Meta-analysis of surgical approaches to lateral ankle instability: Open Broström versus arthroscopic Broström versus lasso-loop repair

IF 1.8 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI:10.1016/j.jor.2026.02.014

Thomas Cho, Colin Jones, Shaza Chaudry, Jiayong Liu

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引用次数: 0

Abstract

Introduction

Anterior talofibular ligament (ATFL) injury is a common cause of chronic lateral ankle instability and is more frequent among those who are active and play sports. There are multiple techniques to repair the ATFL, including the historically gold-standard Open Bröstrom (OB) technique, the Arthroscopic Bröstrom (AB) technique, and the more novel arthroscopic Lasso-Loop (LL) technique. This meta-analysis seeks to compare outcome statistics of these techniques for ATFL repair.

Methods

A literature search was conducted on PubMed and Embase for comparison studies or randomized controlled trials that included at least two of the surgical techniques and at least one relevant functional outcome or complication statistic up until October 2025. Statistical analyses were performed using Review Manager Web, and a P-value ≤0.05 was considered statistically significant.

Results

1426 patients across 21 studies were included in this analysis. When compared to OB, AB had a significantly lower post-operative Visual Analog Scale (VAS) score (P = 0.01), higher Karlsson score (P < 0.001), higher American Orthopaedic Foot and Ankle Society (AOFAS) score (P = 0.003), and shorter time to return to daily work (P = 0.02). Compared to OB, LL had a significantly lower VAS score (P < 0.001) and higher AOFAS score (P = 0.02). However, OB had a lower rate of range of motion (ROM) restriction (P = 0.002) and shorter time to return to running (P = 0.01) when compared to LL. No significant results were found comparing AB and LL.

Conclusion

This study found that AB had a significantly lower VAS score, significantly higher Karlsson and AOFAS scores, and significantly shorter time to return to daily work compared to OB. LL also had significantly lower VAS and significantly higher AOFAS scores compared to OB. However, OB had a significantly lower risk of ROM restriction and significantly shorter time to return to running than LL. The minimally invasive AB and LL techniques seem to be the superior treatment methods for ATFL injuries when compared to OB repair, with no clinically significant differences seen between the two.

Level of evidence

查看原文本刊更多论文

手术入路治疗外侧踝关节不稳的meta分析：开放Broström与关节镜Broström与套索环修复

距腓骨前韧带（ATFL）损伤是慢性踝关节外侧不稳定的常见原因，在活跃和运动的人群中更为常见。有多种技术可以修复ATFL，包括历史上黄金标准的Open Bröstrom （OB）技术、关节镜Bröstrom （AB）技术和更新颖的关节镜Lasso-Loop （LL）技术。本荟萃分析旨在比较这些技术用于ATFL修复的结果统计。方法在PubMed和Embase上检索文献，检索截至2025年10月至少两种手术技术和至少一种相关功能结局或并发症统计数据的比较研究或随机对照试验。使用Review Manager Web进行统计分析，p值≤0.05被认为具有统计学意义。结果21项研究共纳入1426例患者。与OB相比，AB组术后视觉模拟评分（VAS）明显低于OB组（P = 0.01）， Karlsson评分明显高于OB组（P < 0.001），美国骨科足踝学会（AOFAS）评分明显高于AB组（P = 0.003），恢复日常工作时间明显短于OB组（P = 0.02）。与OB相比，LL组VAS评分显著低于OB组（P < 0.001）， AOFAS评分显著高于OB组（P = 0.02）。然而，与LL相比，OB有更低的活动范围限制率（P = 0.002）和更短的恢复跑步时间（P = 0.01）。AB与LL比较无显著性结果。结论本研究发现AB组VAS评分明显低于OB组，Karlsson评分和AOFAS评分明显高于OB组，恢复日常工作时间明显短于OB组。LL组VAS评分明显低于OB组，AOFAS评分明显高于OB组。但OB组ROM限制风险明显低于OB组，恢复跑步时间明显短于OB组。与OB修复相比，微创AB和LL技术似乎是ATFL损伤的优越治疗方法，两者之间没有临床显着差异。证据水平3

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.