الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
In order to get the therapeutic benefit from treating CLAI, arthroscopic anatomical repair of the ATFL is done. All of the following must be taken into account: Patients with a force line abnormality in their lower limbs should read the inclusion/exclusion criteria very carefully at the outset. After surgery, the recurrence rate of ATFL is quite high, proving that simple correction is ineffective. Second, cleaning the hyperplastic synovium tissue at the ankle and peroneal tip may help decrease tissue swelling and discomfort. Ankle lesions, particularly a talus cartilage damage, must be investigated and treated before ATFL may be investigated.
Third, the superficial peroneal nerve and sural nerve should be protected during arthroscopic construction of the anterior channel of the lateral malleolus. Forth, lateral malleolus avulsions may have the little bone mass removed to avoid the development of corpus liberum and impact (241).
Fifth, to promote better healing of ATFL, the anchor should be positioned in the centre of the footprint area of the distal fibula, and bone freshening of the footprint region should be performed prior to anchor insertion. To avoid piercing and fracturing the distal end of the fibula, the anchor’s orientation should be at an angle of 30°–45° with the y-axis of the fibula on the sagittal plane (242).
To avoid damaging the articular cavity or the lateral cortex of the fibula, the anchor should be placed in the middle of the footprint in the horizontal plane.
Sixth, ATFL length and quality should be assessed in real-time throughout the procedure. The ligament should be repaired or the Broström-Gould method should be used if the repair requirements cannot be met (243). To avoid a rupture or fixation failure of the ATFL, it is important to assess the strength of the fixation during arthroscopy before proceeding with ring suture and tight suture.
If you want to avoid tearing the ATFL when you’re sewing and knotting, choose a high-quality location to suture the ring with the suture hook. To achieve the full force and effectiveness of ligament suture, the tying of knots should be performed under arthroscopic guidance in step nine. Standardized rehabilitation activities are necessary to avoid joint stiffness and varus restriction.
While the postoperative data was gathered by a separate assessor, the fact that all procedures were conducted by a single experienced surgeon is a strength of the research. As most of the available literature reports are primarily concerned with the short-term effects of objective direct ATFL repairs for CLAI, the fact that this is one of the first series of all-inside arthroscopic ATFL repairs with a significant number of patients who have undergone intermediate to long-term follow-up is also noteworthy. Mid-term functional outcomes of large patient populations are seldom discussed in the published literature. Furthermore, we included patients with related injuries that necessitated further operations to examine their incidence in CLAI patients and evaluate the influence on post-operative rehabilitation and functional result. In addition, we tried to provide the groundwork for the clinical use of this method by using a variety of functional scores and assessments.
Because of the study’s limitations, a clinical diagnosis supported by radiographic evidence was accepted rather than a quantitative assessment of instability before and after surgery. The absence of a control group that was given the open technique and the fact that the research was conducted retrospectively are further drawbacks. Therefore, well-designed prospective randomised comparative studies are still needed to validate the long-term functional effects of this technique.
Conclusion
CLAI patients who undergo arthroscopic anatomical repair of the ATFL have a greater chance of achieving favourable clinical and functional outcomes with a lower risk of re-injury. Furthermore, it’s medium- and long-term results are encouraging, so it’s likely to be widely implemented in the near future.