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Zhang L, Sun X, Jiang L, Zhou X, Shi H, Yang Y, Cai M, Wang G. The morphology of osseous structure in subtalar joint with chronic ankle instability. Foot Ankle Surg 2024; 30:74-78. [PMID: 37748980 DOI: 10.1016/j.fas.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 07/22/2023] [Accepted: 09/19/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Osseous structures have been demonstrated as risk factors for chronic ankle instability (CAI). Previously, the researchers only focused on the osseous structures of ankle, but ignored the osseous structures of subtalar joint(STJ). Accordingly, the aim of our study was to investigate the morphological characteristics of STJ osseous structures in CAI. METHODS 52 patients with CAI and 52 sex- and age- matched control subjects were enrolled from The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University. The lateral radiographs of ankle in weight-bearing were used to compare the diversity of the two groups. Specifically, The Length of calcaneus, Calcaneal facet height and Absolute foot height, Böhler's angle, Gissane's angle, Calcaneal inclination angle, Talocalcaneal angle, Tibiotalar angle, Tibiocalcaneal angle, Talar-horizontal angle, talar declination angle, facet inclination angle were gauged in the two groups. RESULTS The Böhler's angle, Calcaneal inclination, Talocalcaneal angle, Tibiotalar angle, Talar-horizontal angle, Talar declination angle, Facet inclination angle and Absolute foot height of CAI group were significantly higher than normal control group (P < 0.05). There were no significant differences in Gissane's angle, Tibiocalcaneal angle, Length of calcaneus and Calcaneal facet height between patients with CAI and normal controls (P > 0.05). CONCLUSIONS The osseous structures of STJ in CAI patients are different from normal people in morphology. Therefore, we should pay more attention to the changes of STJ anatomical parameters in the diagnosis and prevention of CAI. LEVEL OF EVIDENCE Ⅲ.
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Affiliation(s)
- Lei Zhang
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China; Center for Orthopedic Diseases Research, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China
| | - Xinghao Sun
- School of Clinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Lu Jiang
- School of Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou 646000, China
| | - Xin Zhou
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China; Center for Orthopedic Diseases Research, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China
| | - Houyin Shi
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China; Center for Orthopedic Diseases Research, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China
| | - Yuening Yang
- School of Clinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Mingyang Cai
- School of Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou 646000, China
| | - Guoyou Wang
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China; Center for Orthopedic Diseases Research, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China.
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Zhang J, Yang K, Wang C, Gu W, Li X, Fu S, Song G, Wang J, Wu C, Zhu H, Shi Z. Risk factors for chronic ankle instability after first episode of lateral ankle sprain: A retrospective analysis of 362 cases. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:606-612. [PMID: 36931594 PMCID: PMC10466191 DOI: 10.1016/j.jshs.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/12/2022] [Accepted: 02/18/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Chronic ankle instability (CAI) is a common sequela following an acute lateral ankle sprain (LAS). To treat an acute LAS more effectively and efficiently, it is important to identify patients at substantial risk for developing CAI. This study identifies magnetic resonance imaging (MRI) manifestations for predicting CAI development after a first episode of LAS and explores appropriate clinical indications for ordering MRI scans for these patients. METHODS All patients with a first-episode LAS who received plain radiograph and MRI scanning within the first 2 weeks after LAS from December 1, 2017 to December 1, 2019 were identified. Data were collected using the Cumberland Ankle Instability Tool at final follow-up. Demographic and other related clinical variables, including age, sex, body mass index, and treatment were also recorded. Univariable and multivariable analyses were performed successively to identify risk factors for CAI after first-episode LAS. RESULTS A total 131 out of 362 patients with a mean follow-up of 3.0 ± 0.6 years (mean ± SD; 2.0-4.1 years) developed CAI after first-episode LAS. According to multivariable regression, development of CAI after first-episode LAS was associated with 5 prognostic factors: age (odds ratio (OR) = 0.96, 95% confidence interval (95%CI): 0.93-1.00, p = 0.032); body mass index (OR = 1.09, 95%CI: 1.02-1.17, p = 0.009); posterior talofibular ligament injury (OR = 2.17, 95%CI: 1.05-4.48, p = 0.035); large bone marrow lesion of the talus (OR = 2.69, 95%CI: 1.30-5.58, p = 0.008), and Grade 2 effusion of the tibiotalar joint (OR = 2.61, 95%CI: 1.39-4.89, p = 0.003). When patients had at least 1 positive clinical finding in the 10-m walk test, anterior drawer test, or inversion tilt test, they had a 90.2% sensitivity and 77.4% specificity in terms of detecting at least 1 prognostic factor by MRI. CONCLUSION MRI scanning is valuable in predicting CAI after first-episode LAS for those patients with at least 1 positive clinical finding in the 10-m walk test, anterior drawer test, and inversion tilt test. Further prospective and large-scale studies are necessary for validation.
