Revisiting the Prevalence of Associated Copathologies in Chronic Lateral Ankle Instability: Are There Any Predictors of Outcome?

Araoye, Ibukunoluwa; Pinter, Zachariah; Lee, Sung; Hudson, Parke; Shah, Ashish

doi:10.1177/1938640018793513

Cited by 14 publications

(9 citation statements)

References 24 publications

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“…443 Symptoms of pain and instability may continue after a LAS and result from coexisting pathologies, including os trigonum syndrome; osteochondral injury; syndesmotic, deltoid, or subtalar ligament injuries; talonavicular, calcaneonavicular, and calcaneocuboid joint injuries; fibularis muscle group injuries; and/or nerve pathologies. 13,56,98,199,210,282,285,340,411,483 In individuals with CAI, intra-articular pathologies may be associated with continued symptoms. 282,411 It should be noted that these coexisting pathologies are seen on diagnostic testing in those who sustain a LAS but do not have symptoms.…”

Section: Pathoanatomical Features Update 2021mentioning

confidence: 99%

“…Frequently, these copathologies are documented at the time of surgery following unsuccessful nonsurgical management. 13,282 Coexisting pathology accompanying CAI may include: • Fibularis muscle pathology 13,199 • Ankle impingement 13,262 • Osteochondral lesions 13 • Synovitis 282 • Chondral lesions (superficial or deep) 196,265,282 • Bony or avulsion fragments 282,364 • Loose bodies 282 • Syndesmotic injury 65,326 • Arthritis 293 • Bifurcate ligament injury 415 • Symptomatic accessory ossicles, 364 including os trigonum syndrome 98…”

Section: Evidence Updatementioning

confidence: 99%

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Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Martin¹,

Davenport²,

Fraser³

et al. 2021

Journal of Orthopaedic & Sports Physical Therapy

102

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B Clinicians should include patient age, body mass index, pain coping strategies, report of instability, history of previous sprain, ability to bear weight, pain with weight bearing, ankle dorsiflexion range of motion (ROM), medial jointline tenderness, balance, and ability to jump and land (as safely tolerated) in their initial assessment, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with an acute lateral ankle sprain (LAS). CLINICAL COURSE -CHRONIC ANKLE INSTABILITYC Clinicians may include previous treatment, number of sprains, pain level, and self-report of function in their evaluation, as well as an assessment of the sensorimotor movement systems of the foot, ankle, knee, and hip during dynamic postural control and functional movements, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with chronic ankle instability (CAI). DIAGNOSIS/CLASSIFICATION -ACUTE LATERAL ANKLE SPRAINB Clinicians should use special tests, including the reverse anterolateral drawer test and anterolateral talar palpation in addition to the traditional anterior drawer test, and a thorough history and physical examination to aid in the diagnosis of a LAS. DIAGNOSIS/CLASSIFICATION -CHRONIC ANKLE INSTABILITYB When determining whether an individual has CAI, clinicians should use a reliable and valid discriminative instrument, such as the Cumberland Ankle Instability Tool or the Identification of Functional Ankle Instability, as well as a battery of functional performance tests that have established validity to differentiate between healthy controls and individuals with CAI. EXAMINATION -OUTCOME MEASURESA Clinicians should use validated patient-reported outcome measures, such as the Patient-Reported Outcomes Measurement Information System physical function and pain interference scales, the Foot and Ankle Ability Measure, and the Lower Extremity Functional Scale, as part of a standard clinical examination. Clinicians should utilize these before and 1 or more times after the application of interventions intended to alleviate the impairments of body function and structure, activity limitations, and participation restrictions associated with an acute LAS or CAI.C Clinicians may use the Pain Self-Efficacy Questionnaire in the acute and postacute periods after a LAS to assess effective coping strategies for pain, and the 11-item Tampa Scale of Kinesiophobia and the Fear-Avoidance Beliefs Questionnaire to assess fear of movement and reinjury and fear-avoidance beliefs in those with CAI. EXAMINATION -PHYSICAL IMPAIRMENT MEASURESA Clinicians should assess and document ankle swelling, ROM, talar translation, talar inversion, and single-leg balance in patients with an acute LAS, postacute LAS, or CAI at baseline and 2 or more times over an episode of care. Clinicians should specifically include measures of dorsiflexion, using the weight-bearing lunge test, static single-limb balance on a firm surface with eyes...

