Arthroscopic vs. open Broström-Gould procedure for chronic lateral ankle instability: a systematic review and meta-analysis

Background Chronic lateral ankle instability (CLAI) is a common complication of ankle sprains, and the Broström-Gould procedure is the preferred option. This study aimed to compare the short-term (with a mean follow-up period of 24 months) clinical efficacy and postoperative recovery rate between arthroscopic and open Broström-Gould surgery in patients with CLAI. Methods The present study followed the PRISMA 2020 guidelines. PubMed, Embase, Cochrane Library, Web of Science were searched to 31 December 2025.Meta-analyses were performed using Review Manager (version5.3) for the following outcomes: surgery time, AOFAS scores, K-P scores, VAS scores, Tegner activity scores, Anterior drawer, Talar tilt, Return to sports, Total complication rates, Bias risk evaluation was performed applying the Cochrane Collaboration's Risk of Bias 2 (RoB2) tool and the Newcastle-Ottawa Scale (NOS). Results 14 studies (875 patients) met criteria, with 421 allocated to open and 454 to arthroscopic groups.There were no statistically significant differences in surgical time mean difference [MD = −5.33; 95% confidence interval CI, −13.68 to 3.01; p = 0.21], AOFAS scores (MD = 0.36; 95% CI, −0.23 to 0.96; p = 0.23), Tegner activity scores (MD = 0.13; 95% CI, −0.10 to 0.36; p = 0.27), anterior drawer test (MD = −0.10; 95% CI, −0.23 to 0.03; p = 0.14), talar tilt (MD = −0.00; 95% CI, −0.51 to 0.51; p = 0.99) and all complication rates odds ratio (OR) = 0.88; 95%CI, 0.55 to 1.41; p = 0.59. The arthroscopy group achieved significantly better results in terms of K-P scores (MD = 0.78; 95% CI, 0.02 to 1.54, p = 0.04), VAS scores (MD = −0.65; 95% CI, −1.17 to −0.12, p = 0.02), and time to return to sports (MD = −3.91; 95% CI, −7.52 to −0.30; p = 0.03). Conclusions Both techniques show broadly comparable outcomes, with possible earlier return to sport or less pain after arthroscopy, although the certainty of this finding is limited. Level of Evidence Level III, systematic review. This protocol has been registered in the PROSPERO database CRD420261298649.