• Title/Summary/Keyword: Ankle instability

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Severe Ankle Osteoarthritis: Treatment with Total Ankle Arthroplasty (중증 족관절 관절염: 족관절 전치환술)

  • Jeong, Bi O;Jung, Hyuk
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.1
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    • pp.8-15
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    • 2018
  • Ankle osteoarthritis is a debilitating condition that causes severe pain associated with functional impairment and decreased activity. Ankle osteoarthritis, unlike that of the knee or hip joint, is rare in primary arthritis. Most cases are traumatic arthritis that occur after ankle sprain or fractures or chronic ankle instability. Although ankle fusion has been regarded as the standard treatment of ankle osteoarthritis in the past, total ankle arthroplasty (TAA) is increasing due to the development of the implant design and surgical techniques. TAA is biomechanically superior to ankle fusion by preserving the movement of the ankle joint. In particular, it is functionally superior to ankle fusion because it enables normal joint motion during gait. In addition, there is an advantage of preserving the movement of the hindfoot and reducing the abnormal stress applied to the adjacent joints after ankle fusion to prevent the occurrence of long-term adjacent joint arthritis. Although the short-term and mid-term results of TAA have been reported to be excellent, long-term follow-up has a relatively low survival rate and high complication rate compared to total knee or hip arthroplasty. Therefore, continuous and further research is needed.

Ankle Arthrodesis in Very Unstable Charcot Arthropathy using Autogenous Fibular Strut Bone Graft (A Case Report) (매우 불안정한 족관절 골관절병증에서 지주형태 자가 비골을 이용한 관절유합술(1예 보고))

  • Suh, Jin-Soo;Chung, Hyun-Wook;Lee, Woo-Chun;Moon, Jeong-Seok;Choi, Jun-Young
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.95-98
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    • 2009
  • Charcot arthropathy of the foot and ankle is characterized by a combination of sensory, motor and autonomic peripheral neuropathy leading to gross swelling, bony destruction and finally severe bony deformity with joint instability. We report a case of very unstable Charcot arthropathy in ankle joint managed with ankle arthrodesis using fibular strut bone grafting technique.

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Evidence-based Treatment of Acute Lateral Ankle Sprain (근거에 기반한 급성 발목관절 외측 염좌의 치료)

  • Cho, Byung-Ki
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.4
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    • pp.135-144
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    • 2018
  • Acute lateral ankle sprain, which is the most common musculoskeletal injury, can be treated effectively with appropriate evidence-based initial care using PRICE (protection, rest, ice, compression, and elevation) and functional rehabilitation. Many systemic reviews reporting a high-level of evidence supporting the clinical usefulness and necessity of primary surgical repair for acute lateral ankle sprain have been insufficient. Regardless of the severity of ligament complex injuries, the surgical treatment for acute lateral ankle sprain without concomitant pathologies is not recommended and should be considered only in young professional athletes with complete ligament rupture (grade III) and severe instability.

Anatomical Reconstruction of the Lateral Ankle Ligaments using Semitendinosus (반건양근 건을 이용한 족관절 외측 인대의 해부학적 재건)

  • Lee, Woo-Chun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.19-23
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    • 2008
  • Purpose: Several methods of anatomical reconstruction for chronic lateral ankle instability has been reported to avoid the problems of nonanatomical reconstruction. Precise reconstruction of the normal anatomy is essential to the restoration of normal joint mechanics and stability. The problem with anatomical reconstruction is that it is very difficult to reconstruct the normal anatomic course of the ligaments. We thought making one tunnel at the fibular attachment of anterior talofibular ligament and calcaneofibular ligament was more anatomical than making separate tunnels for each ligaments because the two ligaments are contiguous. In this article, the basis of anatomical reconstruction of the lateral ankle ligaments was reviewed and a technique of reconstruction using semitendinosus was introduced.

