from elsewhere in the body, such as the lower leg. Surgeons attach the transplanted tissue to bones in the ankle joint.

Researchers evaluated the results of both kinds of surgery in a group of athletes. For these patients, anatomic reconstruction resulted in better ankle movement and stability. It also led to fewer degenerative changes in the joint. Compared to tenodesis, anatomic reconstruction more often gave a good or excellent result. For athletes and other active patients, researchers think anatomic reconstruction is the method of choice.