Ankle Instability and Arthroscopy: Ligament Reconstruction or Not

Significant progress has been made in understanding the anatomy of the lateral ankle ligaments (LAL) and the arthroscopic techniques used to treat chronic ankle instability (CAI). Although arthroscopic repair techniques are indicated as the first-line surgical treatment, endoscopic reconstruction of the LAL is a validated option in case where repair is contraindicated. The intraoperative arthroscopic assessment of the ligaments plays a significant role in this decision as it allows direct visualization, palpation, and mechanical analysis of the ligament's remnants. This article discusses the indications of the endoscopic reconstruction of the LAL, its advantages and disadvantages, and the main technical steps.