All-arthroscopic reconstruction of the anterior talofibular ligament is comparable to open reconstruction: a systematic review

Abstract

The aim of this study was to determine whether all-arthroscopic repair would lead toimproved clinical outcomes, lower complication rates, shorter postoperative immobilizationand earlier return to activity compared to open Broström repair in the surgical treatment ofchronic lateral ankle instability (CLAI).• A systematic literature search was conducted using Pubmed and Embase to identify studiesdealing with a comparison of outcomes between all-arthroscopic and open Broström repairfor CLAI. The search algorithm was ‘ankle instability’ AND ‘Brostrom’ AND ‘arthroscopic’AND ‘open’. The study had to be written in English language, include a direct comparisonof all-arthroscopic and open Broström repair to treat CLAI and have full text available.Exclusion criteria were former systematic reviews, biomechanical studies and case reports.• Overall, eight studies met the inclusion criteria and were included in the analysis. Clinicaloutcomes did not differ substantially between patients treated with either arthroscopic oropen Broström repair. Studies that reported on return to activity and sports following surgerysuggested that patients that had all-arthroscopic Broström repair returned at a quicker rate.Overall complication rate tended to be lower after arthroscopic Broström repair.• Similar to open repair, all-arthroscopic ligament repair for CLAI is a safe treatment optionthat yields excellent clinical outcomes.• Level of Evidence: Level III evidence (systematic review of level I, II and III studies).