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Practice Guideline
. 2025 Apr 4;154(1):ldaf001.
doi: 10.1093/bmb/ldaf001.

All-inside arthroscopic procedures for chronic lateral ankle instability: evidence-based clinical practice guidelines

Shi-Ming Feng  1 , Nicola Maffulli  2   3   4 , C Niek van Dijk  5   6   7   8 , Hai-Lin Xu  9 , Kai Fehske  10   11 , Christian Plaass  12 , Francesco Oliva  13 , Thomas Karius  11 , Shun-Hong Gao  14 , Wei Xu  15 , Lu Bai  16 , Run-Lai Song  17 , Yue-Feng Hao  18 , Hui Zhang  19 , Yang-Bo Xu  20 , Ning Zhang  21 , Lei Lou  22 , Tian-Tian Ren  23 , Guo-Dong Wang  24 , Qi Li  25 , Jian-Hua Wu  26 , Yong-Zhan Zhu  27 , Gang Yin  28 , Tong-Fu Wang  29 , Jian-Zhong Qin  30 , Amol Saxena  31 , Chao Ma  1
Affiliations
Practice Guideline

All-inside arthroscopic procedures for chronic lateral ankle instability: evidence-based clinical practice guidelines

Shi-Ming Feng et al. Br Med Bull. .

Abstract

Background: All-inside arthroscopic procedures are now frequently employed to manage chronic lateral ankle instability (CLAI) with satisfactory functional outcomes. Currently, no evidence-based guidelines exist for all-inside arthroscopic procedures for CLAI. Many surgical decisions remain uncertain and challenging.

Sources of data: Published scientific literature in PubMed, MEDLINE, Web of Science, EMBASE, and Cochrane databases.

Areas of agreement: All-inside arthroscopic repair and reconstruction procedures are reliable treatments for CLAI.

Areas of controversy: The all-inside arthroscopic procedures for CLAI present significant challenges, particularly in the following aspects.

Growing points: Given the lack of guidelines for the all-inside arthroscopic procedures for CLAI, this evidence-based clinical practice guideline provides 11 recommendations to address the controversy.

Areas timely for developing research: In patients with CLAI undergoing all-inside arthroscopic procedures, comparative studies are urgently needed to establish the optimal timing for weight-bearing, as well as return to work and sports.

Keywords: arthroscopic management; chronic lateral ankle instability; guidelines.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Flowchart of the literature search.
Figure 2
Figure 2
Suture configurations. (A) Loop suture configuration. (B) Free-edge suture configuration. (C) Horizontal mattress suture.
Figure 3
Figure 3
Ligament remnant preservation reconstruction.
Figure 4
Figure 4
Repair of the remnant of the ligament with augmentation (Broström–Gould).
Figure 5
Figure 5
(A) Anatomic reconstruction procedure. (B) Broström repair procedure.
See this image and copyright information in PMC

References

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    1. Lee SH, Cho HG, Yang JH. Additional inferior extensor retinaculum augmentation after all-inside arthroscopic anterior talofibular ligament repair for chronic ankle instability is not necessary. Am J Sports Med 2021;49:1721–31. 10.1177/03635465211008097. - DOI - PubMed
    1. Guelfi M, Nunes GA, Malagelada F, et al. Arthroscopic-assisted versus all-arthroscopic ankle stabilization technique. Foot Ankle Int 2020;41:1360–7. 10.1177/1071100720938672. - DOI - PubMed
    1. Mirza K, Menezes RJ, Acharya PU, et al. Donor-site morbidity following arthroscopic anterior cruciate ligament reconstruction using peroneus longus tendon autograft. Eur J Orthop Surg Traumatol 2024;34:3171–80. 10.1007/s00590-024-04046-x. - DOI - PubMed

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