Abstract
The purpose of this study was to evaluate prospectively the findings during arthroscopy in patients with chronic instability of the ankle joint. One hundred and ten consecutive patients who had suffered at least two ankle sprains and were symptomatic for at least 6 months were included in this study. A complete rupture of the anterior talofibular ligament was found in 64%, of the calcancofibular ligament in 41% and of the deltoid ligament in 6%. Cartilage lesions of the talus were seen in 54% of the joints, more of them medial (56%) than lateral (15%) or ventral (20%). Other frequently observed findings were synovialitis (38%), rupture of the syndesmosis (7%), and ventral scarring (6%). While cartilage damage was found independently of the lateral ligament injuries, all complete tears of the deltoid ligament were associated with cartilage injury of the talus. Medial instability was assessed in five ankles clinically and found arthroscopically in 23 ankle joints. Our arthroscopic findings show that chronic instability of the ankle joint is associated with various pathological conditions of ligaments, capsule and cartilage. It can therefore give essential information about the status of the chronic unstable joint with regard to the choice of operative or conservative treatment.
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References
Albert J, Reiman P, Njus G, Kay DB, Theken R (1992) Ligament strain and ankle joint opening during ankle distraction. Arthroscopy 8: 469–473
Cass JR, Settles H (1994) Ankle instability: in vitro kinematics in response to axial load. Foot Ankle Int 15: 134–140
Casteleyn P-P, Handelberg F (1995) Distraction for ankle arthroscopy. Arthroscopy 11: 633–634
Freeman MAR, Dean MRE, Hanham IWF (1965) The etiology and prevention of functional instability of the foot. J Bone Joint Surg [Br] 47: 678–685
Harper MC (1988) The deltoid ligament. An evaluation of need for surgical repair. Clin Orthop 226: 156–168
Harrington KD (1979) Degenerative arthritis of the ankle secondary to longstanding lateral ligament instability. J Bone Joint Surg [Am] 61: 354–361
Hintermann B, Nigg BM (1995) In vitro kinematics of the axially loaded ankle complex in response to dorsiflexion and plantarflexion. Foot Ankle Int 16: 514–518
Kannus P, Renstrom P (1991) Treatment for acute tears of the lateral ligaments of the ankle. Operation, cast, or early controlled mobilization. J Bone Joint Surg [Am] 73: 305–312
Karlsson J, Lansinger O (1993) Chronic lateral instability of the ankle in athletes. Sports Med 16: 355–365
Katcherian D (1994) Soft-tissue injuries of the ankle. In: Lutter LD, Mizel MS, Pfeffer GB (eds) Foot and ankle. AAOS, Rosemont, pp 241–254
Löfvenberg R, Kärrholm J, Lund B (1994) The outcome of nonoperated patients with chronic lateral instability of the ankle: a 20-year follow-up study. Foot Ankle 15: 165–169
Noguchi K (1985) Biomechanical analysis for osteoarthritis of the ankle. Nippon Seikeigeka Gakkai Zasshi 59: 215–222
Palladino SJ (1994) Distraction systems for ankle arthroscopy. Clin Podiatr Med Surg 11: 499–511
Peters JW, Trevino SG, Renstrom PA (1991) Chronic lateral ankle instability. Foot Ankle 12: 182–191
Taga I, Shino K, Inoue M, Nakata K, Maeda A (1993) Articular cartilage lesions in ankles with lateral ligament injury. An arthroscopic study. Am J Sports Med 21: 120–127
Zeegers AV, van der Werken C (1989) Rupture of the deltoid ligament in ankle fractures: should it be repaired? Injury 20: 39–41
Zwipp H, Schievink B (1992) Primary orthotic treatment of ruptured ankle ligaments: a recommended procedure. Prosthet Orthot Int 16: 49–56
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Schäfer, D., Hintermann, B. Arthroscopic assessment of the chronic unstable ankle joint. Knee Surg, Sports traumatol, Arthroscopy 4, 48–52 (1996). https://doi.org/10.1007/BF01565998
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DOI: https://doi.org/10.1007/BF01565998