Postoperative Imaging of the Ankle: Ligament and Tendon Reconstruction

Tendon and ligament disorders are common indications for ankle surgery. Numerous surgeries and related modifications, ranging from simple repairs and debridement to complex reconstructions with tendon transfers or graft, are available. Knowledge of postoperative imaging appearances of common ankle surgeries is critical to identify complications and aid assessment of clinical treatment failure. This comprehensive review article discusses the surgical indications, techniques, imaging appearances, and complications-specifically those related to minimally invasive or arthroscopic surgery-for various ankle and foot conditions. It includes anatomical (Brostrom type) and nonanatomical lateral ligament repairs for ankle instability. Medial compartment procedures are described, such as peroneal tendon and retinacular repairs, as well as treatments for progressive collapsing flatfoot deformity, formerly known as posterior tibial tendon dysfunction or acquired flatfoot deformity. We also examine posterior compartment procedures, focusing on Achilles tendon repairs. Primary imaging modalities covered are magnetic resonance imaging, ultrasound, computed tomography, and radiographs, including expected postoperative appearances and the usefulness of each modality.