What is tightrope surgery, the procedure to repair Brock Bowers’ ankle?

About halfway through the second quarter of the Georgia Bulldogs’ game against the Vanderbilt Commodores, tight end Brock Bowers was tackled on the sideline. He tried to walk back to the huddle, but didn’t make it very far.

Bowers suffered a high ankle sprain, for which he’ll have tightrope surgery. But what does that entail?

A high ankle sprain, known as ankle syndesmosis, happens when the two ligaments holding the fibula and tibia (the two bones of the ankle) are either strained or torn. Surgery repairs and stabilizes the bones, according to Georgia-based Resurgens Orthopaedics, making it an effective way to treat such injuries.

Tightrope surgery is often recommended for athletes because it can shorten rehabilitation time, according to the Centers for Advanced Orthopaedics.

The TightRope, a trademarked device created by Arthrex, uses a fixation plate, surgical screws, a guidewire, an oblong TightRope button and a TightRope cord.

Credit: Arthrex

Credit: Arthrex

According to Resurgens, the surgeon will access the joint through an incision on the outer side of the ankle. After removing or stabilizing any loose bone fragments, they will realign the tibia and fibula, if needed.

The surgeon will then attach the fixation plate to the fibula using surgical screws. This stabilizes the bone.

After drilling a tunnel through both bones, the surgeon will guide an oblong TightRope button, threaded with the TightRope cord, through the tunnel.

As the surgeon tightens the cord, it pulls a second metal button against the fixation plate on the fibula. All this is secured by tying a knot in the cord.

Recovery from tightrope surgery takes, on average, six to eight weeks.