ReviewOrthopaedic journal of sports medicine2026
Suture Augmentation May Be Beneficial for Patients With Generalized Ligamentous Laxity Undergoing Modified Broström-Gould Repair: A Systematic Review and Meta-analysis.
Review in Orthopaedic journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Lateral ankle sprains are the most common lower extremity injury in athletes, most often involving the anterior talofibular ligament (ATFL). Although ATFL repair outcomes are well studied, optimal management for patients with generalized ligamentous laxity (GLL) remains less understood. Purpose: To (1) evaluate the radiographic findings, clinical measures, and complications in patients with GLL undergoing modified Broström-Gould repair and to (2) assess the role of suture augmentation in optimizing outcomes. Study Design: Systematic review; Level of evidence, 4. Methods: During July 2025, the PubMed, EMBASE, and Cochrane library databases were systematically searched to identify studies examining outcomes and complications in GLL patients who underwent modified Broström-Gould repair. Results: Eight studies including 301 GLL patients (309 ankles) and 367 patients (370 ankles) without ligamentous laxity were analyzed. Both cohorts demonstrated postoperative clinical improvement. A significant difference in postoperative talar tilt angle existed only between GLL patients who underwent modified Broström-Gould repair without suture augmentation and patients without ligamentous laxity (mean difference, 2.18°; 95% CI, 0.57°-3.79°; Conclusion: Patients with GLL experienced significantly higher rates of complication and failure following modified Broström-Gould repair compared with patients without ligamentous laxity. Suture augmentation may lower complication rates in GLL patients, but its effect on failure rates remains undetermined, as no studies directly compared augmented and nonaugmented GLL patients. Importantly, both GLL patients and patients without ligamentous laxity experienced clinical improvements from the modified Broström-Gould repair. While GLL increases the risk of mechanical complications, it should not be considered a contraindication to undergoing the modified Broström-Gould procedure. However, suture augmentation may be beneficial for GLL patients to reduce the risk of complications after undergoing ATFL repair. Registration: CRD420251182303 (PROSPERO identifier).
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