Arthroscopic Lateral Ligament Repair Through Two Portals in Chronic Ankle Instability

Jorge Pablo Batista1, *, Jorge Javier del Vecchio2, Luciano Patthauer1, Manuel Ocampo1
1 Centro Artroscópico Jorge Batista, 2446 Pueyrredón Avenue, 1st Floor, 1119 Buenos Aires, Argentina
2 Favaloro Foundation, 461 Solis Street 1st floor, 1078 Buenos Aires, Argentina

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© 2017 Batista et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Centro Artroscópico Jorge Batista, 2446 Pueyrredón Avenue, 1st Floor, 1119 Buenos Aires, Argentina, Tel: 48024718; Fax: 4802-4718115598, E-mail:



Injury to the lateral ligament complex of the ankle is one of the most common sports-related injury.

Usually lateral ankle evolves with excellent clinical recovery with non surgical treatment, however, near about 30% develop a lateral chronic instability sequela.

Several open and arthroscopic surgical techniques have been described to treat this medical condition.

Material and Methods:

Of the 22 patients who were treated; 18 males and 4 females, and aged from 17-42 years (mean 28 years).

All patients presented a history of more than three ankle sprains in the last two years and presented positive anterior drawer and talar tilt test of the ankle in the physical examination.

We perform an anterior arthroscopy of the ankle in order to treat asociated disease and then we performed “All inside¨ lateral ligament repair through two portals (anteromedial and anterolateral) using an anchor knotless suture.


Clinical outcome evaluations were performed at a mean follow up of 25 months. (R: 17-31).

Overall results has been shown by means of the American Orthopaedic Foot and Ankle Society (AOFAS). Mean AOFAS scores improved from 63 points (range 52–77) preoperatively to 90 points (range 73–100) at final follow up.

No recurrences of ankle instability were found in the cases presented.


Several surgical procedures have been described during the last years in order to treat chronic ankle instability. ¨All inside¨ lateral ligament reconstruction presents lower local morbidity than open procedures with few complications. Moreover, it is a reproductible technique, with high clinical success rate, few complications and relatively quick return to sports activities. A high knowledge of the anatomic landmarks should be essential to avoid unwated injuries.

Keywords: Ankle, Chronic instability, Arthroscopy, Reconstruction.