Degenerative arthritis of the ankle secondary to long-standing lateral ligament instability.

Harrington, Kevin D.

doi:10.2106/00004623-197961030-00006

Cited by 454 publications

(257 citation statements)

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“…This is consistent with a retrospective study in which 37 patients (13%) with chronic ankle instability had OA [21]. Another study reported an even higher ligamentous posttraumatic osteoarthritis rate of 78% (particularly varus OA) in 36 patients with chronic lateral ankle instability [10]. The underlying pathomechanisms causing secondary OA in ankle sprains might be twofold: either an acute osteochondral lesion [38], as in single severe ankle sprains, or chronic change in ankle mechanics leading to repetitive cartilage degeneration [11,28], as in recurrent or chronic instable ankles.…”

Section: Discussionsupporting

confidence: 89%

“…1 The age distribution of the study patients with end-stage ankle OA (n = 406) is shown. might be a common finding in chronic ankle instability [10], and there might be a biomechanical explanation for this. In a kinematic gait analysis, it was found that ankles that have sustained an injury to the lateral ligaments abnormally pronate and rotate externally at the time of heel strike and abnormally supinate (ie, varization of the heel) and rotate internally during the acceleration phase [11].…”

Section: Discussionmentioning

confidence: 92%

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Etiology of Ankle Osteoarthritis

Valderrábano

Horisberger

Russell³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

677

415

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The purpose of this study was to evaluate the distribution rate of etiologies leading to ankle arthritis and to quantify and compare the important clinical and radiologic variables among these etiologic groups. We evaluated data from 390 patients (406 ankles) who consulted our center because of painful end-stage ankle osteoarthritis (OA) by using medical history, physical examination, and radiography. Posttraumatic ankle OA was seen in 78% of the cases (n = 318), secondary arthritis in 13% (n = 52), and primary OA in 9% (n = 36). The average American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was 38 points (range, 0-74 points), range of motion was 22°(range, 0°-65°), and visual analog scale for pain was 6.8 (range, 2-10). Patients with posttraumatic endstage ankle OA were younger than patients with primary OA. The average tibiotalar alignment was 88°(range, 51°-116°) and did not differ between the etiologic groups. Our study showed trauma is the main cause of ankle OA and primary OA is rare. In the majority of patients with ankle OA the average tibiotalar alignment is varus regardless of the underlying etiology.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 92%

Etiology of Ankle Osteoarthritis

Valderrábano

Horisberger

Russell³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

677

415

View full text Add to dashboard Cite

show abstract

“…Patients may have a subjective sense of instability where an innocuous misstep may lead to another ankle injury [8]. Recurrent ankle sprains may alter the biomechanics at the ankle joint which can potentially lead to cartilage degeneration over time [9][10][11][12][13]. Up to 93% of patients with ankle instability have associated intra-articular pathology [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Operative treatment of lateral ligament instability

Shakked

Karnovsky

Drakos

2017

Curr Rev Musculoskelet Med

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Purpose of review Ankle sprains, which account for 40% of sports injuries in the USA, can lead to chronic ankle instability. Chronic ankle instability can be classified as functional, mechanical, or a combination of both and is diagnosed using a combination of a physical exam, an MRI, and stress radiographs. This review focuses on different approaches to treatment, including non-operative and operative techniques, of chronic ankle instability, including reviewing traditional procedures as well as more novel and newer techniques. Recent findings Based on existing literature, non-operative treatment should always precede operative treatment of chronic ankle instability. If rehabilitation fails, Brostrom-Gould type ankle stabilization has been the preferred surgical option. Recent literature suggests that arthroscopic repair might reduce recovery time and improve outcomes in certain populations; however, there are higher rates of complication following these surgeries. In more high-risk populations, some literature reports that ligament repair with peroneus brevis transfer could be a more effective treatment option. Summary Currently, varying surgical techniques exist for the treatment of chronic ankle instability. While the more recently reported techniques show promise, it is important to note that there is little evidence showing they are more successful than traditional techniques. It is imperative that future studies focus on outcomes and complication rates of these newer procedures.

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“…Functional ankle instability has been classically defined as an ankle which gives way under normal use (6). Such instability can lead to multiple episodes of recurrent sprain, diminished lower extremity function, and long-term arthritic changes (8).…”

mentioning

confidence: 99%

The Relationship Between Muscle Function and Ankle Stability

Lentell¹,

Katzman²,

Walters³

1990

J Orthop Sports Phys Ther

167

101

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The purpose of this investigation was to document the degree of weakness present in the medial and lateral muscle groups of individuals with chronically unstable ankles. Peak isometric and isokinetic torque measurements were collected bilaterally during the motion of inversion-eversion from 33 subjects, ages 17 to 54, reporting unilateral chronic lateral instability. Values were then compared between the involved and uninvolved sides. A modified Romberg test was also performed bilaterally to determine gross balance differences between the involved and uninvolved lower extremities. No significant difference in muscle strength was documented either isometrically or isokinetically, but balance differences were found between the two extremities in a majority of subjects. The findings suggest that muscular weakness is not a major contributing factor to the chronically unstable ankle. The findings do support the presence of proprioceptive deficits associated with this condition. Based on the results, proprioceptive activities should be a primary consideration in management of the chronically unstable ankle.

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Degenerative arthritis of the ankle secondary to long-standing lateral ligament instability.

Cited by 454 publications

References 0 publications

Etiology of Ankle Osteoarthritis

Etiology of Ankle Osteoarthritis

Operative treatment of lateral ligament instability

The Relationship Between Muscle Function and Ankle Stability

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