Narrative review synthesizing evidence for managing acute and chronic lateral ankle instability — covering classification of sprains, indications for surgical versus nonsurgical treatment, comparison of anatomic repair versus tenodesis techniques, and the role of concurrent arthroscopy.
When evaluating an athlete with chronic ankle instability who has failed rehabilitation, prioritize arthroscopy at the time of ligamentous repair — intra-articular pathology is present in over 90% of cases and will compromise outcomes if left unaddressed.
Choose anatomic repair (Broström or modification) over tenodesis when tissue quality allows; reserve tenodesis only as a historical reference point, as long-term data consistently show inferior results and higher complication rates.
Narrative review synthesizing evidence for managing acute and chronic lateral ankle instability — covering classification of sprains, indications for surgical versus nonsurgical treatment, comparison of anatomic repair versus tenodesis techniques, and the role of concurrent arthroscopy.
When evaluating an athlete with chronic ankle instability who has failed rehabilitation, prioritize arthroscopy at the time of ligamentous repair — intra-articular pathology is present in over 90% of cases and will compromise outcomes if left unaddressed.
Choose anatomic repair (Broström or modification) over tenodesis when tissue quality allows; reserve tenodesis only as a historical reference point, as long-term data consistently show inferior results and higher complication rates.