Fig. 4.

Suture relay technique. The loop of the nylon is retrieved through the ALL portal with a grasping instrument (left). One end of the anchor suture is then passed through the loop of nylon (second from the left). The nylon loop is then used to pull just the mid-portion of the anchor suture through the ATFL such that a loop of suture is created in the ATFL (middle). The free end of the suture is then passed through this loop (second from the right) and pulled tight creating a self-clinching stitch (right)