scholarly journals Treatment of Chronic Ankle Instability

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Edvin Selmani ◽  
Agron Dogjani
Keyword(s):  
Ankle Joint ◽  
Ankle Instability ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Chronic Ankle Instability ◽  
Arthroscopic Repair ◽  
Anatomic Reconstruction ◽  
Direct Repair ◽  
Lateral Ankle Instability ◽  
Short And Long Term

Treatment of chronic ankle instability remains a challenge for orthopedic surgeon. Surgical procedures for this disorder 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. Arthroscopic repair of chronic lateral ankle instability can provide good to excellent short- and long-term clinical outcomes, but the evidence supporting this technique is limited. Deterioration of the ankle joint after surgery is also a concern. Studies are needed on not only treating ligament insufficiency but also on reducing the risk of ankle joint deterioration.

Chronic Lateral Ankle Instability: Results of Anatomic Repair with Polyester Tape Augmentation

2020 ◽  
Vol 22 (1) ◽  
pp. 27-33
Author(s):  
Islam Sarhan ◽  
Islam Mubark ◽  
Ahmed Waly
Keyword(s):  
Ankle Sprain ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
High Rate ◽  
Anatomic Reconstruction ◽  
Foot And Ankle ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Anatomic Repair ◽  
Lateral Ankle Instability

Background. Ankle sprains are one of the most common injuries in both athletes and the general population. A major problem accompanying ankle injury is the high rate of recurrence, with about 20% of acute ankle sprain patients developing chronic ankle instability. Unlike acute ankle sprain, chronic ankle instability usually needs surgical intervention. Various anatomic reconstruction techniques using the ruptured ends of the ligaments to restore stability have gained popularity. The purpose of this study was to evaluate the functional results of the treatment of chronic lateral ankle instability with anatomic repair of the injured ligaments and reinforcement with polyester tape. Material and methods. A prospective study of 30 consecutive patients who underwent anatomic reconstruction of the lateral ligaments using transosseous suturing and augmentation using a polyester tape done at a single centre by a single surgeon from 2016 to 2017. All patients were assessed preoperatively and postoperatively at 6 weeks, 3, 6 and 12 months. The American Orthopaedic Foot and Ankle Score (AOFAS) and Free Online Foot and Ankle Ability Measure (FAAM) were recorded and used for results analysis. Results. At 12 months’ follow-up, the AOFAS had improved from mean 52.47 ± 2.06 to 91.0 ± 6.03 (p< 0.001) .The FAAM mean score had improved from mean 55.21± 1.9 to 90.43 ± 4.02 Conclusion. The ankle ligament reconstruction with additional polyester tape augmentation is an effective technique in treating chronic ankle instability with a satisfactory surgical outcome.

scholarly journals People with chronic ankle instability benefit from brace application in highly dynamic change of direction movements

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Patrick Fuerst ◽  
Albert Gollhofer ◽  
Markus Wenning ◽  
Dominic Gehring
Keyword(s):  
Ankle Joint ◽  
Repeated Measures ◽  
Ankle Instability ◽  
Dynamic Change ◽  
Chronic Ankle Instability ◽  
Mechanical Resistance ◽  
Healthy Controls ◽  
Neuromuscular Activation ◽  
Ankle Inversion ◽  
Ankle Brace

Abstract Background The application of ankle braces is an effective method for the prevention of recurrent ankle sprains. It has been proposed that the reduction of injury rates is based on the mechanical stiffness of the brace and on beneficial effects on proprioception and neuromuscular activation. Yet, how the neuromuscular system responds to the application of various types of ankle braces during highly dynamic injury-relevant movements is not well understood. Enhanced stability of the ankle joint seems especially important for people with chronic ankle instability. We therefore aimed to analyse the effects of a soft and a semi-rigid ankle brace on the execution of highly dynamic 180° turning movements in participants with and without chronic ankle instability. Methods Fifteen participants with functional ankle instability, 15 participants with functional and mechanical ankle instability and 15 healthy controls performed 180° turning movements in reaction to light signals in a cross-sectional descriptive laboratory study. Ankle joint kinematics and kinetics as well as neuromuscular activation of muscles surrounding the ankle joint were determined. Two-way repeated measures analyses of variance and post-hoc t-tests were calculated. Results Maximum ankle inversion angles and velocities were significantly reduced with the semi-rigid brace in comparison to the conditions without a brace and with the soft brace (p ≤ 0.006, d ≥ 0.303). Effect sizes of these reductions were larger in participants with chronic ankle instability than in healthy controls. Furthermore, peroneal activation levels decreased significantly with the semi-rigid brace in the 100 ms before and after ground contact. No statistically significant brace by group effects were found. Conclusions Based on these findings, we argue that people with ankle instability in particular seem to benefit from a semi-rigid ankle brace, which allows them to keep ankle inversion angles in a range that is comparable to values of healthy people. Lower ankle inversion angles and velocities with a semi-rigid brace may explain reduced injury incidences with brace application. The lack of effect of the soft brace indicates that the primary mechanism behind the reduction of inversion angles and velocities is the mechanical resistance of the brace in the frontal plane.

