Early stage and small medial osteochondral lesions of the talus in the presence of chronic lateral ankle instability: A retrospective study

2020 ◽  
Vol 25 (1) ◽  
pp. 178-182
Author(s):  
Kazuya Ikoma ◽  
Masamitsu Kido ◽  
Masahiro Maki ◽  
Kan Imai ◽  
Yusuke Hara ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Ankle Instability ◽  
Early Stage ◽  
Osteochondral Lesions ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability

Arthroscopic Evaluation of Impingement and Osteochondral Lesions in Chronic Lateral Ankle Instability

2015 ◽  
Vol 36 (9) ◽  
pp. 1045-1049 ◽  
Author(s):  
Saurabh Odak ◽  
Raju Ahluwalia ◽  
Deepak G. Shivarathre ◽  
Atif Mahmood ◽  
Nicola Blucher ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Osteochondral Lesions ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Arthroscopic Evaluation ◽  
Lateral Ankle Instability

scholarly journals Risk Factors for Osteochondral Lesions and Osteophytes in Chronic Lateral Ankle Instability: A Case Series of 1169 Patients

2020 ◽  
Vol 8 (5) ◽  
pp. 232596712092282 ◽  
Author(s):  
Ding-yu Wang ◽  
Chen Jiao ◽  
Ying-fang Ao ◽  
Jia-kuo Yu ◽  
Qin-wei Guo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ankle Instability ◽  
Older Age ◽  
Osteochondral Lesions ◽  
Anterior Talofibular Ligament ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Bony Impingement ◽  
Lateral Ankle Instability ◽  
Male Sex

Background: Osteochondral lesions (OCLs) and bony impingement are common secondary lesions of chronic lateral ankle instability (CLAI), but the risk factors that predict OCLs and bony impingement are unknown. Purpose: To analyze the risk factors for the development of OCLs and osteophytes in patients with CLAI. Study Design: Case-control study; Level of evidence, 3. Methods: Patients diagnosed with CLAI at our institution from June 2007 to May 2018 were enrolled. The assessed potential risk factors were age, sex, postinjury duration, body mass index, injury side, and ligament injury type (isolated anterior talofibular ligament [ATFL] injury, isolated calcaneofibular ligament [CFL] injury, or concomitant ATFL and CFL injuries). Univariate and multivariate logistic regression analyses were performed to evaluate the association between these factors and the presence of OCLs and osteophytes. Results: A total of 1169 patients with CLAI were included; 436 patients (37%) had OCLs and 334 (31%) had osteophytes. The presence of OCLs was significantly associated with the presence of osteophytes ( P < .001). Male sex and older age were significantly associated with the presence of OCLs in the medial and lateral talus. A postinjury duration of 5 years or longer was significantly associated with the presence of OCLs in the medial talus (odds ratio [OR], 1.532; 95% CI, 1.023-2.293; P = .038) but not in the lateral talus. ATFL and CFL injuries were both significantly associated with the presence of lateral OCLs. Risk factors for the presence of osteophytes were male sex, older age, postinjury duration 5 years or longer, and CFL injury. Patients with concomitant ATFL and CFL injuries were significantly more likely to have osteophytes than were patients with single-ligament injuries ( P = .018). Conclusion: Risk factors for OCLs and osteophytes were postinjury duration of 5 years or longer, older age, and male sex. ATFL injury was associated with the presence of lateral OCLs, whereas CFL injury was associated with the presence of lateral OCLs and osteophytes. Patients with these risk factors should be closely monitored and treated to reduce the incidence of ankle arthritis.

scholarly journals Chronic lateral ankle instability: a current concepts review

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Ziyaad Mayet ◽  
Paulo NF Ferrao ◽  
Nikiforos Ρ Saragas ◽  
Richard Paterson ◽  
Sebastian KM Magobotha ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Osteochondral Lesions ◽  
Mechanical Instability ◽  
Functional Rehabilitation ◽  
Level Of Evidence ◽  
Ankle Ligaments ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Lateral Ankle Ligaments

