Fig 6.

(A) An 18-gauge needle with a No. 3-0 nylon loop is introduced through the accessory lateral portal and serves as a suture passer. (B) Two anchors have been inserted in the lateral malleolus (red arrows). The needle (yellow arrow) trespasses the proximal half of the anterior talofibular ligament remnants. (C) A grasper is used to retrieve the nylon loop. (D) By use of the grasper, the nylon loop is retrieved outside the joint and the solid-blue wire from the first anchor is passed through. The nylon loop (including the solid-blue wire) is then pulled out through the skin. (E, F) Retrieval of the solid-blue wire through the accessory lateral portal with a hook probe. (G) The solid-blue wire of the anchor is passed through the nitinol loop of the deployment device of the anchor. (H) A second, blue-white loop is detached and slides over the solid-blue wire. Soft tissue is tensioned against the footprint by pulling the solid-blue wire. A small pull on the blue-white wire locks the mechanism.