After repeated sprains, the ligaments on the outside of the ankle stretch out and stop holding the joint together properly. The two main operations are modified Bröstrom repair (the existing ligament is tightened back into position and reinforced — the workhorse procedure for primary cases) and anatomical reconstruction with a tendon graft (used when the original ligament is too damaged to repair, or where a previous repair has failed). Both are typically performed with an arthroscopic look inside the joint first — long-standing instability commonly produces a cartilage lesion, loose body, or impingement that should be addressed at the same operation. Surgery is the second line, not the first. The first line is structured proprioception and strength rehab, often with bracing — many patients settle with that alone. Surgery is reserved for the minority whose ankle keeps giving way despite a fair rehabilitation trial, or whose damage is structural rather than functional.