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Affiliation(s)
- Jieyuan Zhang
- National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai 200233, China; Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai 200233, China
| | - Kai Yang
- Department of Radiology, Shanghai Sixth People's Hospital, Shanghai 200233, China
| | - Cheng Wang
- National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai 200233, China; Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai 200233, China
| | - Wenqi Gu
- National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai 200233, China; Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai 200233, China
| | - Xueqian Li
- National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai 200233, China; Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai 200233, China
| | - Shaoling Fu
- National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai 200233, China; Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai 200233, China
| | - Guoxun Song
- National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai 200233, China; Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai 200233, China
| | - Jiazheng Wang
- National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai 200233, China; Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai 200233, China
| | - Chenglin Wu
- National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai 200233, China; Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai 200233, China
| | - Hongyi Zhu
- National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai 200233, China; Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai 200233, China; Institute of Clinical Research, National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai 200233, China.
| | - Zhongmin Shi
- National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai 200233, China; Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai 200233, China.
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Kleipool RP, Stufkens SAS, Dahmen J, Vuurberg G, Streekstra GJ, Dobbe JGG, Blankevoort L, Knupp M. Difference in orientation of the talar articular facets between healthy ankle joints and ankle joints with chronic instability. J Orthop Res 2022; 40:695-702. [PMID: 33913551 PMCID: PMC9291144 DOI: 10.1002/jor.25068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 03/31/2021] [Accepted: 04/26/2021] [Indexed: 02/04/2023]
Abstract
Since both the talocrural and subtalar joints can be involved in chronic ankle instability, the present study assessed the talar morphology as this bone is the key player between both joint levels. The 3D orientation and curvature of the superior and the posteroinferior facet between subjects with chronic ankle instability and healthy controls were compared. Hereto, the talus was segmented in the computed tomography images of a control group and a chronic ankle instability group, after which they were reconstructed to 3D surface models. A cylinder was fitted to the subchondral articulating surfaces. The axis of a cylinder represented the facet orientation, which was expressed by an inclination and deviation angle in a coordinate system based on the cylinder of the superior talar facet and the geometric principal axes of the subject's talus. The curvature of the surface was expressed as the radius of the cylinder. The results demonstrated no significant differences in the radius or deviation angle. However, the inclination angle of the posteroinferior talar facet was significantly more plantarly orientated (by 3.5°) in the chronic instability group (14.7 ± 3.1°) compared to the control group (11.2 ± 4.9°) (p < 0.05). In the coronal plane this corresponds to a valgus orientation of the posteroinferior talar facet relative to the talar dome. In conclusion, a more plantarly and valgus orientated posteroinferior talar facet may be associated to chronic ankle instability.
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Affiliation(s)
- Roeland P. Kleipool
- Department of Medical Biology, Amsterdam UMCUniversity of Amsterdam, Amsterdam Movement SciencesAmsterdamThe Netherlands,Academic Center for Evidence‐Based Sports Medicine (ACES)AmsterdamThe Netherlands
| | - Sjoerd A. S. Stufkens
- Academic Center for Evidence‐Based Sports Medicine (ACES)AmsterdamThe Netherlands,Department of Orthopedic Surgery, Amsterdam UMCUniversity of Amsterdam, Amsterdam Movement SciencesAmsterdamThe Netherlands,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research CenterAmsterdamThe Netherlands
| | - Jari Dahmen
- Academic Center for Evidence‐Based Sports Medicine (ACES)AmsterdamThe Netherlands,Department of Orthopedic Surgery, Amsterdam UMCUniversity of Amsterdam, Amsterdam Movement SciencesAmsterdamThe Netherlands,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research CenterAmsterdamThe Netherlands
| | - Gwendolyn Vuurberg
- Academic Center for Evidence‐Based Sports Medicine (ACES)AmsterdamThe Netherlands,Department of Orthopedic Surgery, Amsterdam UMCUniversity of Amsterdam, Amsterdam Movement SciencesAmsterdamThe Netherlands,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research CenterAmsterdamThe Netherlands,Department of Radiology and Nuclear medicine, Amsterdam UMCUniversity of Amsterdam, Amsterdam Movement SciencesAmsterdamThe Netherlands,Department of Radiology and Nuclear medicineRijnstate ZiekenhuisArnhemThe Netherlands