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Section: Pathoanatomical Features Update 2021mentioning

confidence: 99%

Section: Evidence Updatementioning

confidence: 99%

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Martin¹,

Davenport²,

Fraser³

et al. 2021

Journal of Orthopaedic & Sports Physical Therapy

102

View full text Add to dashboard Cite

show abstract

“…Over the past decades, surgical and scientific attention has been focused on medially located lesions of the talar dome. However, as we are aware of the fact that 24% of the OLTs are located on the lateral talar dome and that the laterally located OLTs are associated with chronic lateral ankle instability, there is a clinical need to present surgical techniques that are amenable and effective for laterally located OLTs [ 2 , 37 , 40 , 41 , 43 ]. Moreover, it is stated that concomitant lateral ankle instability is considered a negative prognostic factor regarding the clinical outcomes of surgical treatment of OLTs [ 17 , 20 , 27 ].…”

Section: Surgical Principle and Objectivementioning

confidence: 99%

Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for lateral osteochondral lesions of the talus: operative technique

Dahmen

Rikken

Kerkhoffs

et al. 2023

Oper Orthop Traumatol

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Objective To provide a natural scaffold, good quality cells, and growth factors to facilitate replacement of the complete osteochondral unit with matching talar curvature for large osteochondral lesions of the lateral talar dome. Indications Symptomatic primary and non-primary lateral osteochondral lesions of the talus not responding to conservative treatment. The anterior–posterior or medial–lateral diameter should exceed 10 mm on computed tomography (CT) for primary lesions; for secondary lesions, there are no size limitations. Contraindications Tibiotalar osteoarthritis grade III, malignancy, active infectious ankle joint pathology, and hemophilic or other diffuse arthropathy. Surgical technique Anterolateral arthrotomy is performed after which the Anterior TaloFibular Ligament (ATFL) is disinserted from the fibula. Additional exposure is achieved by placing a Hintermann distractor subluxating the talus ventrally. Thereafter, the osteochondral lesion is excised in toto from the talar dome. The recipient site is micro-drilled in order to disrupt subchondral bone vessels. Thereafter, the autograft is harvested from the ipsilateral iliac crest with an oscillating saw, after which the graft is adjusted to an exactly fitting shape to match the extracted lateral osteochondral defect and the talar morphology as well as curvature. The graft is implanted with a press-fit technique after which the ATFL is re-inserted followed by potential augmentation with an InternalBrace™ (Arthrex, Naples, FL, USA). Postoperative management Non-weightbearing cast for 6 weeks, followed by another 6 weeks with a walking boot. After 12 weeks, a computed tomography (CT) scan is performed to assess consolidation of the inserted autograft. The patient is referred to a physiotherapist.

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“…14 However, a more recent retrospective case series (Level IV) revealed that the reoperation rate was actually lower in patients with peroneal pathology compared with others (8.7% vs 27.5%, P = .032) which was attributed to a more comprehensive initial surgery. 2 The senior authors routinely perform ankle arthroscopy at the time of ligamentous stabilization because of the high rate of intra-articular lesions in this patient population, including OTLs and soft-tissue or bony impingement.…”

Section: Associated Pathologymentioning

confidence: 99%

Lateral Ankle Sprain and Chronic Ankle Instability

Sarcon

Heyrani

Giza

et al. 2019

Foot & Ankle Orthopaedics

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A select 10-30% of patients with recurrent lateral ankle sprains develop chronic ankle instability (CAI). Patients with chronic ankle instability describe a history of the ankle "giving way" with or without pathological laxity on examination. Evaluation includes history, identification of predisposing risk factors for recurrent sprains, and the combination of clinical tests (eg, laxity tests) with imaging to establish the diagnosis. There are a variety of nonoperative strategies to address chronic ankle instability, which include rehabilitation and taping or bracing to prevent future sprains. Patients who fail conservative treatment are candidates for surgery. The anatomic approaches (eg, modified Broströ m) are preferred to nonanatomic procedures since they recreate the ankle's biomechanics and natural course of the attenuated ligaments. There is a growing interest in minimally invasive procedures via ankle arthroscopy that also address the associated intra-articular disorders. This article provides a review of chronic lateral ankle instability consisting of relevant anatomy, associated disorders, evaluation, treatment methods, and complications.

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Revisiting the Prevalence of Associated Copathologies in Chronic Lateral Ankle Instability: Are There Any Predictors of Outcome?

Abstract: Level III: Retrospective cohort.

Cited by 14 publications

References 24 publications

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for lateral osteochondral lesions of the talus: operative technique

Lateral Ankle Sprain and Chronic Ankle Instability

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