ABSTRACT Injuries to the lateral ankle ligaments are quite common, with a reported incidence of up to 22% of all sports injuries, and 85% of all ankle sprains. Most of these are effectively managed using nonoperative measures in the acute setting. Approximately 20% of patients will, however, develop chronic lateral ankle instability (CLAI). Although the anatomy and biomechanics are well documented, more recently, the concepts of the lateral talofibular calcaneal ligament (LTFCL) and microinstability have been described. For those who develop CLAI, a full assessment is mandatory to not only search for correctable risk factors (malalignment), but also to differentiate between functional and mechanical instability. Associated injuries need to be excluded, such as osteochondral lesions of the talus. Rotational ankle instability is a new concept that needs to be considered. Patients who present with CLAI are initially managed conservatively in the form of functional rehabilitation. This management is especially effective in patients with functional instability. Surgery is generally indicated after failed conservative management in patients with objective mechanical instability. The elite athlete is a relative indication to performing surgery early. The choice of surgical procedure is made on an individualised basis, although open anatomical procedures remain the gold standard. Non-anatomical procedures are no longer recommended. Newer minimally invasive and endoscopic techniques show promise in experienced hands but there is only limited evidence to support its use at present. The use of a suture tape as an augment is reserved for specific indications and should not be used routinely. Level of evidence: Level 5 Keywords: chronic lateral ankle instability, ATFL, CFL, functional rehabilitation, Broström, surgical procedures for lateral ankle ligaments

scholarly journals Consistency and Reliability of Ankle Stress Radiography in Patients With Chronic Lateral Ankle Instability

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110040
Author(s):  
Ji Hye Choi ◽  
Kug Jin Choi ◽  
Chin Youb Chung ◽  
Moon Seok Park ◽  
Ki Hyuk Sung ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Tilt Angle ◽  
Ankle Instability ◽  
Interobserver Reliability ◽  
Initial Presentation ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Stress Radiographs ◽  
Lateral Ankle Instability

Background: Ankle stress radiographs are important tools for evaluating chronic lateral ankle instability. The consistency of a patient’s ankle condition as it affects the reliability of ankle stress radiographs has never been evaluated. Purpose: To investigate the consistency and reliability of ankle stress radiographs in patients with chronic lateral ankle instability without an ankle injury during the study period. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Included were patients with chronic lateral ankle instability who underwent 2 repeated ankle stress radiographs between January 2014 and July 2019; those with an ankle injury during the study period were excluded. The tibiotalar tilt angle on varus stress radiographs and anterior translation of the talus on anterior drawer stress radiographs were measured at initial presentation and final follow-up examination. Interobserver reliability and consistency of ankle stress radiographs were analyzed using the intraclass correlation coefficient (ICC). Results: A total of 45 patients (mean ± standard deviation age, 36.4 ± 13.4 years; 18 men and 27 women; follow-up duration, 9.1 ± 3.2 months) were included. The mean ± standard deviation tibiotalar tilt angle and anterior talar translation at initial presentation were 10.8° ± 5.2° and 6.9 ± 2.7 mm, respectively. The interobserver reliabilities of the tibiotalar tilt angle and anterior talar translation were excellent (ICC = 0.926 [95% CI, 0.874-0.959] and 0.911 [95% CI, 0.766-0.961], respectively). The consistency between the initial and final radiographs was good for tibiotalar tilt angle (ICC = 0.763 [95% CI, 0.607-0.862]) and poor for anterior talar translation (ICC = 0.456 [95% CI, 0.187-0.660]). Conclusion: Although the interobserver reliability of the radiographic measurements was excellent, the consistency of the ankle stress radiographs was not as acceptable. Surgeons need to be cautious when deciding whether to operate on a patient with chronic lateral ankle instability based on a single ankle stress radiograph.

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