Fig 8.

Optional technique for the graft fixation in the fibular tunnel (right ankle). (A) When the bone quality is weak, the JuggerKnot Soft Anchor-2.9 mm is placed at the bottom of the fibular tunnel through the ST portal. (B) One strand is sutured to the fibular end of the tendon graft; the other strand is pulled; then, the strands are tied. If the patient is an athlete and wants to start rehabilitation as early as possible, both suture anchor and interference screw fixation are used for stronger initial fixation. There is another operative scar on the lateral skin of the calcaneus, and the tendon graft is a straight shape for ATFL reconstruction, because the patient in these figures underwent calcaneal osteotomy combined with arthroscopic ATFL reconstruction. (ATFL, anterior talofibular ligament; ST, subtalar.)