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Chronic lateral ankle instability

Rafael Sierra-Guzmán, Fernando Jiménez, Javier Abián-Vicén
BACKGROUND: Previous studies have reported the factors contributing to chronic ankle instability, which could lead to more effective treatments. However, factors such as the reflex response and ankle muscle strength have not been taken into account in previous investigations. METHODS: Fifty recreational athletes with chronic ankle instability and 55 healthy controls were recruited. Peroneal reaction time in response to sudden inversion, isokinetic evertor muscle strength and dynamic balance with the Star Excursion Balance Test and the Biodex Stability System were measured...
March 6, 2018: Clinical Biomechanics
Jasmin Diallo, Joe Wagener, Christine Schweizer, Tamara Horn Lang, Roxa Ruiz, Beat Hintermann
BACKGROUND: An acute ankle sprain can result in a bony avulsion of the lateral ankle ligaments. The extent of concomitant lesions and subsequent instability patterns are not clearly understood. The high incidence of old avulsion fractures found in symptomatic chronic ankle instability may indicate the need for primary fixation. METHODS: Ten patients (5 male, 5 female; mean age, 34 years; range, 15-64 years) with bony avulsion fractures of the fibula after acute ankle sprains were included...
March 1, 2018: Foot & Ankle International
Youichi Yasui, Yoshiharu Shimozono, John G Kennedy
Surgical procedures for managing chronic lateral ankle instability include anatomic direct repair, anatomic reconstruction with an autograft or allograft, and arthroscopic repair. Open direct repair is commonly used for patients with sufficient ligament quality. Reconstruction incorporating either an autograft or an allograft is another promising option in the short term, although the longevity of this procedure remains unclear. Use of an allograft avoids donor site morbidity, but it comes with inherent risks...
March 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
Yaning Sun, Huijuan Wang, Yuchao Tang, Shiji Qin, Mingming Zhao, Fengqi Zhang
This study aimed to report our institution's experience in the diagnosis and treatment of chronic lateral ankle instability (CLAI) with ligamentum bifurcatum (LB) injury.This retrospective study included 218 consecutive patients with CLAI who underwent surgery from January 2012 to December 2015. The 218 patients received tendon allograft reconstruction of the lateral ligament. CLAI was combined with LB injury in 51.4% (112/218) of patients. The 112 patients with concurrent LB injury had this treated simultaneously; 36 patients underwent excision of the anterior process of the calcaneus, 68 underwent LB repair, and 8 underwent LB reconstruction...
March 2018: Medicine (Baltimore)
Chee Ping Chew, Kevin Oon Thien Koo, Denny Tjiauw Tjoen Lie
INTRODUCTION: Chronic lateral ankle instability occurs in up to 20% of ankle injuries. Most can be treated conservatively, but surgical reconstruction is required if conservative treatment fails. Modified Broström-Gould procedure is an effective surgical treatment and the augmentation of this procedure with a periosteal flap may confer additional stability. We report on the outcome of a technique combining a modified Broström-Gould procedure augmented with a periosteal flap in patients with chronic lateral ankle instability...
January 2018: Journal of Orthopaedic Surgery
Hao Zhang, Bing Xie, Hai-Peng Xue, Chao Yang, Bing Liu, Xin Ma, Jing Tian, Da-Peng Zhou, Liang-Bi Xiang
OBJECTIVE: To investigate clinical effects of chronic anterolateral ankle instability by reconstructing lateral ligament with semitendinosus autograft. METHODS: From September 2014 to November 2016, 28 patients with chronic anterolateral ankle instability underwent lateral ligament reconstruction with semitendinosus autograft. Among them, including 20 males and 8 females with an average age of 28.6 years(18 to 47 years old). Preoperative complications were recorded...
June 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
J Chris Coetzee, J Kent Ellington, James A Ronan, Rebecca M Stone
BACKGROUND: The Broström procedure is the most commonly used lateral ligament repair for chronic instability, but there is concern about the strength of the repair and the risk of reinjury. Currently, the InternalBraceTM ligament augmentation repair is an accepted augmentation method for management of a Broström procedure. Our hypothesis was that augmentation of the Broström repair with an InternalBraceTM would allow accelerated rehabilitation and return to activity and would aid in stability of the repair without a tendency to stretch...
