Although the open modified Broström technique remains widely accepted as the gold standard for operative treatment of ankle instability, use of the arthroscopic repair technique has been rapidly increasing. Our aim is to conduct a comparative systematic review and meta-analysis of the data to determine whether there is a significant difference in clinical outcomes between arthroscopic and open repair for lateral ankle instability. A systematic literature review was performed using PubMed, Web of Science, the Cochrane Library, and EMBASE from 1980 to March 2018 to identify all English-language studies (level of evidence 1 to 3) comparing functional outcomes of arthroscopic versus open repair of lateral ankle instability. Four studies (1 level 1, 3 level 3) involving 207 patients met inclusion criteria. Of those, 97 participants were treated with arthroscopic repair, and 110 were treated with open repair. All of the subjective outcomes were improved for both groups across the 4 studies, without a significant difference in improvement between groups, except in 1 study, in which time to return to daily activity was significantly shorter in arthroscopic group (p < .05). Overall, this review demonstrated no statistically significant difference in outcome measures between arthroscopic versus open repair, both of which reported favorable and satisfactory outcomes, and produced equivalent clinical results. Additional randomized controlled studies of larger numbers of patients with longer follow-up times, however, are required to confirm whether arthroscopic repair leads to earlier recovery.

Level of Clinical Evidence:​ 3