Arthroscopic Broström repair: does the early advantage last?
Journal of Orthopaedic Surgery and Research · 19 Oct 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
Chronic lateral ankle instability is a common indication for ankle ligament surgery, and knowing that arthroscopic repair mainly changes early recovery and wound problems, not long-term function, helps frame surgical choice and patient counselling.
The evidence
This meta-analysis pooled 18 studies (5 randomised trials and 13 nonrandomised comparative studies, 1,102 ankles) comparing arthroscopic with open Broström repair for chronic lateral ankle instability. Arthroscopic repair had higher AOFAS function scores at 6 months (mean difference 4.35 points, 95% CI 1.33 to 7.37), but the gap shrank and was no longer significant at 12 and 24 months, and the 6-month benefit lost significance when only randomised trials were analysed. Wound and incision complications were about one third as common after arthroscopy (RR 0.33). Overall complications, nerve complications, recurrent instability and measured ankle laxity showed no significant difference.
AOFAS ankle-hindfoot score at 6 months: Mean difference 4.35 (95% CI 1.33 to 7.37; AOFAS). The interval favours the first group; the size of the benefit needs clinical interpretation.
Why this rigour score?
Meta-analysis (mixed designs)Design starting point: 42.6
Raised the score
- Prospectively registered+5.1
- Compared against current standard of care+3.4
Lowered the score
- Pools mixed study designs−3.4
Methods at a glance
Recorded assessment- Comprehensive literature searchMet
- Risk of bias assessedMet
- Bias considered in synthesisMet
- Publication bias assessedMet
- Study exclusions justifiedNot met
- Prospective registrationMet
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
See the full score breakdown
- Study design starting point
- 42.6
- Compared against current standard of care
- +3.4
- Prospectively registered
- +5.1
- Pools mixed study designs
- −3.4
- Comprehensive literature search
- +3.4
- Risk of bias assessed in the included studies
- +3.4
- Risk of bias carried into the synthesis
- +2.5
- Publication bias assessed
- +2.5
- Final rigour score rounded
- 60 / 100
Study design sets the starting point and a ceiling of 82. Recorded methods then adjust the score. Points are shown to one decimal place; the final score uses unrounded values.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.For an athlete with chronic lateral ankle instability who prioritises a fast return to sport or work, how would you weigh the possible early recovery and lower wound complication rate of arthroscopic repair against the established track record of open Broström-Gould repair?
2.How would you counsel a patient about nerve injury risk, including the superficial peroneal nerve, when offering arthroscopic versus open lateral ligament repair, given that neurologic complications were not shown to differ but the estimate leaned toward more events with arthroscopy?
Original publication title
Does the early advantage of arthroscopic Broström repair persist? A systematic review and meta-analysis of time-specific outcomes and complication profiles