Fig 5.

(A, B) Arthroscopic view of the lateral gutter of a left ankle through the anteromedial portal. The quality of the anterior talofibular ligament remnant (yellow arrows) must be inspected, and the contour of the tip of the medial malleolus (blue arrows) is identified. (C) A key to success is for the surgeon to prepare the tip of the lateral malleolus using a shaver blade until reaching bleeding bone before inserting the anchor (black arrow). (D) JuggerKnotless anchor (Zimmer Biomet) placement through the lateral portal. (E) Inside view of the anchor guide (the arthroscope is in the medial portal). (F) Introduction of the anchor. (G) Verification that both ends of the anchor are adequately sliding. (H) Confirmation of the pullout resistance of the anchor by raising the leg from the table while pulling through the anchor wires.