• 한국운동역학회지
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• 제29권2호
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• pp.61-70
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• 2019

Objective: This study aimed to investigate the characteristics of the declination of the subtalar joint rotation axis and the structural features of the ankle joint complex such as rear-foot angle alignment and ligament laxity test between chronic ankle instability (CAI) patients and healthy control. Method: A total of 76 subjects and CAI group (N=38, age: $23.11{\pm}7.63yrs$, height: $165.67{\pm}9.54cm$, weight: $60.13{\pm}11.71kg$) and healthy control (N=38, age: $23.55{\pm}7.03yrs$, height: $167.92{\pm}9.22cm$, weight: $64.58{\pm}13.40kg$) participated in this study. Results: The declination of the subtalar joint rotation axis of the CAI group was statistically different from healthy control in both sagittal slope and transverse slope. The rear-foot angle of CAI group was different from a healthy control. Compared to healthy control, they had the structure of rear-foot varus that could have a high occurrence rate of ankle varus sprain. CAI group had loose ATFL and CFL compared to the healthy control. Conclusion: The results of this study showed that the deviation of the subtalar joint rotation axis and the structural features of the ankle joint complex were different between the CAI group and the healthy control and this difference is a meaningful factor in the occurrence of lateral ankle sprains.

• 대한족부족관절학회지
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• 제10권2호
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• pp.274-278
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• 2006

Lateral malleolar bursitis rarely progresses to septic arthritis. In our case, the 27 year old man visited due to progressive left ankle pain, despite the antibiotics treatment of lateral malleolar bursitis. 8 years ago, modified Brostrom procedure was performed owing to chronic ankle instability. Previous surgery altered anatomical structure of lateral ankle bursa, so it may cause the infection to spread to the ankle joint. We reported rare case of secondary septic arthritis caused by lateral malleolar bursitis.

• 한국전문물리치료학회지
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• 제28권3호
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• pp.200-207
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• 2021

Background: Postural control deficit is a major characteristic in patients with chronic ankle instability (CAI). Elastic ankle tapings are commonly used to facilitate postural control in patients with CAI as well as prevent relapse of a lateral ankle sprain. However, equivocal evidence exists concerning the effect of elastic ankle taping on postural control. Objects: This study aimed to evaluate the effects of elastic ankle tapings using kinesio taping (KT) and dynamic taping (DT) on static and dynamic postural control in patients with CAI. Methods: Fifteen subjects with CAI were participated in this study. The participants performed tests under three conditions (barefoot, KT, and DT). Static postural control was evaluated using the one-leg standing test (OLST) and dynamic postural control using the modified Star Excursion Balance Test (mSEBT). One-way repeated-measures analysis of variance was used to compare center of pressure (CoP) data and normalized mSEBT reach distances among the three conditions (with α = 0.05). Results: The CoP parameters (path length, ellipse area, and mean velocity) of the OLST significantly decreased on applying KT and DT compared with those when barefoot. The normalized reach distances in the anteromedial (AM), medial (M), and posteromedial (PM) directions of the mSEBT significantly increased with DT compared to that in the control condition. Further, the higher reach distances with KT compared with those in the control condition were obtained in the M and PM directions of the mSEBT. No significant differences were identified in any of the OLST and SEBT parameters between the two different taping applications. Conclusion: KT and DT improved static postural control during the OLST compared with the control condition. Moreover, these tapes improved dynamic postural control during the mSEBT compared to the control. Therefore, elastic ankle tapings are useful prophylactic devices for the prevention and treatment of ankle sprain in people with CAI.

• 대한족부족관절학회지
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• 제27권4호
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• pp.137-143
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• 2023

Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 2007년도 학술대회
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• pp.38-38
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• 2007

• 대한족부족관절학회지
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• 제14권1호
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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.

• Korean Journal of Radiology
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• 제22권3호
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• pp.384-394
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• 2021

Objective: To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods: This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student's t test, and Pearson's correlation coefficient. Results: T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). Conclusion: CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.

