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Stop Living With a Loose Ankle

Modified Broström-Gould Ankle Ligament Reconstruction

If your ankle keeps giving way — on the field, on stage, or just stepping off a curb — you may have chronic ankle instability. When six to twelve months of dedicated rehab still leaves you rolling the ankle, it's time to fix the ligaments themselves. The modified Broström-Gould procedure is the gold standard, and it's the operation I've built much of my practice around.

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By Victor R. Prisk, MD, FAAOS — Board-Certified Orthopaedic Surgeon, Foot & Ankle Fellowship (HSS) · Last updated August 2026

At a Glance

Best for
Chronic ankle instability
Technique
Anatomic repair, your own tissue
Surgery
Outpatient — home same day
Walking boot
Within 1–2 weeks
Physical therapy
Starts 3–4 weeks
Full activity
About 5 months

Do You Need It?

When Sprains Become Instability

After repeated sprains, the ligaments on the outside of the ankle (the ATFL and CFL) heal with weak, stretched-out scar tissue. Bracing and therapy help many people. But when quality conservative care fails, the ankle that keeps giving way is telling you the hardware is the problem — not the effort.

  • Recurrent sprains or a "giving way" feeling on uneven ground
  • Persistent swelling or pain after each new sprain
  • 6–12 months of real rehab without lasting stability
  • An athlete or dancer who no longer trusts the ankle

Everything starts in the exam room, not the operating room. I test the ligaments directly with the anterior drawer and talar tilt exams — and I look at the whole limb, because a high-arched heel or weak peroneal tendons can doom a ligament repair that ignores them.

Same-Day Answers

The Workup, Under One Roof

Weight-bearing CT (LineUP) — your true standing alignment, not a tabletop guess.

Dynamic ultrasound — ligaments and peroneal tendons evaluated while they move.

MRI when needed — cartilage injury travels with instability more often than most people realize.

The Procedure

Anatomic Repair With Your Own Tissue

In the modified Broström-Gould reconstruction, I repair and re-tension your native ligaments anatomically, then reinforce the repair with the inferior extensor retinaculum — the Gould modification. No cadaver graft. No synthetic tape implant. Your own tissue, restored to the anatomy it was born with.

I trained at the Hospital for Special Surgery with physicians who helped popularize this procedure, and I've published research on ankle instability biomechanics in laboratory and clinical settings. I've also revised failed synthetic-tape stabilizations from other practices — one reason I remain committed to the anatomic repair. I explain that decision in detail in my article on chronic ankle instability surgery.

Anatomic, not artificial

The repair restores your ligaments' real attachment points — a stable ankle that still moves like an ankle.

Gould reinforcement

The extensor retinaculum backs up the repair, adding strength without sacrificing motion.

Built for early motion

The construct is designed so protected weight-bearing starts in weeks, not months.

Athletes & Dancers

Stability That Performs

I'm a former NCAA All-American gymnast and professional dancer, and I care for dancers from Pittsburgh's professional ballet companies. "Stable" means something different when your sport demands cutting, landing, or pointe work — and your rehab plan will reflect that.

  • Fellowship-trained at the Hospital for Special Surgery
  • Published ankle instability biomechanics research
  • Independent practice — operating privileges at both AHN and UPMC facilities
  • On-site P.O.W.ER physical therapy, on my protocol, in my building

Hurt at Work?

Ankle ligament injuries are common work injuries. We treat workers' compensation cases and provide independent medical examinations.

The Comeback

Recovery: Built for People Who Want Their Life Back

My technique is designed for early motion — and recovery is a partnership. Our physical therapists are in the same building, on the same protocol, talking to me about your progress every week.

  1. Weight-bearing in a walking boot

    Most of my patients are up in a boot within 1–2 weeks — many walking at 10–12 days.

  2. Formal physical therapy begins

    Range of motion, then progressive strength and balance work with the P.O.W.ER team.

  3. Jogging and light sport

    A graded return to running, cutting progressions, and sport-specific work.

  4. Full activity

    Cleared by milestones — dancers and cutting-sport athletes get sport-specific benchmarks before release.

Questions Patients Ask

Broström Surgery, Answered

Do I need surgery after one bad ankle sprain?
Almost never. Most sprains heal with proper rehab. Surgery is for chronic instability — when the ankle still gives way after 6–12 months of quality conservative care, bracing, and strengthening.
How soon will I walk after Broström surgery?
My patients are typically weight-bearing in a walking boot within 1–2 weeks of surgery. Formal physical therapy usually begins at 3–4 weeks.
When can I return to sports?
Most patients jog and begin light sport at 3–4 months and return to full activity around 5 months. Dancers and cutting-sport athletes get sport-specific milestones before clearance.
Do you use the InternalBrace or synthetic tape?
No. I perform an anatomic repair using your own tissue, reinforced with the Gould modification. I've revised failed synthetic-tape procedures from other offices, and I explain my reasoning in my ankle instability surgery article.
Will my ankle be stiff afterward?
The goal of anatomic repair is a stable ankle that still moves like an ankle. Restoring normal anatomy — rather than over-tightening with synthetic material — is how we protect motion.
Is this covered by insurance?
We are in-network with Highmark/BCBS, UPMC, Aetna, Cigna, United, most Medicare plans, and others. Call the office to confirm your specific plan.

Prisk Orthopaedics and Wellness

Ready for an Ankle You Can Trust?

If your ankle won't stop giving way, let's find out why — and fix it properly.

Request an AppointmentCall (412) 525-7692

2490 Mosside Blvd, Monroeville, PA 15146  ·  Serving Pittsburgh, Monroeville, Murrysville, Plum, Penn Hills & Greensburg  ·  Insurance accepted