Stabilization of Anterior Aspect of Distal Tibiofibular Syndesmosis: A Fully Arthroscopic Technique

The anteroinferior tibiofibular ligament (AITFL) is 1 of the 4 ligaments forming the distal tibiofibular syndesmosis. When damaged, it is crucial to assess and address the lesion properly because a neglected or underdiagnosed lesion may invoke ankle osteoarthritis with underlying tibiofibular joint instability. In this technical note, we present a fully arthroscopic stabilization of the AITFL without the need for soft-tissue grafting. Our technique aims to create horizontal suture fixation over the damaged AITFL that serves as a mechanically efficient stabilization for the anterior aspect of the distal tibiofibular syndesmosis.