TightRope Ankle Surgery — Return to Your Routine in Record Time


Recently injured University of Alabama quarterback, Tua Tagovailoa, is hoping TightRope ankle surgery will help get him off the bench and back in the game long before the season’s end.

Tagovailoa suffered a high ankle sprain during a mid-October game against long-time rival, Tennessee. Crimson Tide fans are counting the days until he’s cleared to return to the football field. With the innovative TightRope procedure, they shouldn’t have long to wait.

Innovation That Makes a Difference

TightRope ankle surgery is used to repair injured or torn ligaments that result from a high ankle sprain or to treat certain types of fractures, according to Dr. Nicholas T. Gates, an orthopaedic surgeon with OrthoCincy Orthopaedics & Sports Medicine who specializes in ankle surgery.

In more traditional ankle surgery, a screw is used to stabilize the injured ankle while the torn ligaments or broken bones healed. The screw’s rigidity prevents much movement during the early stages of recovery, which requires several months of rehabilitation and restricted activity. Once the ankle heals, a second surgery is required to remove the screw.

During the TightRope procedure, a hole is drilled across the two leg bones and a strong suture is made with a braided polyethylene cord. The cord goes through the drilled hole and holds the leg bones together to stabilize the injured ankle. The “tightrope” that’s created takes the place of the injured ligaments and provides long-term stability and improved function while they heal. The tightrope stays in place and does not require a second surgery for removal.

The end result is “a speedier recovery, faster rehab and earlier return to play,” said Dr. Gates.

“I began doing TightRope about seven years ago. In the ‘old days’ we couldn’t let a person move or walk on their injured ankle because the screw we used for the repair was too rigid to allow normal motion,” said Dr. Gates. “With TightRope, normal motion of the ankle is restored early on.”

Not Just for Athletes

The desire for a faster recovery and shorter rehabilitation is not limited to high-level athletes.

“Everyone wants to return to normal quickly. An earlier return to your job, your hobbies, your everyday life – that’s everything to a lot of people,” said Dr. Gates.

Hanna Mills, a college student and kickbox instructor, couldn’t agree more. Hanna recently sustained a high ankle sprain when she jumped off the dock at Licking River and unexpectedly landed in shallow water.

“I went to the ER and they put me in a splint and gave me crutches,” Hanna said. When that didn’t provide relief, Hanna sought out Dr. Gates, who told her she’d torn the ligaments in her ankle and separated her leg bones. “He said I needed surgery right now,” Hanna explained.

Hanna had TightRope surgery to repair her ankle and within just a few days she was back in class studying massage therapy. She’s wearing a protective boot and doing physical therapy several weeks earlier than would’ve been possible with standard ankle repair and she no longer needs crutches to get around.

Like Tagovailoa, Hanna doesn’t expect her injury to keep her on the sidelines for long.

“I’m so grateful,” she said. “Everyone recommended Dr. Gates. He knew right off the bat what was wrong with my ankle. He sat down with me, talked to me and answered all my questions. He broke down everything for me and made sure I understood. In a couple weeks I’ll be fine.”

For more information about this procedure or about Dr. Gates and the affiliated orthopaedic surgeons at OrthoCincy Orthopaedics & Sports Medicine, visit orthocincy.com or call (859) 301-BONE (2663).