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Plantar Hypoesthesia Alters Gait Kinematics Pattern in Individuals with and without Chronic Ankle Instability (만성 발목 불안정성 환자군과 정상인 군의 발바닥 감각기능 저하에 따른 운동학적 보행 패턴의 변화)

  • Kang, Tae Kyu;Lee, Sae Yong;Lee, Inje;Kim, Byong Hun;Jeong, Hee Seong;Kim, Chang Young
    • Korean Journal of Applied Biomechanics
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    • v.31 no.2
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    • pp.79-86
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    • 2021
  • Objective: The purpose of this study was to identify the effect of reduced plantar cutaneous sensation on gait kinematics during walking with and without CAI. Method: A total of 20 subjects involved in this study and ten healthy subjects and 10 CAI subjects participated underwent ice-immersion of the plantar aspect of the feet before walking test in this study. The gait kinematics were measured before and after ice-immersion. Results: We observed a before ice-immersion on plantar cutaneous sensation, CAI subject were found to reduced ankle dorsiflexion, knee external rotation, hip adduction, and internal rotation compared to control subject. After ice-immersion, CAI subjects were found to reduce knee external rotation, hip adduction. However, no significant ankle joint kinematics. Conclusion: While walking, gait pattern differences were perceived between groups with and without plantar cutaneous sensation. The results of the study may explain the abductions in the hip angle movements in CAI patients at initial contact compared to healthy subjects in the control group when plantar cutaneous sensation was reduced. A change in proximal joint kinematics may be a conservative strategy to promote normal gait patterns in CAI patients.

Novel Balance Tests for Assessing Functional Ankle Instability: Relationships with BMI and Gender (기능적 족관절 불안정성을 평가할 수 있는 새로운 균형 평가법: 체질량 지수와 성별과의 연관성)

  • Patankar, Harshad P.;Yeo, Eui-Dong;Kim, Seung-Joo;Lim, Hong-Chul;Hwang, Myong-Hoi;Park, Se-Hyun;Kim, Hak-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.128-134
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    • 2012
  • Purpose: To design novel balance tests to assess FAI and evaluate whether these tests are affected by BMI or gender, with the goal of developing reliable FAI assessment tests that are not influenced by these factors. Materials and Methods: Participants included 20 young, healthy volunteers, 12 males and 8 females, with a mean age of $24{\pm}4$ years and a mean BMI of $23{\pm}2.28$. None of the subjects had known ankle instability. The following tests were assessed in each participant: single leg balance (SLB), percentage of leg press (PLP), single leg cycling (SLC), one leg squat (OLS), multiple direction reach-front/back/side (MDR-F/B/S), single leg hop (SLH), two leg jump (TLJ) and side step (SS). Data were analyzed using the SPSS 12.0 software program with ANOVA and t-test used. Results: When grouped by BMI, we found that despite differences in BMI, the performances of all subjects were equivalent except for the one-leg-squat test, for which the mean ratios for underweight ($1.69{\pm}0$), normal weight ($1.05{\pm}0.19$), and overweight ($0.93{\pm}0.30$) individuals were significantly different (p=0.02); ratios for SLB (p=0.273), SLC (p=0.903), PLP (p=0.664), MDR-F/B/S (p=0.498, 0.908, and 0.503, respectively), SLH (p=0.332) were not significantly different. When calculated according to gender, we found that the OLS (p=0.013) and MDRS (p=0.034) were significantly different, while parameters for all the remaining tests were not affected. Conclusion: We found that the SLB, PLP, SLC, MDR-F/B, and SLH ratios were unaffected by BMI or sex and, therefore, are reliable parameters for assessing ankle instability.

