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The modified Brostrom repair is currently the method of choice for the primary operative treatment of chronic lateral ankle instability. Before 2007, the investigators used the traditional open approach with or without the use of suture anchors. This study describes our current technique for arthroscopic lateral ankle ligament reconstruction, which has been continuously refined over the past several years. We believe that this novel technique simplifies the ligament reconstruction procedure when performed with ankle arthroscopy, potentially reduces operative time, and will produce results equivalent to the long-term outcome of the traditional open Brostrom procedure. Since November 2007, twenty-three patients (24 ankles) have undergone arthroscopic lateral ligament repair. All patients had positive ankle instability with manual stress testing and failed nonoperative management. Initially, only one suture anchor was used for the technique and now all cases are performed with 2 anchors. After an average follow-up of 10.9 months, all patients reported significant improvement compared with their preoperative symptoms. Four patients were noted to a have mildly positive residual stress test despite no functional limitations. One patient had persistent peroneal tendon symptoms necessitating exploration and debridement; and 1 developed an unrelated neurological process. We describe our technique for arthroscopic lateral ankle ligament reconstruction and preliminary results.