Arthroscopic stapling repair for chronic lateral instability.

We have presented a preliminary report on a limited number of patients with chronic lateral instability of the ankle treated with arthroscopic stapling reconstruction. As stated, the longest follow-ups are about 5 years, so the results over the long term are not yet known. Early adults have been quite encouraging, however, with improved functional stability of the ankle. Only one patient in more than two dozen has had recurrent instability that required more surgery. He returned with a history of additional sports trauma. The principle of secure fixation of ligaments to exposed bone surfaces with staples is a well-accepted and effective technique familiar to surgeons for many years. What is changing is that microsurgical techniques can be adapted to common orthopedic problems. Ankle arthroscopy is expanding continually to meet the needs of many patients. Discomfort is minimal, and many patients do not even fill their prescriptions for analgesic medication. The period of disability is relatively short and rehabilitation is rapid. Because most patients prefer arthroscopy to an open procedure, we must continue to explore all avenues of surgical technique. New tools and developments are constantly on the horizon. As in most arthroscopic surgical procedures, instruments of the correct size are most important, as is precise surgical technique. The key to successful arthroscopic surgery is careful forethought, meticulous planning, constant education, and a dependable team.