gms | German Medical Science

Objectives: Lateral ankle sprains are among the most common sports injuries. In most cases of lateral ankle ligament injury, conservative treatment yields good results and approximately 80 to 90% of patients regain ankle stability by immobilization in a brace. However, about 10 to 20% develop chronic lateral ankle instability (CLAI) and consequently require surgical ligament repair. The Broström technique as well as its modifications are considered the gold standard for treating CLAI. In recent years, interest in less invasive methods to perform lateral ligament repair has increased, including arthroscopic techniques. Up until now, there is still no evidence whether open or all-arthroscopic lateral ligament repair should be considered as gold standard.

The aim of this study was to determine whether all-arthroscopic repair would lead to improved clinical outcomes, lower complication rates, shorter postoperative immobilization and earlier return to activity compared to open Broström repair in surgical treatment of chronic lateral ankle instability (CLAI).

Methods: A systematic literature search was conducted using Pubmed and Embase to identify studies dealing with a comparison of outcomes between all-arthroscopic and open Broström repair for chronic lateral ankle instability. The search algorithm was "ankle instability" AND "Brostrom" AND "arthroscopic" AND "open". The study had to be written in English language, include a direct comparison of all-arthroscopic and open Broström repair to treat chronic lateral ankle instability, and have full text available. Exclusion criteria were former systematic reviews, biomechanical studies and case reports.

Results and conclusion: Overall, eight studies met the inclusion criteria and were included in the analysis. Clinical outcomes did not differ substantially between patients treated with either arthroscopic or open Broström repair. Studies that reported on return to activity and sports following surgery suggested that patients that had all-arthroscopic Broström repair returned at a quicker rate. Overall complication rate tended to be lower after arthroscopic Broström repair.

In conclusion, similar to open repair, all-arthroscopic ligament repair for chronic lateral ankle instability is a safe treatment option that yields excellent clinical outcomes.