Arthroscopic Findings in Patients with Chronic Ankle Instability

Hintermann, Beat; Boss, Andreas; Schäfer, Doris

doi:10.1177/03635465020300031601

Cited by 530 publications

(373 citation statements)

References 25 publications

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“…Chondral lesions, peroneal tears, and other disorders occur relatively frequently in patients with chronic ankle instability [2,7,9,20]. These associated lesions may be an important potential cause of long-term problems [7,10,15,19,24], and appropriate treatment depends on accurate diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Ankle sprains are extremely common injuries [6,7]. Although many patients are successfully treated nonoperatively, residual problems may occur [4,8].…”

Section: Introductionmentioning

confidence: 99%

“…Although many patients are successfully treated nonoperatively, residual problems may occur [4,8]. Twenty to 40% of patients with chronic instability have associated disorders, such as chondral lesions of the talus, peroneal tears, or loose bodies [2,3,7]. These lesions may contribute to morbidity after an ankle sprain [7,10,19,24].…”

Section: Introductionmentioning

confidence: 99%

“…Twenty to 40% of patients with chronic instability have associated disorders, such as chondral lesions of the talus, peroneal tears, or loose bodies [2,3,7]. These lesions may contribute to morbidity after an ankle sprain [7,10,19,24]. In the absence of definitive data, diagnosis and treatment at the time of reconstructive ligament surgery appear desirable.…”

Section: Introductionmentioning

confidence: 99%

“…Often patients arrive for surgical consultation with MR images obtained and read at outside institutions, which may add additional variability to the scenario. Some authors have recommended routine ankle arthroscopy to detect intraarticular disorders at the time of ligament reconstruction [3,7,10].…”

Section: Introductionmentioning

confidence: 99%

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Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

O’Neill

Aman

Guyton

2010

Clinical Orthopaedics &Amp; Related Research

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Background Chondral lesions, peroneal tendon tears, and other disorders in patients with chronic ankle instability may not be detected by preoperative MRI. Also, MRI often is obtained and interpreted at the referring institution, leading to variability in reading. Questions/PurposesWe assessed the accuracy of the radiologists' and orthopaedic surgeon's reading of preoperative MRI for diagnosing ankle lesions in patients with ankle instability warranting surgery. Patients and Methods We retrospectively reviewed 133 patients who underwent 135 surgeries for lateral ankle ligament reconstruction with concomitant ankle arthroscopy and who had preoperative MRI. Results We found 72 associated lesions in 66 of the 135 surgeries, including 38 chondral injuries, 18 peroneus brevis tears, seven loose bodies, and nine other miscellaneous abnormalities. Eliminating eight lesions for which the decision to operate was not based on operative findings, there were 127 surgeries with 64 associated lesions that required intraoperative confirmation or were detected intraoperatively. In the original reports, the radiologists identified 39% (15) of the chondral injuries, 56% (10) of the peroneal tears, and 57% (four) of the loose bodies. Radiologists' MRI sensitivity for detecting lesions was 45%. The attending surgeon identified 47% (18) of the chondral injuries, 89% (16) of the loose bodies, 71% (five) of the peroneus brevis tears, and the posterior talus process lesion, with a sensitivity of 63%. ConclusionsOur data suggest orthopaedic surgeons should review preoperative MRIs and also suggest the sensitivity of MRI may not be adequate to detect lesions in these patients before surgery.

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Section: Discussionmentioning

confidence: 99%

“…Ankle sprains are extremely common injuries [6,7]. Although many patients are successfully treated nonoperatively, residual problems may occur [4,8].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

O’Neill

Aman

Guyton

2010

Clinical Orthopaedics &Amp; Related Research

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Radiographic evaluation of frontal talar edge configuration for osteochondral plug transplantation

et al. 2008

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For successful reconstruction of osteochondral lesions of the talus, the anatomic configuration of the talar edge must be respected. This study evaluated the radiographic configuration of the talar edge in the anterior-posterior (AP) view by analyzing medial and lateral talar edge angles and radii in 81 patients with a true AP view and without ankle pathology. The mean lateral talar edge angle was 91.8 degrees , and the mean medial talar edge angle was 110.0 degrees . The medial frontal talar edge radius was 4.8 mm and the lateral 3.5 mm, respectively. No correlation between angle and radius was found. These results revealed a significant difference between the medial and the lateral talar edge configuration. This may be due to the three-dimensional function of the human ankle joint. No study so far has addressed these differences radiologically. These differences should be addressed in the reconstruction of osteochondral lesions and be included in the preoperative planning.

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Prevalence and location of bone spurs in anterior ankle impingement: A cadaveric investigation

2018

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Anterior ankle impingement (AAI) results from repetitive microtrauma leading to pain and decreased dorsiflexion due to spur formation and synovial hypertrophy. Information about the prevalence of anterior spur formation in a large population, and the individual contributions of the talus and tibia to osseous impingement, is limited. A total of 670 ankle specimens from 344 individuals (n = 111 females, n = 233 males) aged 20 to 40 years at the time of death were examined. Matching tibia and talus were opposed and any spurring causing impingement was recorded. Spur locations were measured and ratios calculated to allow for inter-specimen comparison between: (1) medial-to-lateral and anterior-to-posterior spur location versus dimensions of talar neck width, and (2) medial-to-lateral spur location to dimensions of distal anterior tibial width. Differences in spur prevalence in relation to sex, race, height and age were identified by univariant and multivariable statistical analyses. Bony impingement was observed in 21% (n = 72) of specimens, with bilateral involvement in 8% (n = 27). For ankles with AAI, spurs were seen on the talus only in 61%, on the tibia only in 14%, and on both the tibia and talus in 26%. Spurs were significantly more prevalent in males (P = 0.001) and with increasing specimen age (P = 0.002). There were no significant differences related to specimen height or race. Spurs were predominately located on the anterolateral talus (78%) and the anterolateral portion of the distal tibial margin (80%). AAI was present in 21% of young osseous specimens and was significantly more prevalent in males and with increasing specimen age. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc.

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Arthroscopic Findings in Patients with Chronic Ankle Instability

Abstract: Preoperative ankle arthroscopy revealed an essential amount of information that would otherwise have been undetected. For instance, the ligaments showed typical abnormalities corresponding to different entities of ankle instability and different intraarticular pathologic conditions.

Cited by 530 publications

References 25 publications

Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

Radiographic evaluation of frontal talar edge configuration for osteochondral plug transplantation

Prevalence and location of bone spurs in anterior ankle impingement: A cadaveric investigation

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