February 1, 2018: Foot & Ankle International
Matteo Guelfi, Marco Zamperetti, Andrea Pantalone, Federico G Usuelli, Vincenzo Salini, Xavier Martin Oliva
BACKGROUND: Chronic ankle instability is defined by an instability lasting more than 6 months, in those cases where a comprehensive conservative treatment fails a surgical stabilization is required. Several surgical techniques have been proposed for the management of the chronic lateral instability of the ankle and even after 50 years, the Broström-Gould technique is still considered the gold standard for the treatment of this pathology. Recently, many authors have developed completely arthroscopic lateral ligament repair and the use of these procedures is rapidly increasing...
February 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Erik A Wikstrom, Tricia Hubbard-Turner, Sophie Guderian, Michael J Turner
CONTEXT:   Ankle sprains are the most common orthopaedic injury that occurs during sport and physical activity. Many individuals who sprain their ankles develop chronic ankle instability (CAI), a condition characterized by recurrent injury, decreased physical activity, and decreased quality of life. These residual impairments are believed to persist for the remainder of the patient's life, in part due to the link between CAI and posttraumatic ankle osteoarthritis. However, this belief remains speculative due to the lack of long-term prospective investigations...
February 7, 2018: Journal of Athletic Training
Byung-Ki Cho, Ji-Kang Park, Seung-Myung Choi, Nelson F SooHoo
BACKGROUND: Although various minimally invasive procedures for chronic ankle instability are increasingly being used, a question regarding whether these procedures can be a viable alternative of the modified Broström procedure remains controversial. This study was conducted to compare the intermediate-term clinical outcomes between lateral ligaments augmentation using suture-tape and modified Broström repair in a selected cohort of patients. METHODS: Sixty female patients with chronic lateral ankle instability were randomly assigned and underwent surgical treatments by one surgeon...
October 18, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Caio Nery, Lucas Fonseca, Fernando Raduan, Marcus Moreno, Daniel Baumfeld
BACKGROUND: Lateral ankle ligament injury is among the most common orthopedic injuries. The objective of this study is to present the preliminary prospective results of treatment using the "Inside-Out" variant of the fully arthroscopic Broström-Gould technique. METHODS: Twenty six patients were included: 20 male and 6 female, aged 19-60 years, mean 41 years. All patients had positive "anterior drawer" and "talar tilt" tests. When necessary, cartilage injuries were treated with microfracture and arthroscopic resection for anterior impingement; three patients had hindfoot varus, on whom Dwyer osteotomy was performed; one patient had peroneal tendinopathy and was treated with tendoscopic debridement and another one had partial injury of the deltoid ligament, which was treated by direct repair...
March 22, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Yaning Sun, Huijuan Wang, Yuchao Tang, Haitao Zhao, Shiji Qin, Fengqi Zhang
BACKGROUND: This study aimed to report our institution's experience in the treatment of chronic lateral ankle instability using the anterior half of the peroneus longus tendon (AHPLT) to reconstruct the lateral ligament. METHODS: This retrospective study included 32 consecutive patients with chronic lateral ankle instability who underwent surgery from January 2013 to December 2014. All patients had failed to resolve with conservative treatment. A total of 32 ankles underwent AHPLT transfer...
November 23, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Jesús Vilá-Rico, Josep María Cabestany-Castellà, Bernat Cabestany-Perich, César Núñez-Samper, Cristina Ojeda-Thies
BACKGROUND: Anatomic graft reconstruction of the anterior talo-fibular ligament is an alternative for patients who are bad candidates for standard procedures such as a Broström-Gould reconstruction (high-demand athletes, obesity, hyperlaxity or collagen disorders, capsular insufficiency or talar avulsions). The purpose of this study is to describe an all-inside arthroscopic technique for ATFL reconstruction, and the results in a series of patients with chronic ankle instability. METHODS: We reviewed patients with chronic ATFL ruptures treated with an all-inside arthroscopic allograft reconstruction of the ATFL, with a minimum 2-year follow-up...
December 23, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Qianru Li, Kui Ma, Hongyue Tao, Yinghui Hua, Shuang Chen, Shiyi Chen, Yutong Zhao
PURPOSE: To compare the results of anatomical lateral ankle ligament (LAL) reconstruction with tendon allograft and autograft using clinical scores and ultrashort echo time (UTE) sequence of MRI. METHODS: A total of 26 patients with LAL reconstruction were recruited in this study, including 16 using semitendinosus allografts and 10 using semitendinosus autograft. All of them were diagnosed as chronic ankle instability and accepted anatomic reconstruction. The American Orthopedic Foot and Ankle Society (AOFAS) score, Karlsson score, and radiological evaluation using MRI UTE scanning were extracted from each patient...