• 대한족부족관절학회지
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• 제16권4호
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• pp.241-246
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• 2012

Purpose: The purpose of our study was to perform a comparison of the outcomes of the modified Brostrom procedure using only a suture anchor compared with using a suture anchor with a pushlock anchor. Materials and Methods: This was a retrospective study of chronic lateral ankle instability that underwent a modified Brostrom procedure using a bioabsorbable suture anchor & a pushlock anchor, performed by a single surgeon. A total of 88 patients were enrolled in the study. The function of the patient's ankles were scored using the American Orthopaedic Foot and Ankle Society (AOFAS), visual analogue scale (VAS) both preoperatively and postoperatively. Results: The difference in the overall means between the group A and group B was not statistically significant. But, the patient's satisfaction was better in the group B, and there were more complications in the group A. Conclusion: The technique presented here uses the modified Brostrom procedure with pushlock anchors to prevent the problems associated with subcutaneous knot irritation.

• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.1-9
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• 2021

Objective: Joint mobilization for arthrokinematics altered by the positional fault of chronic ankle instability (CAI) is an effective intervention for stabilization. In this study, we compared the effects of ankle dorsi flexion range of motion (DFROM) and dynamic balance ability (DBA) in CAI patients via passive joint mobilization (PJM), a method traditionally performed in previous studies, and active joint mobilization (AJM), a method that can have a greater effect on cortical excitability with spontaneous movements. Design: Single-blind two-arm randomized controlled trial Methods: A total of 30 participants were registered: 15 each to the PJM and AJM groups. Each participant received a total of 10 intervention sessions, 10 minutes per session, 5 times a week for 2 weeks. PJM used Maitland's mobilization method to apply joint mobilization with talus in the posterior direction and AJM used an angular joint motion to induce patient's voluntary motion of medial malleolus anterior gliding and lateral malleolus posterior gliding, respectively. DFROM of the ankle was measured by using tape and DBA was evaluated by using the balance system. Results: Significant improvement was observed after intervention in both the PJM and AJM groups except for the DBA-anterior and DBA-right variables of the PJM group. There were statistically significant differences between the AJM and PJM groups in the DFROM, DBA-anterior, DBA-posterior, and DBA-right variables. Conclusions: The overall improvement of DFROM and DBA was found to be more effective in joint mobilization including voluntary movement. When it is accompanied by voluntary movement, it further affects the neuromuscular system of the ankle.

• 대한정형외과스포츠의학회지
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• 제10권1호
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• pp.35-40
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• 2011

목적: 만성 발목 관절 외측 불안정성 환자에 대한 기계적 불안정성의 평가에서 스트레스 방사선검사의 진단적 유용성을 알아보고자 하였다. 대상 및 방법: 본원에서 변형 Brostrom 술식을 시행받은 환자들 중 수술 소견상 외측 측부인대(전 거비 인대)의 완전 파열이 확인되었던 42예를 대상으로 하였다. 대조군으로는 발목 관절 손상의 과거력이 없고 이학적 검사상 불안정성 소견을 보이지 않는 정상 한국인 성인 총 60명(120예)을 모집하였다. Telos 기구를 이용한 전방 전위 및 내반 스트레스 검사를 시행한 뒤, 거골 경사각과 거골 전방전위 정도를 계측하였다. 대조군에서 얻어진 정상범위를 기준으로 스트레스 방사선검사의 민감도, 특이도, 양성 예측도, 음성 예측도를 분석하였다. 결과: 스트레스 방사선검사 상 정상 한국인 성인에서의 거골 경사각은 평균 $4.2{\pm}2.1$도, 거골 전방전위는 평균 $3.9{\pm}1.9$ mm로 계측되었다. 95% 신뢰한계 분석을 이용한 정상 범위의 설정시 거골 경사각의 정상 범위는 8.3도 이하, 거골 전방전위는 7.6 mm 이하로 분석되었다. 이 수치를 기준값으로 하는 경우 발목 관절 스트레스 방사선검사 상 거골 경사각의 민감도는 57%, 특이도는 97%, 양성 예측도는 89%, 음성 예측도는 86% 였고, 거골 전방전위의 민감도는 69%, 특이도는 97%, 양성 예측도는 91%, 음성 예측도는 90% 였다. 결론: 만성 발목 관절 외측 불안정성 환자에 대한 기계적 불안정성의 평가에서 스트레스 방사선검사는 비교적 우수한 특이도 및 양성, 음성 예측도를 보였으나 민감도는 낮아, 유용하지만 정확성은 떨어지는 검사법인 것으로 분석되었다. 기계적 불안정성이 발목 관절 스트레스 방사선검사 상 실제보다 덜 반영된다고 생각되며, 스트레스 방사선검사 소견만으로 발목 관절 외측 불안정성을 배제해서는 안 될 것으로 생각한다.