Brostrom Procedure NYC — Lateral Ankle Stabilization at New York Bone & Joint

The Brostrom procedure is indicated when a patient has documented chronic lateral ankle instability that has failed a genuine course of physical therapy. Clinical criteria include: a positive Anterior Drawer Test (anterior translation of the talus relative to the tibia, indicating ATFL laxity) and a positive Talar Tilt Test (excessive inversion of the talus, indicating CFL involvement). These two bedside stress tests are the primary clinical confirmation of mechanical instability. Stress X-rays under fluoroscopy and high-resolution MRI to evaluate ATFL and CFL tissue quality provide imaging confirmation. Dr. Popovitz and Dr. Brown both evaluate instability using this examination framework before recommending surgery.

The ankle is evaluated arthroscopically before the open Brostrom repair. This allows concurrent intra-articular pathology to be addressed in the same session. The ligament repair itself is performed as a small open procedure (or arthroscopic-assisted technique in selected cases). The incision is small and well-tolerated.

Splint for 1–2 weeks non-weight-bearing. Boot for 4–6 weeks with progressive weight-bearing. Physical therapy begins at 6 weeks. Return to jogging at 3 months. Return to cutting and sport-specific activity at 4–6 months with criteria-based clearance based on strength symmetry and functional testing.

The Brostrom repair restores the native ATFL and CFL to their anatomical length and tension, which significantly reduces the risk of recurrent instability. No surgical repair eliminates all risk of future ankle sprain. Completing the full rehabilitation protocol — particularly the proprioceptive and peroneal strengthening phases — is essential to protecting the repair.

The Gould modification incorporates the inferior extensor retinaculum into the ATFL repair to reinforce the ligament reconstruction. It is a standard augmentation that improves repair strength and has become part of the standard Brostrom technique. Most surgeons performing the Brostrom procedure routinely include the Gould modification. Rehabilitation note: Many patients with chronic lateral ankle instability present with tight calf muscles and limited dorsiflexion from years of compensatory guarding. New York Bone & Joint’s rehabilitation program specifically targets gastrocnemius and soleus stretching alongside peroneal strengthening — because limited dorsiflexion increases the stress placed on the repaired ATFL during weight-bearing, and restoring full ankle range of motion is as important as restoring ligament tension.

Yes — the Brostrom procedure has excellent outcomes in athletes at all levels of competition. Return to sport rates are high and re-dislocation rates are low when the procedure is performed for the correct indication and the rehabilitation is completed fully. Athletes with high functional demands and documented instability are among the best candidates for the procedure.