Title : Comparison of open brostrom-gould repair and arthroscopic anatomical repair of the Anterior Talo Fibular Ligament (ATFL) in the management of Chronic Lateral Ankle Instability (CLAI)
Abstract:
Background: Chronic lateral ankle instability (CLAI) is commonly treated with surgical repair of the anterior talofibular ligament (ATFL). While the brostrom-gould procedure is widely accepted, minimally invasive arthroscopic techniques have gained popularity. This study compares early outcomes and cost-effectiveness between open brostrom-gould repair and arthroscopic anatomical ATFL repair.
Methods: A retrospective cohort of 40 patients who underwent ATFL repair between September 2024 and February 2025 was analyzed. Patients were divided into open repair (n = 20) and arthroscopic repair (n = 20) groups. Primary outcomes included surgical duration, hospitalization time, procedural cost, and functional recovery assessed by the AOFAS and Karlsson-Peterson scores at baseline and 3 months postoperatively. Complication rates were also recorded.
Results: Open repair resulted in significantly shorter operative time and hospital stays (p < 0.05). Both groups showed significant postoperative improvements in AOFAS and Karlsson scores (p < 0.01), with no significant differences between groups at baseline or follow-up. No major complications were reported, and the incidence of minor complications was similar in both groups.
Conclusion: Open brostrom-gould and arthroscopic ATFL repair yield comparable early clinical outcomes in CLAI. The arthroscopic technique offers the benefit of smaller incisions, while the open approach demonstrates advantages in operative efficiency and cost. These findings support a tailored surgical approach based on patient needs and available resources.
