PURPOSE The purpose of this meta-analysis was to analyze the current comparative studies of arthroscopic and open techniques for lateral ankle ligament repair to treat chronic lateral ankle instability. METHODS A systematic search of MEDLINE, EMBASE and Cochrane Library databases was performed during February 2018. Included studies were evaluated with regard to level of evidence and quality of evidence using the Modified Coleman Methodology Score. Total number of patients, patient age, follow-up time, gender ratio, surgical technique, surgical complications, complication rate, recurrent instability or revision rate, clinical outcome measures and percentage of patients who returned to sport at previous level were also evaluated. Statistical analysis was performed using RevMan, and a p value of < 0.05 was considered to be statistically significant. RESULTS Four comparative studies for a total of 207 ankles were included. There was a significant difference in favor of arthroscopic repair with regard to AOFAS score, and there was no significant difference with regard to Karlsson score. There was a statistically significant difference in AOFAS score in favor of the arthroscopic repair (MD; 1.41, 95% CI 0.29-2.52, I2 = 0%, p < 0.05). There was no statistically significant difference in Karlsson score (MD; 0.00, 95% CI - 3.51 to 3.51, I2 = 0%, n.s.). There was no statistically significant difference in total, nerve, or wound complications. CONCLUSIONS The current meta-analysis found that short-term AOFAS functional outcome scores were significantly improved with arthroscopic lateral ankle repair compared to open repair. There was no significant difference between arthroscopic and open repair with regards to Karlsson functional outcome score, total complication rate, or the nerve and wound complication subsets with the included studies with at least 12 months of follow-up. However, the current evidence is still limited, and further prospective trials with longer follow-up are needed. LEVEL OF EVIDENCE III.

中文翻译：

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关节镜与外侧踝韧带的开放修复治疗慢性外侧踝不稳：一项荟萃分析。

目的本荟萃分析的目的是分析目前关节镜和开放技术对踝关节外侧韧带修复的比较研究，以治疗慢性踝关节不稳。方法在2018年2月对MEDLINE，EMBASE和Cochrane图书馆数据库进行了系统搜索。使用改良的Coleman方法论评分对纳入的研究进行了证据水平和证据质量评估。还评估了患者总数，患者年龄，随访时间，性别比，手术技术，手术并发症，并发症发生率，复发性不稳定性或翻修率，临床结局指标以及恢复到先前水平的运动患者的百分比。使用RevMan进行统计分析，p值<0。05被认为具有统计学意义。结果包括四项比较性研究，共研究207个脚踝。关节镜修复的AOFAS评分有显着差异，而卡尔森评分无明显差异。支持关节镜修补的AOFAS评分存在统计学差异（MD； 1.41，95％CI 0.29-2.52，I2 = 0％，p <0.05）。Karlsson评分无统计学差异（MD； 0.00，95％CI-3.51至3.51，I2 = 0％，ns）。总并发症，神经并发症或伤口并发症均无统计学差异。结论当前的荟萃分析发现，与开放式修复相比，关节镜下外侧踝关节修复可显着改善短期AOFAS功能结局评分。关节镜检查和开放性修复之间在卡尔森功能结局评分，总并发症发生率，神经和伤口并发症亚组方面无显着差异，所纳入的研究至少随访了12个月。但是，目前的证据仍然有限，需要进一步的前瞻性试验和更长的随访时间。证据级别III。