Modified All-Inside Arthroscopic Anterior Tibiofibular Ligament Repair and Reinforcement in Chronic Ankle Instability

Chronic ankle instability often requires surgical intervention, with arthroscopic anterior talofibular ligament repair being a preferred technique; however, outcomes in cases with poor ligament quality remain challenging. This study introduces a "modified suture augmentation" technique, which uses an individualized portal placement and arthroscopic lasso-loop suturing, followed by a flexible "turn-back" reinforcement of the anterior talofibular ligament using the suture limbs. This all-inside, suture-based augmentation method aims to provide anatomic reconstruction and enhanced stability while potentially avoiding the risk of joint stiffness associated with rigid internal bracing.