# Predictor of clinical and functional outcomes in ankle arthroscopic ligament repair with ‘all‐inside’ technique

## TL;DR

This study shows that arthroscopic 'all-inside' ligament repair for chronic ankle instability leads to significant improvements in function and pain, with better results for patients using two anchors.

## Contribution

The study identifies key predictors of successful outcomes in all-inside ankle ligament repair, including anchor use and BMI.

## Key findings

- Patients showed significant improvement in FAAM scores from 71% preoperatively to 95% at final follow-up.
- Two-anchor repairs resulted in better outcomes than single-anchor procedures (p = 0.01).
- Higher BMI was linked to poorer outcomes, but internal bracing improved function in this group.

## Abstract

Chronic ankle instability (CAI) is a common condition characterized by recurrent episodes of lateral instability, often due to a lesion of the ankle collateral lateral ligament complex. If untreated, CAI can lead to persistent symptoms and long‐term degenerative changes. Arthroscopic ‘all‐inside’ repair has gained traction as a minimally invasive technique offering functional and clinical benefits.

This retrospective study analyzed 43 patients undergoing arthroscopic ligament repair using the all‐inside technique between 2021 and 2024. Functional outcomes were evaluated preoperatively (T0), post‐rehabilitation (T1), and at the final follow‐up (T2) using the Foot and Ankle Ability Measure (FAAM) score, VAS, and satisfaction ratings. Complications occurred were recorded during the follow up. Subgroup analyses investigated the influence of BMI, anchor use, and preoperative functional scores on outcomes.

Patients demonstrated significant improvement in FAAM scores (T0: 71%, T2: 95%) and pain reduction (VAS: T0: 7.67, T2: 1.00). Two‐anchor repairs yielded superior outcomes compared to single‐anchor procedures (p = 0.01). While higher BMI was associated with poorer outcomes (p = 0.04), internal bracing improved functional scores in this subgroup. Preoperative FAAM scores did not predict postoperative outcomes (p = 0.21).

All‐inside arthroscopic ligament repair is a safe and effective option for CAI, providing rapid recovery, low complication rates, and excellent patient satisfaction.

Level IV.