Talar Anchor Placement for Modified Brostrom Lateral Ankle Stabilization Procedure

2008 ◽  
Vol 98 (6) ◽  
pp. 473-476 ◽  
Author(s):  
Arush K. Angirasa ◽  
Michael J. Barrett
Keyword(s):  
Research Study ◽  
Ankle Instability ◽  
Suture Technique ◽  
Anatomic Reconstruction ◽  
Ankle Ligaments ◽  
Lateral Ankle ◽  
Lateral Ankle Instability ◽  
Stabilization Procedure ◽  
Lateral Ankle Ligaments ◽  
Modified Broström Procedure

The modified Brostrom procedure has been a proven procedure with excellent utility in the treatment of lateral ankle instability within limitation. Multiple variations of the original technique have been described in the literature to date. Included in these variations are differences in anchor placement, suture technique, or both. In this research study, we propose placing a bone screw anchor into the lateral shoulder of the talus rather than the typical placement at the lateral malleolus for anatomic reconstruction of the lateral ankle ligaments. (J Am Podiatr Med Assoc 98(6): 473–476, 2008)

scholarly journals Surgical Management of Lateral Ankle Instability in Athletes

2019 ◽  
Vol 54 (6) ◽  
pp. 639-649 ◽  
Author(s):  
Luis D. Camacho ◽  
Zachary T. Roward ◽  
Yu Deng ◽  
L. Daniel Latt
Keyword(s):  
Surgical Management ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Anatomic Reconstruction ◽  
Ankle Sprains ◽  
Functional Rehabilitation ◽  
Ankle Ligaments ◽  
Lateral Ankle ◽  
Initial Surgery ◽  
Lateral Ankle Ligaments

Ankle sprains are common injuries involving the lateral ankle ligaments and affect athletes of all levels. Most patients heal uneventfully, but those with symptoms persisting past 3 months should be evaluated for chronic ankle instability and its associated conditions as well as for the presence of varus malalignment. Chronic ankle instability is initially treated nonoperatively, with surgical management reserved for those who have failed to improve after 3 to 6 months of bracing and functional rehabilitation. Anatomic repair using a modification of the Broström procedure is the preferred technique for initial surgery. Anatomic reconstruction with tendon graft should be considered when repair is not possible, as it maintains physiological joint kinematics. Nonanatomic reconstructions are seldom indicated. Arthroscopic repair or reconstruction of the lateral ankle ligaments is a promising new technique with results similar to those of open surgery.

The Immediate Effects of Ankle Joint Mobilization on Ankle Musculotendinous Stiffness in Individuals With Chronic Ankle Instability

2020 ◽  
pp. 1-5
Author(s):  
M. Spencer Cain ◽  
Kyeongtak Song ◽  
J. Troy Blackburn ◽  
Kimmery Migel ◽  
Erik A. Wikstrom
Keyword(s):  
Ankle Joint ◽  
Ankle Instability ◽  
Change Score ◽  
Chronic Ankle Instability ◽  
Minimal Detectable Change ◽  
Plantar Flexor ◽  
Joint Mobilization ◽  
Before And After ◽  
Damped Oscillation ◽  
Musculotendinous Stiffness

Ankle joint mobilization has been shown to be effective at improving outcomes in those with chronic ankle instability (CAI), but the neuromuscular mechanisms are still unknown. We aimed to determine the immediate effect of a single Grade III anterior-to-posterior ankle joint mobilization bout on ankle musculotendinous stiffness (MTS) in those with CAI. Seventeen CAI participants had plantar flexor and fibularis MTS assessed before and after a 5-min joint mobilization treatment. MTS outcomes were estimated using the damped oscillation method. Fibularis (0.25 ± 0.41 N/m/kg, p = .028) but not plantar flexor MTS (−2.18 ± 14.35 N/m/kg, p = .539) changed following mobilization and exceeded the calculated minimal detectable change score (0.12 N/m/kg). Increased fibularis MTS may represent a neuromuscular mechanism by which ankle joint mobilizations improve postural control in those with CAI.

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