J Korean Foot Ankle Soc.  2021 Mar;25(1):25-31. 10.14193/jkfas.2021.25.1.25.

Arthroscopic Procedure in the Treatment of Chronic Lateral Ankle Instability

• Lee HJ
• Jeong BO

• KMID: 2513650
• DOI: http://doi.org/10.14193/jkfas.2021.25.1.25

Abstract

The open Broström procedure is considered the surgery of choice for treating chronic lateral ankle instability. The role of arthroscopy has gained popularity in the surgical treatment of chronic lateral ankle instability, partly for the ability to manage the intra-articular pathology combined with ankle instability. Arthroscopic techniques can be divided broadly into the arthroscopic-assisted Broström technique and arthroscopic all-inside ligament repair. The clinical results of these arthroscopic techniques are similar to open procedures. The arthroscopic technique may be an excellent alternative to the open Broström procedure in treating chronic lateral ankle instability when applying the appropriate indications.

Keyword

Ankle lateral ligament; Joint instability; Arthroscopy; Surgical procedures

Figure

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  Figure. 1 (A) Debride the synovial tissue with a shaver and visualize the remnant of anterior talofibular ligament. (B, C) Insert a suture lasso through the anterolateral portal to wrap the ligament from the lateral to the medial direction. Push the nitinol loop into the suture lasso and pull it out from the portal. (D) Remove the suture lasso from the anterolateral portal. (E) Replace the nitinol loop to a suture. Make a sliding knot on the ligament with the suture. (F) Drilling is performed on the fibular side origin of the anterior talofibular ligament before inserting the suture anchor. The drilling direction is tilted 45 degrees from the axis of fibula and parallel to the lateral gutter. (G) A knotless suture anchor is loaded with the suture arm which is tied on the anterior talofibular ligament and is inserted in the previously drilled hole with tension. (H) The anterior talofibular ligament is repaired on its origin.

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