Anterolateral Rotational Instability in the Ankle Joint:<i>An Experimental Study of Anterolateral Rotational Instability, Talar Tilt, and Anterior Drawer Sign in Relation to Injuries to the Lateral Ligaments</i>

Rasmussen, Ove; Tovborg-Jensen, Ib

doi:10.3109/17453678108991767

Cited by 41 publications

(19 citation statements)

References 5 publications

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“…These findings are in agreement with the results of previous in vitro studies of the anterior and anteriorposterior load-displacement response of the ankle joint (8,11,19). The increase in neutral zone laxity that resulted from sectioning the anterior talofibular ligament was an average of 2.5 mm at 20" of plantar flexion of the ankle.…”

Section: Discussionsupporting

confidence: 92%

“…The anterior drawer test is the most common clinical examination technique used to evaluate the status of the anterior talofibular ligament. Many clinical studies of this examination have been reported, some of which have demonstrated its value for evaluating the integrity of the anterior talofibular ligament (2,5,6,12,20,22,23,26), whereas other studies have found the examination to be unreliable (10,19). This divergence may be attributed to the fact that an optimal position of the ankle and magnitude of load applied to perform the anterior drawer test have yet to be defined.…”

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confidence: 99%

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Biomechanical analysis of the ankle anterior drawer test for anterior talofibular ligament injuries

Tohyama

Beynnon

Renström

et al. 1995

Journal Orthopaedic Research

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The effect of sectioning the anterior talofibular ligament on the load-displacement behavior of the ankle was evaluated in vitro during the anterior drawer test using the flexibility approach. Controlled forces were applied across the ankle joint in the anterior-posterior direction, and the resulting displacements were measured at four flexion angles (10 degrees of dorsiflexion, neutral, and 10 degrees and 20 degrees of plantar flexion). The anterior talofibular ligament then was sectioned, and the anterior-posterior loadings were repeated at the four flexion angles. Two parameters were developed to describe the nonlinear load-displacement response of the ankle joint: neutral zone laxity (joint displacement between +/- 2.5 N) and flexibility (a measure of the nonlinear load-displacement response of the ankle between 10 and 50 N of anterior drawer loading). After sectioning the anterior talofibular ligament, significant increases in neutral zone laxity were observed at all angles of ankle flexion. The largest increases in neutral zone laxity were found with the ankle in 10 degrees of plantar flexion (76.3% increase) and 20 degrees of plantar flexion (89.7% increase). After sectioning the ligament, a significant increase (19.3%) in flexibility of the ankle was observed at 10 degrees of dorsiflexion, but no change in flexibility was observed with the ankle in the neutral and plantar flexed positions. These findings indicate that anterior drawer testing of the anterior talofibular ligament-deficient ankle between 10 degrees and 20 degrees of plantar flexion results in the largest increase in neutral zone laxity compared with the normal ankle with intact ligaments.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

Biomechanical analysis of the ankle anterior drawer test for anterior talofibular ligament injuries

Tohyama

Beynnon

Renström

et al. 1995

Journal Orthopaedic Research

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“…ATFL excision increased talar anterior translation during ankle plantar flexion and increased talar inversion/internal rotation during ankle rotation; these movements were further increased by resecting the CFL. [36][37][38][39][40][41] Various symptoms such as swelling, pain, and range of motion (ROM) deficit occur in the acute or subacute phase of LAS. Ten days after LAS injury, swelling significantly decreases compared to that after 3 days, but there is no significant improvement in ROM deficit.…”

Section: Pathology and Prognosismentioning

confidence: 99%

Lateral Ankle Sprain and Chronic Ankle Instability

Kobayashi

Gamada

2014

Foot & Ankle Specialist

116

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“…This may in part be due to different fixation techniques in cadaver studies which result in altered kinematics and varying degrees of freedom. For example, talus’ anterior movement is always accompanied by internal rotation, therefore the if the specimen is fixed (e.g., by screwing) in the mediolateral axis, this will limit the reproducibility of such measurements in a clinical setting . Caused by the surgical approach to the ligament in a cadaver specimen, especially when dissecting skin and capsula around the ankle, it must be considered that the properties of surrounding soft tissue may be altered and thereby cause differences between cadaver and in vivo measurements .…”

Section: Discussionmentioning

confidence: 99%

In vivo arthrometer measurements of mechanical ankle instability—A systematic review

Lohrer²,

Gollhofer

et al. 2019

Journal Orthopaedic Research

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Chronic ankle instability is caused by functional and/or mechanical deficits. To differentiate the two entities, mechanical ankle instability can be assessed using arthrometers. The measurement of mechanical instability is essential, since it can only be addressed surgically. The aim of this systematic literature review was to find out whether chronic mechanical ankle instability could be adequately and objectively assessed using in vivo arthrometer measurements. Articles were included if the main focus was to evaluate the contribution of mechanical deficits to chronic ankle instability and if they provided sufficient description of the device used. This systematic review was performed according to the PRISMA-recommendations. Initially 47 articles were screened for eligibility, of which 33 studies reporting 10 different devices were included. While the reliability of the measurements was mostly good to excellent, only two studies aimed to assess the sensitivity and specificity of their results in regard to chronic ankle instability. Several devices reported conflicting results about mechanical deficits. In summary, this systematic review reveals a substantial deficit in diagnostic accuracy when assessing mechanical ankle instability in a clinical setting. Biases in recruiting and classification of participants raise the question whether the two entities of functional and mechanical ankle instability are properly defined. Clinical Significance: In recent years, this may have led to a misinterpretation of mechanical deficits and the subsequent need for surgical intervention. ß 2019

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Anterolateral Rotational Instability in the Ankle Joint:An Experimental Study of Anterolateral Rotational Instability, Talar Tilt, and Anterior Drawer Sign in Relation to Injuries to the Lateral Ligaments

Cited by 41 publications

References 5 publications

Biomechanical analysis of the ankle anterior drawer test for anterior talofibular ligament injuries

Biomechanical analysis of the ankle anterior drawer test for anterior talofibular ligament injuries

Lateral Ankle Sprain and Chronic Ankle Instability

In vivo arthrometer measurements of mechanical ankle instability—A systematic review

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