February 5, 2018: International Orthopaedics
Zahra Ebrahimabadi, Sedigheh Sadat Naimi, Abbas Rahimi, Heydar Sadeghi, Seyed Majid Hosseini, Alireza Akbarzadeh Baghban, Syed Asadullah Arslan
OBJECTIVE: The main objective of the present study was to analyze how supra spinal motor control mechanisms are altered in different directions during anticipatory postural phase of gait initiation in chronic ankle instability patients. It seems that supra spinal pathways modulate anticipatory postural adjustment phase of gait initiation. Yet, there is a dearth of research on the effect of chronic ankle instability on the anticipatory postural adjustment phase of gait initiation in different directions...
January 2018: Journal of Bodywork and Movement Therapies
Antoine Morvan, Shahnaz Klouche, André Thes, Philippe Hardy, Thomas Bauer
PURPOSE: To evaluate the value of analyzing the anterior talofibular ligament (ATFL) on preoperative MRI as a decision-making tool to determine the surgical technique in patients undergoing surgery for chronic lateral ankle instability. METHODS: A retrospective study of prospective data was performed. All patients who underwent surgery between 2013 and 2016 for arthroscopic stabilization of the ankle were included. The ATFL was evaluated on preoperative MRI including axial T2-weighted images by two readers who were blinded to arthroscopic results...
January 3, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Cailbhe Doherty, Chris Bleakley, Jay Hertel, Brian Caulfield, John Ryan, Eamonn Delahunt
OBJECTIVE: To evaluate whether a battery of clinical assessments for acute lateral ankle sprain (LAS) can be used to predict long-term recovery. DESIGN: Cohort study SETTING: University biomechanics laboratory PARTICIPANTS: Eighty-two individuals were assessed using a clinical test battery within two-weeks of incurring a first-time LAS. MAIN OUTCOME MEASURES: The clinical test battery included scores on the 'talar-glide' (deg), anterior-drawer, talar-tilt, figure-of-eight [figure8] for swelling (mm), knee-to-wall (mm) and hand-held goniometric range-of-motion [inversion; eversion; plantar-flexion (in degrees)]...
December 20, 2017: Archives of Physical Medicine and Rehabilitation
Sheng-Kun Li, Yu-Jie Song, Hong Li, Baofu Wei, Ying-Hui Hua, Hong-Yun Li
PURPOSE: This study aimed to investigate the results of arthroscopic treatment combined with ankle stabilization procedure for sinus tarsi syndrome (STS) in patients with chronic ankle instability (CAI). METHODS: A total of 57 patients (31 males and 26 females, average age 29.9 ± 8.4 years ranging from 15 to 52 years) with STS and CAI who accepted operation from 2013 to 2015 were included in this retrospective study. Surgical procedures included thorough tarsal sinus debridement and repair or reconstruction of lateral ankle ligaments according to the quality of ligaments...
November 30, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Tyler M Miklovic, Luke Donovan, Omar A Protzuk, Matthew S Kang, Mark A Feger
Lateral ankle sprains (LAS) have been reported as one of the most common musculoskeletal injuries observed in sports and in individuals who are recreationally active. Approximately 40% of individuals who sustain a LAS develop a condition known as chronic ankle instability (CAI). Years of research has identified numerous impairments associated with CAI such as decreases in range of motion (ROM), strength, postural control, and altered movement patterns during functional activities when compared to individuals with no LAS history...
February 2018: Physician and Sportsmedicine
Dong Jiang, Yin-Fang Ao, Chen Jiao, Xing Xie, Lin-Xin Chen, Qin-Wei Guo, Yue-Lin Hu
PURPOSE: The purpose of the study was to evaluate the effect of concurrent arthroscopic osteochondral lesion (OCL) treatment and lateral ankle ligament repair on the outcome of chronic lateral ankle instability. It was hypothesized that the arthroscopic OCL treatment might have some negative effect on the outcome of chronic lateral ankle instability (CLAI) by compromising the rehabilitation program. METHODS: Ankle arthroscopy and anatomic lateral ankle ligament repair with suture anchors were performed for 70 patients with CLAI between 2010 and 2012...
November 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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