The role of macrophages in aortic physiology and pathophysiology.

Chronic lateral ankle instability (CLAI) commonly follows inadequately healed injuries of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) and manifests as recurrent sprains, pain, and functional limitations in athletes and active individuals (,). Although most acute sprains improve with nonoperative management, approximately 20–30% of patients develop persistent mechanical or functional instability that may ultimately require surgical treatment (,). The traditional open Broström or Broström-Gould repair has long been considered the gold standard surgical approach. It reliably restores ankle stability and enables a return to sport (RTS). Long-term follow-up studies have demonstrated that both augmented direct anatomical repair and lateral ligament reconstruction provide durable restoration of ligament laxity and functional stability for up to 15 years after surgery (). However, arthroscopic techniques provide a minimally invasive approach that allows for the management of concomitant intra-articular findings, including synovitis and periarticular soft-tissue adhesions (), and achieve clinical outcomes comparable to those of open procedures (,-). Recent comparative reviews and meta-analyses have reported similar stability and complication profiles between arthroscopic and open Broström-Gould repairs (,), with some data suggesting faster RTS after arthroscopy (,,). Additionally, advancements in arthroscopic instrumentation and suture anchor technology have made possible various modified techniques possible, such as all-inside repairs, double-row constructs, and anatomic reconstructions using autografts or allografts under arthroscopic guidance (,). These innovations have broadened the scope of arthroscopic procedures, allowing them to be tailored to each patient’s specific pathology and functional demands. Consequently, arthroscopy is now viewed not only as a minimally invasive alternative, but also as a versatile platform for repair and reconstruction strategies in CLAI.