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It was hypothesised that there was no difference between the two techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 2013 to 2018, 30 CLAI patients with grade III joint instability confirmed by anterior drawer test underwent anatomic reconstruction of lateral ankle ligament with the autologous gracilis tendon (reconstruction group) in our institute. Another 30 patients undergoing MBG procedure (MBG group) were matched in a 1:1 ratio based on demographic parameters. The post\u2010operative American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) pain score, Tegner activity score, Karlsson\u2013Peterson score, surgical complications, return\u2010to\u2010activities and work were retrospectively evaluated and compared between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All subjective scores significantly improved after the operation (all with <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) without difference between the two groups (all n.s.). The MBG group showed a significantly higher proportion of postoperative sprain recurrence than the reconstruction group (26.7% vs. 0, <jats:italic>p<\/jats:italic>\u2009=\u20090.002). The reconstruction group showed a significantly longer period to start walking with full weight\u2010bearing (10.5\u2009\u00b1\u20096.9 vs. 7.0\u2009\u00b1\u20093.1 weeks, <jats:italic>p<\/jats:italic>\u2009=\u20090.015), jogging (17.1\u2009\u00b1\u20098.9 vs. 12.7\u2009\u00b1\u20096.9 weeks, <jats:italic>p<\/jats:italic>\u2009=\u20090.043) and return\u2010to\u2010work (13.5\u2009\u00b1\u200912.6 vs. 8.0\u2009\u00b1\u20094.7 weeks, <jats:italic>p<\/jats:italic>\u2009=\u20090.039) than the MBG group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both anatomic reconstruction using the autologous gracilis tendon and MBG procedure could equally achieved reliable long\u2010term clinical outcomes and the tendon reconstruction showed a relatively lower incidence of postoperative sprain recurrence but delayed recovery to walking, jogging and return\u2010to\u2010work. The MBG procedure was still the first choice with rapid recovery but the tendon reconstruction was recommended for patients with higher strength demand.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07011-5","type":"journal-article","created":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T10:03:04Z","timestamp":1654682584000},"page":"4181-4188","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Anatomic reconstruction using the autologous gracilis tendon achieved less sprain recurrence than the Brostr\u00f6m\u2010Gould procedure but delayed recovery in chronic lateral ankle instability"],"prefix":"10.1002","volume":"30","author":[{"given":"Tong","family":"Su","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Medicine Peking University Third Hospital, Institute of Sports 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