To follow the short-term efficacy of arthroscopy combined with small incision-assisted anterior tibiofibular ligament (ATFL) suture for chronic lateral ankle instability (CLAI) to provide reference for its further application.

Retrospective analysis was performed in the patients with chronic lateral ankle instability from January 2016 to May 2018 who underwent arthroscopy combined with ligament suture. The patients with mechanical instability who failed conservative treatment were selected, and patients with other medical histories such as functional instability and malformation of foot and ankle were excluded. Sixty-three patients with chronic lateral malleolus instability treated by arthroscopic surgery combined with ligamentous suture were included. Perioperative complications were recorded, and paired t test was used to analyze ankle visual analog scale (VAS) score and American Orthopedic Foot and Ankle Society (AOFAS) score at the last follow-up before and after one year.

The last follow-up showed significantly improved VAS and AOFAS scores compared with the preoperative ones, and the difference was statistically significant (t=17.8, 20.8, both P<0.01). Arthroscopic probe found 47 cases of soft tissue impingement, 24 case of avulsion fracture, 11 cases of anterior ankle impingement, eight cases of osteochondral lesions of the talus, two cases of joint loose bodies, and one case of peroneal tendon dislocation. There was no serious postoperative complication.

Arthroscopy combined with ligament suture for CLAI which utilizes the minimally invasive arthroscopic technique to treat the intra-ankle joint combined injury and the anchor technology to suture the ATFL, has an ideal short-term efficacy and the advantages of relatively simple operation and low complications.