This study compared the safety, efficacy, short-, and long-term clinical outcomes of open versus arthroscopic Broström-Gould repair in management of chronic lateral ankle instability (CLAI). This randomized clinical trial enrolled 40 patients with CLAI despite ≥6 months of conservative management or avulsion injury of anterior talofibular ligament at the fibular attachment confirmed arthroscopically. Patients were randomized to receive either open Broström-Gould (Group A) or arthroscopic Broström-Gould repair (Group B). Patients were followed-up for 18 months. Primary outcomes were Visual Analog Scale (VAS) score, American Orthopedic Foot and Ankle Society score, and Karlsson Ankle Functional Score. Secondary outcomes included operative time, postoperative complications, and return-to-work interval. Operative time was significantly shorter in the open Broström-Gould group than in arthroscopic group (44.2±8.5 vs. 79.5±23.11 min; p<0.001). Both techniques produced significant postoperative improvement in all outcome scores (p<0.001). The AB group showed better early postoperative outcomes at 6 months, including lower VAS scores and higher functional scores; however, no significant differences were observed between groups at 12 and 18 months. Return to work (8.8±1.51 vs. 11.15±3.62 weeks; p=0.002) occurred earlier after arthroscopic repair. Complication rates were comparable between groups, with no recurrent instability or reoperations. Both open and arthroscopic Broström-Gould repair provide significant clinical and functional improvement in patients with CLAI, with comparable mid- to long-term outcomes. Arthroscopic repair demonstrates advantages mainly in the early postoperative period, without evidence of long-term superiority. Surgical decision-making should therefore be individualized based on patient characteristics, associated pathology, and surgeon expertise.
Wahib et al. (Sun,) studied this question.