Predictor of clinical and functional outcomes in ankle arthroscopic ligament repair with 'all-inside' technique.

Purpose: Chronic ankle instability (CAI) is a common condition characterized by recurrent episodes of lateral instability, often due to a lesion of the ankle collateral lateral ligament complex. If untreated, CAI can lead to persistent symptoms and long-term degenerative changes. Arthroscopic 'all-inside' repair has gained traction as a minimally invasive technique offering functional and clinical benefits. Methods: This retrospective study analyzed 43 patients undergoing arthroscopic ligament repair using the all-inside technique between 2021 and 2024. Functional outcomes were evaluated preoperatively (T0), post-rehabilitation (T1), and at the final follow-up (T2) using the Foot and Ankle Ability Measure (FAAM) score, VAS, and satisfaction ratings. Complications occurred were recorded during the follow up. Subgroup analyses investigated the influence of BMI, anchor use, and preoperative functional scores on outcomes. Results: Patients demonstrated significant improvement in FAAM scores (T0: 71%, T2: 95%) and pain reduction (VAS: T0: 7.67, T2: 1.00). Two-anchor repairs yielded superior outcomes compared to single-anchor procedures (p = 0.01). While higher BMI was associated with poorer outcomes (p = 0.04), internal bracing improved functional scores in this subgroup. Preoperative FAAM scores did not predict postoperative outcomes (p = 0.21). Conclusion: All-inside arthroscopic ligament repair is a safe and effective option for CAI, providing rapid recovery, low complication rates, and excellent patient satisfaction. Level of Evidence: Level IV.