An instrumented, dynamic test for anterior laxity of the ankle joint complex

Kerkhoffs, Gino M. M. J.; Blankevoort, Leendert; Schreurs, A. W.; Jaspers, Janneke E.; Dijk, C. Niek van

doi:10.1016/s0021-9290(02)00189-6

Cited by 24 publications

(33 citation statements)

References 15 publications

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“…(3) is slightly inaccurate for large deformations (Pioletti et al, 1998). Research has recently focused on the effect of dynamic ligament loading (Crisco et al, 2002;Kerkhoffs et al, 2002). The results from the present work indicate that it is possible to compare the clinical ADT, where an impulse force is applied to the foot, with the results from in vitro studies, where typically quasi-static loading conditions are adopted.…”

Section: ° Plmentioning

confidence: 76%

Mechanics of the anterior drawer test at the ankle: the effects of ligament viscoelasticity

Corazza

Leardini

O’Connor

et al. 2005

Journal of Biomechanics

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Section: ° Plmentioning

confidence: 76%

Mechanics of the anterior drawer test at the ankle: the effects of ligament viscoelasticity

Corazza

Leardini

O’Connor

et al. 2005

Journal of Biomechanics

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“…4 Limited biomechanical information is available regarding passive end-range stiffness characteristics of the ankle complex with anterior loading after ankle injury. 2,3,13,14 With inversion loading, no authors of biomechanical studies have reported end-range stiffness characteristics for the intact ankle or for the ankle with combined lesions of the ATFL and CFL despite reporting increased instability. [14][15][16][17][18][19] Therefore, the mechanical property of stiffness may be important to understanding how injury affects joint stability.…”

mentioning

confidence: 99%

“…2,3,13,14 With inversion loading, no authors of biomechanical studies have reported end-range stiffness characteristics for the intact ankle or for the ankle with combined lesions of the ATFL and CFL despite reporting increased instability. [14][15][16][17][18][19] Therefore, the mechanical property of stiffness may be important to understanding how injury affects joint stability. Given the lack of information on the behavior of the viscoelastic properties of the ankle complex after ankle ligament injury, our understanding of the characteristics of the passive connective tissues before and after injury could be enhanced by examining these effects.…”

mentioning

confidence: 99%

Joint Stability Characteristics of the Ankle Complex After Lateral Ligamentous Injury, Part I: A Laboratory Comparison Using Arthrometric Measurement

Kovaleski

Heitman

Gurchiek

et al. 2014

Journal of Athletic Training

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. Dr Liu is currently at the School of Kinesiology, Auburn University, AL. Context:The mechanical property of stiffness may be important to investigating how lateral ankle ligament injury affects the behavior of the viscoelastic properties of the ankle complex. A better understanding of injury effects on tissue elastic characteristics in relation to joint laxity could be obtained from cadaveric study.Objective: To biomechanically determine the laxity and stiffness characteristics of the cadaver ankle complex before and after simulated injury to the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) during anterior drawer and inversion loading.Design: Cross-sectional study. Setting: University research laboratory.Patients or Other Participants: Seven fresh-frozen cadaver ankle specimens.Intervention(s): All ankles underwent loading before and after simulated lateral ankle injury using an ankle arthrometer. Main Outcome Measure(s):The dependent variables were anterior displacement, anterior end-range stiffness, inversion rotation, and inversion end-range stiffness.Results: Isolated ATFL and combined ATFL and CFL sectioning resulted in increased anterior displacement but not end-range stiffness when compared with the intact ankle. With inversion loading, combined ATFL and CFL sectioning resulted in increased range of motion and decreased end-range stiffness when compared with the intact and ATFL-sectioned ankles.Conclusions: The absence of change in anterior end-range stiffness between the intact and ligament-deficient ankles indicated bony and other soft tissues functioned to maintain stiffness after pathologic joint displacement, whereas inversion loading of the CFL-deficient ankle after pathologic joint displacement indicated the ankle complex was less stiff when supported only by the secondary joint structures.Key Words: ankle instability, joint laxity measurement, ankle sprains Key PointsThe injury mechanism consisted of serial sectioning of the major anatomic support structures of the lateral ankle complex. Anterior displacement was greater in the ankles with isolated anterior talofibular ligament (ATFL) sectioning and combined ATFL and calcaneofibular ligament (CFL) sectioning than in the intact ankles, but end-range stiffness did not increase after lateral ligament sectioning, indicating that bony and other soft tissues functioned to maintain anterior stiffness after pathologic joint displacement. With inversion loading, ankle-complex rotation increased and end-range stiffness decreased after CFL sectioning, indicating that the ankle complex was less stiff when supported only by the secondary joint structures.

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“…ligament tester (DAAT) was developed that showed promising preliminary results [11]. Simultaneously, a quasi-static anterior ankle tester (QAAT) was developed [12] that used a similar approach as the above-mentioned KT1000.…”

mentioning

confidence: 99%

Two ankle joint laxity testers: reliability and validity

Kerkhoffs

Blankevoort

Sierevelt

et al. 2005

Knee Surg Sports Traumatol Arthrosc

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Two test devices were manufactured to objectively measure ankle joint laxity: the dynamic anterior ankle tester (DAAT) and the quasi-static anterior ankle tester (QAAT). The primary aim was to analyse the reliability of both testers; The secondary aim was to assess validity in correlation with TELOS stress test and manual anterior drawer test. Twenty-four normal subjects and 14 patients 1 year after acute lateral ankle ligament injury were included. Both ankles were tested with the DAAT and QAAT by two different observers; one experienced orthopaedic surgeon performed the manual test; the TELOS stress X-rays were evaluated by one observer. Intra observer reliability for the DAAT varied between 0.81 and 0.94; for the QAAT between 0.71 and 0.94. Inter observer reliability for the DAAT varied between 0.84 and 0.94; for the QAAT between 0.76 and 0.82. Concurrent validity showed fair correlation between DAAT and QAAT for the first couple observers (0.71); however, a poor correlation was observed for the second couple (0.42). No significant correlations were found between neither DAAT and the TELOS and the manual test, nor QAAT and the TELOS and the manual test. In conclusion, reliability of both testers is high. Validity of the testers needs further investigation.

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An instrumented, dynamic test for anterior laxity of the ankle joint complex

Cited by 24 publications

References 15 publications

Mechanics of the anterior drawer test at the ankle: the effects of ligament viscoelasticity

Mechanics of the anterior drawer test at the ankle: the effects of ligament viscoelasticity

Joint Stability Characteristics of the Ankle Complex After Lateral Ligamentous Injury, Part I: A Laboratory Comparison Using Arthrometric Measurement

Two ankle joint laxity testers: reliability and validity

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