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Ligament reconstruction uses a tendon graft to rebuild a ligament that has been chronically damaged or stretched beyond the point of direct repair. It is performed when a joint remains unstable despite physiotherapy and bracing, and is designed to restore the structural support the joint needs to function under load. At London Cartilage Clinic, ligament reconstruction is offered for the ankle, elbow, wrist, and hand, with the surgical technique adapted to the anatomy and demands of each joint.
Reviewed byProf Paul Lee MBBch, FRCS (Tr & Orth), PhDLast reviewed 1 May 2026
Ligament reconstruction is considered for chronic joint instability that has not responded to physiotherapy, bracing, or injection therapy. The ligament tissue itself is no longer viable for direct repair.
The goal of reconstruction is to restore mechanical stability so the joint can tolerate normal loads and sporting demands without giving way.
A tendon graft is harvested, passed through bone tunnels at the anatomical ligament attachment sites, and secured under tension. The graft remodels over time into functional ligament tissue.
Rehabilitation is structured around graft maturation timelines. Each phase builds on the last, with the goal of returning you to full function with confidence in the stability of the joint.
You may have more options than you think
At London Cartilage Clinic we follow a structured clinical framework across four areas of treatment. Before recommending a single procedure, we assess which combination of approaches gives you the best outcome.
Protect what you have. Slow degeneration and manage symptoms.
Fix specific damage. Torn tissue, unstable joints, structural problems.
Rebuild lost tissue. Biological treatments that stimulate new growth.
When other options are exhausted. Joint replacement as a last resort.
This treatment can be applied across multiple joints. Select yours to see the full range of options we offer, organised by clinical approach.
Explore All Treatment Options
At London Cartilage Clinic, ligament reconstruction is performed across multiple joints including the ankle (lateral ligament complex), elbow (ulnar collateral ligament), wrist (scapholunate ligament), and hand (collateral ligaments). The principles are similar, but the surgical technique is adapted to each joint.
Reconstruction is considered when the ligament tissue is too damaged, attenuated, or scarred to be repaired directly. This is common in chronic instability where the ligament has been stretched repeatedly over months or years. A tendon graft is used to rebuild the ligament and restore structural support.
The graft is typically taken from a nearby tendon that can be sacrificed without significant functional loss, or from a donor (allograft). The choice depends on the joint, the reconstruction technique, and patient-specific factors. Your surgeon will discuss the options during planning.
Recovery varies by joint. Ankle ligament reconstruction typically allows weight-bearing in a boot within two weeks, with return to sport from four to six months. Elbow and wrist reconstructions may require a longer period of immobilisation. Your rehabilitation plan is tailored to the specific reconstruction performed.
Yes. Ligament reconstruction is specifically designed to restore the stability needed for sporting activity. Return to sport is guided by functional testing and typically occurs between four and nine months depending on the joint and the demands of your sport.
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