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Chronic lateral ankle instability

N Harrasser, K Eichelberg, F Pohlig, H Waizy, A Toepfer, R von Eisenhart-Rothe
Because of their frequency, ankle sprains are of major clinical and economic importance. The simple sprain with uneventful healing has to be distinguished from the potentially complicated sprain which is at risk of transition to chronic ankle instability. Conservative treatment is indicated for the acute, simple ankle sprain without accompanying injuries and also in cases of chronic instability. If conservative treatment fails, good results can be achieved by anatomic ligament reconstruction of the lateral ankle ligaments...
October 13, 2016: Der Orthopäde
A Rosen, J Ko, C Brown
Chronic ankle instability is a common pathological consequence of ankle sprains. However, screening tools which assess self-reported dysfunction offer little insight into clinical factors which may be useful to improve deficits. The purpose of this study was to identify factors that contribute most to self-reported dysfunction. 93 individuals completed the Cumberland Ankle Instability Tool (CAIT), active range of motion, dynamic postural stability assessments, and an arthrometer inversion stress test to assess lateral ankle laxity and stiffness...
October 5, 2016: International Journal of Sports Medicine
R Lopes, C Decante, L Geffroy, K Brulefert, T Noailles
Anatomical reconstruction of the lateral ankle ligaments has become a pivotal component of the treatment strategy for chronic ankle instability. The recently described arthroscopic version of this procedure is indispensable to ensure that concomitant lesions are appropriately managed, yet remains technically demanding. Here, we describe a simplified variant involving percutaneous creation of the calcaneal tunnel for the distal attachment of the calcaneo-fibular ligament. The rationale for this technical stratagem was provided by a preliminary cadaver study that demonstrated a correlation between the lateral malleolus and the distal footprint of the calcaneo-fibular ligament...
September 27, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ewout S Veltman, Ernst Ja Steller, Philippe Wittich, Jort Keizer
A case of complicated lateral subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. Complications include avascular necrosis of the talus, infection, posttraumatic osteoarthritis requiring arthrodesis and chronic subtalar instability. Negative prognostic factors include lateral and complicated dislocations, total talar extrusions, and associated fractures. A literature search was performed to identify studies describing outcome after lateral subtalar joint dislocation...
September 18, 2016: World Journal of Orthopedics
Terry L Grindstaff, Nadyne Dolan, Sam K Morton
OBJECTIVES: To determine differences in ankle dorsiflexion range of motion (ROM) between three groups of individuals with chronic ankle instability (CAI) based on Lateral Step Down Test quality of movement. The secondary purpose was to quantify the relationship between ankle dorsiflexion ROM and Lateral Step Down Test scores. DESIGN: Descriptive laboratory study. SETTING: University research laboratory. PARTICIPANTS: Fifty-nine participants with CAI...
July 29, 2016: Physical Therapy in Sport
Guilherme S Nunes, Marcos de Noronha
OBJECTIVES: To investigate the impact different ways to define reference balance can have when analysing time to stabilization (TTS). Secondarily, to investigate the difference in TTS between people with chronic ankle instability (CAI) and healthy controls. DESIGN: Cross-sectional study. SETTING: Laboratory. PARTICIPANTS: Fifty recreational athletes (25 CAI, 25 controls). MAIN OUTCOME MEASURES: TTS of the center of pressure (CoP) after maximal single-leg vertical jump using as reference method the single-leg stance, pre-jump period, and post-jump period; and the CoP variability during the reference methods...
August 1, 2016: Physical Therapy in Sport
James M Cottom, Joseph S Baker, Phillip E Richardson
Lateral ankle sprains are a common injury that typically respond well to nonoperative therapy. When nonoperative therapy fails and patients develop chronic lateral ankle instability, they become candidates for surgical repair. The present study examined 45 consecutive patients (45 ankles) with chronic lateral ankle instability who underwent arthroscopic Broström repair using a double-row suture anchor construct. The 45 patients (27 females and 18 males) were followed up for a mean of 14 (range 12 to 20) months...
September 21, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Kathryn A Webster, Brian G Pietrosimone, Phillip A Gribble
CONTEXT:  Ankle instability is a common condition in physically active individuals. It often occurs during a jump landing or lateral motion, particularly when participants are fatigued. OBJECTIVE:  To compare muscle activation during a lateral hop prefatigue and postfatigue in individuals with or without chronic ankle instability (CAI). DESIGN:  Cross-sectional study. SETTING:  Sports medicine research laboratory...
September 14, 2016: Journal of Athletic Training
Adriano Russo, Paolo Giacchè, Enrico Marcantoni, Annalisa Arrighi, Luigi Molfetta
PURPOSE: this study was conducted to evaluate long-term results following treatment of chronic lateral ankle instability using the Broström-Gould technique in athletes. METHODS: eighteen athletes involved in competitive sports at different levels, who suffered from chronic lateral ankle instability, underwent Broström-Gould ligamentoplasty between 2000 and 2005. The results of the surgery were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scale...
April 2016: Joints
Matthew D Sorensen, John Baca, Keith Arbuckle
Arthroscopic lateral ankle stabilization procedures have been described for many years. New technological advances and a deeper understanding of the pathobiomechanics involved in chronic lateral ankle instability have allowed an expansion of arthroscopic approaches to this common pathology. As experience is gained and outcomes within the patient profile are understood, the authors feel that the arthroscopic approach to lateral ankle stabilization may prove superior to traditional methods secondary to the risk and traditional complications that are mitigated within minimally invasive arthroscopic approaches...
