{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T18:36:57Z","timestamp":1792867017542,"version":"4.5.0"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Suture augmentation has been introduced to enhance stability and accelerate rehabilitation following modified Brostr\u00f6m repair for chronic lateral ankle instability, however, its clinical value remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, and Cochrane Library databases were systematically searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Outcomes included patient demographics, radiographic parameters, clinical outcomes, return to sport (RTS), complications, failures, and revisions. Meta-analyses comparing augmented and non-augmented repairs were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen studies were included, with 672 patients undergoing anterior talofibular ligament (ATFL) repair with suture augmentation, and 315 patients without suture augmentation. Both cohorts demonstrated significant improvements in radiographic and clinical outcomes. Suture augmentation demonstrated a faster RTS (13.0 vs 19.6\u2009weeks) but a lower overall RTS rate (74.0% vs 82.9%). There was no statistically significant difference in complications (risk ratio [RR]\u2009=\u20090.86, 95% confidence interval [CI], 0.30-2.47) or failures (RR\u2009=\u20090.65, 95% CI, 0.25-1.65). Open suture augmentation demonstrated a higher reported complication (6.9% vs 0%) and failure rate (3.1% vs 0.8%) compared with arthroscopic augmentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis did not demonstrate clinically meaningful differences in radiographic parameters, patient-reported outcomes, complications, or failure rates between isolated modified Brostr\u00f6m repair and suture-augmented repair. Although suture augmentation was associated with a faster RTS, this did not translate into higher overall RTS rates, indicating that earlier return does not equate to improved functional recovery. Arthroscopic techniques may demonstrate lower complication rates than open approaches, however, this observation should be interpreted with caution given the limited and non-comparative evidence base.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">IV, systematic review and meta-analysis<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19386400261495186","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T11:21:21Z","timestamp":1792668081000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Suture Augmentation May Facilitate Earlier Return to Sport Without Improving Return Rates or Clinical Outcomes Following Modified Brostr\u00f6m Repair: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","author":[{"given":"Jared","family":"Rubin","sequence":"first","affiliation":[{"name":"Division of Foot &amp; Ankle Surgery, Department of Orthopaedic Surgery, NYU Langone Health, New York City, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0327-7967","authenticated-orcid":false,"given":"Osama","family":"Alzobi","sequence":"additional","affiliation":[{"name":"Division of Foot &amp; Ankle Surgery, Department of Orthopaedic Surgery, NYU Langone Health, New York City, New York"},{"name":"Orthopedic Surgery Department, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davis","family":"Hedbany","sequence":"additional","affiliation":[{"name":"Division of Foot &amp; Ankle Surgery, Department of Orthopaedic Surgery, NYU Langone Health, New York City, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Tham","sequence":"additional","affiliation":[{"name":"Division of Foot &amp; Ankle Surgery, Department of Orthopaedic Surgery, NYU Langone Health, New York City, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Milner","sequence":"additional","affiliation":[{"name":"Division of Foot &amp; Ankle Surgery, Department of Orthopaedic Surgery, NYU Langone Health, New York City, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaj S.","family":"Emanuel","sequence":"additional","affiliation":[{"name":"Programs Sports and Musculoskeletal Health, Amsterdam Movement Sciences, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Galetta","sequence":"additional","affiliation":[{"name":"Division of Foot &amp; Ankle Surgery, Department of Orthopaedic Surgery, NYU Langone Health, New York City, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Samuel R.","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Division of Foot &amp; Ankle Surgery, Department of Orthopaedic Surgery, NYU Langone Health, New York City, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gino M. 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J.","family":"Kerkhoffs","sequence":"additional","affiliation":[{"name":"Programs Sports and Musculoskeletal Health, Amsterdam Movement Sciences, Amsterdam, the Netherlands"},{"name":"Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"D\u2019Hooghe","sequence":"additional","affiliation":[{"name":"Fortius Clinic, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond J.","family":"Walls","sequence":"additional","affiliation":[{"name":"Division of Foot &amp; Ankle Surgery, Department of Orthopaedic Surgery, NYU Langone Health, New York City, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7286-0689","authenticated-orcid":false,"given":"John G.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Division of Foot &amp; Ankle Surgery, Department of Orthopaedic Surgery, NYU Langone Health, New York City, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.01537"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-013-0102-5"},{"issue":"4","key":"e_1_3_2_4_2","first-page":"364","article-title":"Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability","volume":"37","author":"Hertel J.","year":"2002","unstructured":"Hertel J. 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