Radiographic Measurement of Ankle Lateral Stability in Normal Korean Adults (정상 한국 성인에서 발목관절 외측 안정성의 방사선학적 계측)

  • Shon, Hyun-Chul;Kim, Yong-Min;Kim, Dong-Soo;Choi, Eui-Sung;Park, Kyoung-Jin;Cho, Byung-Ki;Park, Ji-Kang;Hong, Kyung-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.41-46
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    • 2010
  • Purpose: Anterior drawer and varus stress test are commonly used for radiologic evaluation of chronic lateral ankle instability. However, there are controversies regarding the method of measurement and the normal value. This study was performed to investigate radiologic normal values in normal Korean adults and to analyze differences by age and gender. Materials and Methods: Sixty Korean adults were recruited and divided in three groups (20 in their twenties, 20 in their thirties, 20 in their forties). There were 10 males and 10 females in each group. The selection criteria were no history of ankle injury and no evidence of instability on physical examination. Radiologic measurement of varus talar tilt and anterior talar translation were performed through anterior and varus stress radiographs using Telos device (150N force). The measurement was repeated twice by three researchers, and intraobserver reproducibility and interobserver reliability were analyzed. The average talar tilt and anterior talar translation were obtained. Results: Talar tilt and anterior talar translation on ankle stress radiographs had good intraobserver reproducibility and interobserver reliability. Talar tilt was average $3.7^{\circ}$ and $5.1^{\circ}$ in male and female of twenties of age, $3.9^{\circ}$ and $4.8^{\circ}$ in their thirties, $3.4^{\circ}$ and $4.5^{\circ}$ in their forties. Anterior talar translation was average 3.5 mm and 4.2 mm in their twenties, 4.1 mm and 3.8 mm in their thirties, 3.6 mm and 4.1 mm in their forties. There was no significant difference in talar tilt and anterior talar translation by age. However, there was significant difference in talar tilt by gender. Conclusion: Normal range of talar tilt angle in Korean adults was below $8.3^{\circ}$, and normal range of anterior talar translation was below 7.6 mm. It seems to be able to serve as a good reference for radiologic evaluation and for treatment of chronic lateral ankle instability.

Comparison of the Modified Brostrom Repair Technique with and without Augmentation Using Suture Tape for Chronic Ankle Instability (만성 족관절 불안정성을 가진 환자군에서 변형 브로스트롬 술식과 봉합 테이프를 추가한 술식 간의 결과 비교)

  • Gwak, Heui-Chul;Jung, Soo-Hwan;Kim, Jung-Han;Park, Dae-Hyun;Choo, Hye-Jung;Kim, Dae-Yoo
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.1
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    • pp.40-47
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    • 2022
  • Purpose: The modified Broström repair (BR) technique has yielded good outcomes in patients with chronic ankle instability. This study compared clinical and radiological outcomes between two groups of patients who underwent modified BR or lateral ligament augmentation using suture tapes (ST). Materials and Methods: Seventy-seven patients (ST group [n=47], BR group [n=30]; body mass index <26.61 kg/m2; mean age, 30.7±11.0 years [range, 17~39 years]; mean follow-up, 34.0±12.0 months [range, 24~59 months]) were retrospectively reviewed between January 2014 and July 2017. The Foot and Ankle Outcome Score (FAOS), American Orthopedic Foot and Ankle Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS) score, and Sefton grading system were used for clinical assessment. The talar tilt angle and anterior talar translation were measured using the Telos stress device (Telos GmbH, Marburg, Germany) at 150 N for radiological evaluation. Results: FAOS, AOFAS, FAAM, and VAS scores improved in both groups at final follow-up (ST, 91.1±5.2, 93±2, 88.1±4.5, 1.5±0.7 vs. BR, 91.3±5.4, 93±3, 83.3±4.8, 1.2±0.7, respectively; p=0.854, 0.971, <0.001, 0.04, respectively). According to the FAOS, mean sports activity scores for the ST and BR groups at the final follow-up were 90.3±3.2 and 76.6±4.2, respectively, reflecting superior outcomes in the ST group (p<0.001). Sefton grading revealed satisfactory functional outcomes (ST, 91.5% vs. BR, 90.0%). There was significant improvement in the talar tilt angle and anterior talar translation in both the ST and BR groups (7.6°±1.2°, 10.5±1.8 mm vs. 4.9°±1.1°, 7.9±1.5 mm, respectively; p<0.001). Conclusion: The ST group demonstrated comparable clinical but better improvement in mechanical stability and FAOS sports scores than the BR group.