Lateral ankle instability is a common sequela of ankle sprains. Surgical treatment may be required if nonoperative treatment fails, and the modified Broström procedure is considered the gold standard. Many techniques have been described, with a suture anchor in the lateral malleolus commonly utilized. More recently, suture implants with surgical tape have been introduced. These are proposed to provide immediate stability, allowing more aggressive rehabilitation. However, they require a 3.4 mm drill hole in the talus, along with the 2.7 mm drill hole in the fibula. We present a case of avascular necrosis (AVN) of the talus after utilization of this suture tape construct, requiring total talus replacement.