| | - Geert J. Streekstra
- Department of Biomedical Engineering and Physics, Amsterdam UMCUniversity of Amsterdam, Amsterdam Movement SciencesAmsterdamThe Netherlands
| | - Johannes G. G. Dobbe
- Department of Biomedical Engineering and Physics, Amsterdam UMCUniversity of Amsterdam, Amsterdam Movement SciencesAmsterdamThe Netherlands
| | - Leendert Blankevoort
- Academic Center for Evidence‐Based Sports Medicine (ACES)AmsterdamThe Netherlands,Department of Orthopedic Surgery, Amsterdam UMCUniversity of Amsterdam, Amsterdam Movement SciencesAmsterdamThe Netherlands,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research CenterAmsterdamThe Netherlands
| | - Markus Knupp
- Mein Fusszentrum, BaselUniversity of BaselSwitzerland
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Su BY, Yi SY, Peng T, Yi G, Zhang L. Comparison of Arthroscopic Surgery Versus Open Surgical Repair of the Anterior Talofibular Ligament: A Retrospective Study of 80 Patients from a Single Center. Med Sci Monit 2021; 27:e928526. [PMID: 33587726 PMCID: PMC7893828 DOI: 10.12659/msm.928526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background This retrospective study from a single center aimed to compare the safety and clinical outcomes of arthroscopic surgery vs open surgical repair of the anterior talofibular ligament (ATFL). Material/Methods We randomly divided 80 patients with ATFL injury divided into 2 groups: an open surgery group and an arthroscopic group. The operation time, intraoperative bleeding volume, and the postoperative recovery time of all patients were analyzed. The anterior displacement and talus tilt angle, the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS), the Jersey Shore Science Fair (JSSF) ankle-hindfoot scale score, and the Karlsson Ankle Functional Score (KAFS) were compared at 6 months, 1 year, and 2 years after surgery. We collected data on the incidence of postoperative complications during follow-up. All significant results were supported with a P value. Results The operation time, intraoperative bleeding volume, and postoperative recovery time in the arthroscopic group were better than in the open group (P<0.05). The AOFAS, JSSF, and KAFS in the arthroscopic group were better than in the open group at 6 months after the operation (P<0.05). The AOFAS, JSSF, and KAFS scale scores were not significantly different between the 2 groups at 1 year and 2 years after the operation (P<0.05). Conclusions The findings from this retrospective study showed that the use of arthroscopic surgical repair of the ATFL is a safe minimally invasive technique with reduced blood loss and surgical duration and good clinical outcomes.
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Affiliation(s)
- Bo-Yuan Su
- Department of Orthopedics, Dongguan Hospital of Traditional Chinese Medicine, Dongguan, Guangdong, China (mainland)
| | - Shu-Yun Yi
- Department of Orthopedics, Zengcheng Branch of South Hospital of Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Ting Peng
- Clinical Medical College of Southwest Medical University, Luzhou, Sichuan, China (mainland)
| | - Gang Yi
- Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China (mainland).,Center for Orthopedic Diseases Research, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China (mainland).,Expert Workstation in Luzhou, Luzhou, Sichuan, China (mainland).,Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center, Luzhou, Sichuan, China (mainland)
| | - Lei Zhang
- Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China (mainland).,Center for Orthopedic Diseases Research, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China (mainland).,Expert Workstation in Luzhou, Luzhou, Sichuan, China (mainland).,Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center, Luzhou, Sichuan, China (mainland)
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Abstract
Ankle sprains are one of the most common musculoskeletal injuries, being the most frequent musculoskeletal trauma among athletes. Most of these injuries are successfully treated conservatively; however, up to 70% of patients can develop long-lasting symptoms. Therefore, understanding prognostic factors for an ankle sprain could help clinicians identify patients with poor prognosis and choose the right treatment. A suggested approach will be presented in order to positively identify the factors that should warrant a more aggressive attitude in the initial conservative treatment. There are some prognostic factors linked to a better recovery and outcome; nevertheless, prognostic factors for full recovery after initial ankle sprain are not consistent.
Cite this article: EFORT Open Rev 2020;5:334-338. DOI: 10.1302/2058-5241.5.200019
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Affiliation(s)
| | - João Vide
- Department of Orthopaedics, Hospital Beatriz Ângelo, Portugal
| | - Daniel Mendes
- Department of Orthopaedics, Hospital Beatriz Ângelo, Portugal
| | - João Protásio
- Department of Orthopaedics, Hospital Beatriz Ângelo, Portugal
| | - Rui Viegas
- Department of Orthopaedics, Hospital Beatriz Ângelo, Portugal
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