Suture tape augmentation in arthroscopic lateral ligament repair for chronic ankle instability yields similar clinical outcomes but faster return to sport compared to isolated repair.

Abstract Purpose Arthroscopic ligament repair is a standard treatment for chronic ankle instability (CAI). In patients with risk factors for failure, isolated repair (ILR) may be insufficient and augmentation techniques have been proposed. This study compared ILR with suture tape–augmented repair (LR + STA), hypothesizing comparable outcomes in higher‐risk patients. Methods In this retrospective, indication‐based cohort study, all patients who underwent arthroscopic treatment for CAI between 2019 and 2022 were included. Patients were allocated to two groups: Group A underwent ILR, and Group B underwent LR + STA due to pivoting‐sport participation, generalized ligamentous laxity or poor‐quality remnant ligament. Clinical evaluation was performed preoperatively and at 3, 6, 12 and 24 months using the Foot Function Index (FFI), visual analogue scale (VAS) and Foot and Ankle Ability Measure–Sports Subscale (FAAM‐SS). Return to daily activities (RTD), work (RTW), sport (RTS) and complications were recorded at final follow‐up. Results A total of 105 patients (mean age 30.8 ± 14.5 years) were included: 44 in Group A and 61 in Group B. Both groups demonstrated significant improvements in all clinical outcomes from baseline to final follow‐up ( p < 0.001). At 2 years, no significant between‐group differences were observed in VAS (1.2 ± 1.7 vs. 0.7 ± 1.0; 95% confidence interval CI: –1.6; 0.6), FFI (9.7 ± 13.5 vs. 5.7 ± 7.6; 95% CI –12.7; 4.7) or FAAM‐SS (86.6 ± 20.9 vs. 90.5 ± 12.9; 95% CI: –9.9; 17.5). No major complications or recurrences of instability occurred. RTS was significantly earlier in Group B (12 vs. 20 weeks, p < 0.001), while RTD and RTW showed no significant differences. Conclusion Both isolated repair and suture tape‐augmented repair achieved excellent outcomes with no significant differences at 2 years. Despite being performed in patients with higher functional demands or greater failure risk, suture tape‐augmented repair demonstrated similar complication rates, no recurrence of instability and an earlier RTS. Level of Evidence Level III, retrospective cohort study.