Chris Main, DO, (Macon, MO) demonstrates his surgical technique to treat proximal tibiofibular instability. He utilizes two diverging Syndesmosis TightRope® fixations proximal and one Syndesmosis TightRope distal for stabilization. The Knotless Syndesmosis TightRope is comprised of a #5 UHMWPE suture tensioned between two metallic buttons against tibia and fibula.