All-Inside Arthroscopic Anatomic Anterior Talofibular Ligament Repair for Chronic Lateral Ankle Instability and Injury at the Talar Attachment: Surgical Technique

Recently, arthroscopic anterior talofibular ligament (ATFL) repair has become popular, and favorable outcomes have been reported. In general, ATFL injuries are often caused by fibular attachment, and there are no reports of arthroscopic ligament repair of talar attachment injuries. We present a surgical technique for arthroscopic ligament repair via the anterolateral portal, accessory anterolateral portal, and far accessory anterolateral portal for ATFL injuries on the talar side. Ligament plication is performed using a suture anchor at the talar footprint of the ATFL after the small bone fragments are removed under arthroscopy. Arthroscopic surgery may lead to less postoperative swelling and pain than open surgery, allowing for early exercise and return to activity.