October 2016: Clinics in Podiatric Medicine and Surgery
Mark A Feger, Shannon Snell, Geoffrey G Handsfield, Silvia S Blemker, Emily Wombacher, Rachel Fry, Joseph M Hart, Susan A Saliba, Joseph S Park, Jay Hertel
BACKGROUND: Patients with chronic ankle instability (CAI) have demonstrated altered neuromuscular function and decreased muscle strength when compared with healthy counterparts without a history of ankle sprain. Up to this point, muscle volumes have not been analyzed in patients with CAI to determine whether deficits in muscle size are present following recurrent sprain. PURPOSE: To analyze intrinsic and extrinsic foot and ankle muscle volumes and 4-way ankle strength in young adults with and without CAI...
June 2016: Orthopaedic Journal of Sports Medicine
Hyeon-Wook Ahn, Keun-Bae Lee
BACKGROUND: Subfibular ossicles are frequently found in patients with chronic lateral ankle instability (CLAI). However, there is a lack of consensus about the optimal surgical treatment for CLAI with subfibular ossicle. PURPOSE: To evaluate the clinical and radiographic outcomes of the modified Broström procedure with subfibular ossicle excision compared with the same procedure for CLAI without subfibular ossicle. STUDY DESIGN: Cohort study; Level of evidence, 3...
August 15, 2016: American Journal of Sports Medicine
Frederick Michels, Guillaume Cordier, Stéphane Guillo, Filip Stockmans
Chronic instability is a common complication of lateral ankle sprains. If nonoperative treatment fails, a surgical repair or reconstruction may be indicated. Today, endoscopic techniques to treat ankle instability are becoming more popular. This article describes an endoscopic technique, using a step-by-step approach, to reconstruct the ATFL and CFL with a gracilis graft. The endoscopic technique is reproducible and safe with regard to the surrounding anatomic structures. Short and midterm results confirm the benefits of this technique...
September 2016: Foot and Ankle Clinics
R Lopes, T Noailles, K Brulefert, L Geffroy, C Decante
PURPOSE: An anatomic study was performed to confirm whether the lateral malleolus could serve as a simple and reproducible anatomic reference for the distal insertion of the calcaneofibular ligament (CFL). METHODS: Dissection was performed after placement of a Kirschner wire to simulate the calcaneal tunnel for the distal insertion of the CFL. The skin was penetrated 1 cm distal and posterior to the tip of the lateral malleolus. The main information recorded was the distance from the Kirschner wire to the centre of the distal insertion of the CFL...
August 6, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
He-Xing Xu, Keun-Bae Lee
BACKGROUND: Generalized joint laxity (GJL) has been considered a risk factor for late failure of ligament reconstruction in the knee; however, it is not known whether GJL is the cause of recurrent instability after the modified Broström procedure for chronic lateral ankle instability. PURPOSE: To compare the clinical results of the modified Broström procedure for chronic lateral ankle instability in patients with or without GJL. STUDY DESIGN: Cohort study; Level of evidence, 3...
August 5, 2016: American Journal of Sports Medicine
Mark A Feger, Jay Hertel
BACKGROUND: Rehabilitation is ineffective at restoring normal gait in chronic ankle instability patients. Our purpose was to determine if a novel gait-training device could decrease plantar pressure on the lateral column of the foot in chronic ankle instability patients. METHODS: Ten chronic ankle instability patients completed 30s trials of baseline and gait-training walking at a self-selected pace while in-shoe plantar pressure and surface electromyography were recorded from their anterior tibialis, peroneus longus, medial gastrocnemius, and gluteus medius...
August 2016: Clinical Biomechanics
Emily M Hartley, Matthew C Hoch, Patrick O McKeon
Individuals with chronic ankle instability (CAI) have demonstrated deviations in gait initiation (GI) compared to healthy individuals. However, the intersession reliability of GI measures remains unknown in this population. The objective of this study was to determine the reliability and responsiveness of GI measures between two testing days in those with CAI. Twelve individuals with CAI volunteered. Participants performed barefoot GI on a force plate which captured center of pressure (COP). Data was collected on two separate occasions separated by one week...
September 2016: Gait & Posture
Saad R El Ashry, Tarek A El Gamal, Simon R Platt
Chronic ankle instability is a disabling condition, often occurring as a result of traumatic ankle injury. A paucity of published data is available documenting chronic ankle instability in the pediatric population. Much of the data has been confined to the adult population. We present 2 cases of chronic ankle instability, 1 in a 12-year-old and 1 in a 9-year-old patient. Unlike the typical adult etiology, the cause of instability was a dysfunctional lateral ligamentous complex as a consequence of bony avulsion of the tip of the fibula...
June 14, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Youichi Yasui, Christopher D Murawski, Adi Wollstein, John G Kennedy
PURPOSE: Over 50 % of the patients with chronic lateral ankle instability present with some degree of intra-articular pathology. To date, no consensus regarding the concomitant ankle arthroscopy procedures along with ankle ligament procedures has been reached. The purpose of current study was to investigate reoperation rates and postoperative complications following ankle ligament procedures with and without concomitant arthroscopic procedures. METHODS: Reoperations and postoperative complications following ankle ligament procedures with and without concomitant arthroscopic procedures were investigated using the PearlDiver Patient Record Database (PearlDiver Technologies, Inc...
June 16, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Kentaro Matsui, Masato Takao, Yuki Tochigi, Satoru Ozeki, Mark Glazebrook
PURPOSE: To gain a better understanding of the precise anatomy of the lateral ligaments of the ankle through a systematic review of published cadaveric studies in order to improve anatomical minimally invasive surgery (MIS) for treatment of chronic ankle instability (CAI). METHODS: A systematic review of the literature was performed using the PubMed, EMBASE, Cochrane databases and Web of Science on June 2015 with the two search concepts: "lateral ligament of the ankle" and "anatomy"...
June 13, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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