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A systematic review and meta-analysis were conducted to determine the rate of return to sport (RTS) and related factors after anatomic lateral ankle stabilization (ALAS) surgery for chronic lateral ankle instability. The review included 25 publications with a total of 1384 participants. The results showed that 95% of patients returned to any sport, 83% returned to their preinjury level of sport, and 87% returned to competitive sport after surgery. The mean time to RTS was 12.45 weeks. Age and body mass index (BMI) were found to be factors influencing RTS failure, with older age and higher BMI associated with higher risk. Elite athletes had a higher rate of RTS compared to nonelite athletes. Overall, ALAS surgery allows most patients to return to some level of sport, with some achieving preinjury levels. Age, BMI, and athlete status should be considered when predicting RTS outcomes.
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