The goal of this clinical trial is to learn if treating only the anterior talofibular ligament (ATFL) tear with ligament repair is as effective as treating both the ligament tear and the associated osteochondral lesion of the talus at the same time in adults with ankle instability and pain. The main questions it aims to answer are: * Do patients who undergo both ligament repair and treatment of the cartilage lesion have better clinical and functional outcomes than those who only have the ligament repaired? * Is there a difference in pain relief, recovery time, and return to physical activity between the two approaches? Researchers will compare patients who receive isolated ligament repair to those who receive ligament repair plus microfracture surgery to see if treating both injuries provides better results. Participants will: * Be randomly assigned to one of the two treatment groups. * Undergo surgery by the same surgeon. * Complete questionnaires about ankle function and pain before surgery and at multiple follow-up points. * Have physical exams and imaging to assess ankle stability and healing.
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Change in AOFAS (American Orthopaedic Foot and Ankle Society) score
Timeframe: Baseline, 3 months, 6 months, 12 months, and 24 months postoperative