• Journal of the Korean Society of Radiology
• /
• v.82 no.6
• /
• pp.1402-1412
• /
• 2021

Chronic lateral ankle instability (CLAI) is a major complication of acute ankle sprain that can cause discomfort in both daily and sports activities and may lead to degenerative changes in the ankle joint as the long-term sequelae. The precise cause of CLAI remains debatable and is most probably multifactorial. However, identifying chronic lateral ankle ligament injury is critical in determining the primary etiology and formulating an appropriate treatment plan. This review discusses the features and effectiveness of various imaging techniques in diagnosing chronic lateral ankle ligament injury.

• Journal of Korean Foot and Ankle Society
• /
• v.24 no.1
• /
• pp.1-8
• /
• 2020

Acute ankle sprain is the most common injury in the lower extremities, and approximately 10% to 40% of acute lateral ankle ligament injury causes chronic pain or instability. For chronic symptoms lasting after an acute sprain, the possibility of joint damage, such as bony structures, ligaments, cartilage, and nerves around the ankle joint, should be considered. Patients with chronic lateral ankle instability usually complain of repeated sprains or giving way sensations. There has been steady progress in the treatment options until recently, however new treatments are still being attempted. This paper describes the causes, diagnosis, and recent trends in the conservative and operative treatment of chronic lateral ankle instability.

• Journal of Korean Foot and Ankle Society
• /
• v.24 no.2
• /
• pp.98-101
• /
• 2020

We report on the case of a patient with chronic instability of the ball-and-socket ankle joint. The patient, a 21-year-old male, was diagnosed 10 years previously with chronic instability of the ball-and-socket ankle joint. He underwent Broström procedure and augmentation using a periosteal turn down from the fibula for this chronic instability despite having received conservative treatment since the diagnosis. After the procedure, the clinical symptoms of ankle instability were improved and the patient is being periodically followed-up. We report on this case of using a Broström procedure as a treatment option for patients with instability of the ball-and-socket ankle joint with normal range of foot and normal ankle joint alignment without damage in the joint and cartilage.

• Korean Journal of Applied Biomechanics
• /
• v.32 no.1
• /
• pp.9-16
• /
• 2022

Objective: The purpose of this study was to investigate how the chronic ankle instability affects postural control during forward jump landing. Method: 20 women with chronic ankle instability (age: 21.7 ± 1.6 yrs, height: 162.1 ± 3.7 cm, weight: 52.2 ± 5.8 kg) and 20 healthy adult women (age: 21.8 ± 1.6 yrs, height: 161.9 ± 4.4 cm, weight: 52.9 ± 7.2 kg) participated in this study. For the forward jump participants were instructed to stand on two legs at a distance of 40% of their body height from the center of force plate. Participants were jump forward over a 15 cm hurdle to the force plate and land on their non-dominant or affected leg. Kinetic and kinematic data were obtained using 8 motion capture cameras and 1 force plates and joint angle, vertical ground reaction force and center of pressure. All statistical analyses were using SPSS 25.0 program. The differences in variables between the two groups were compared through an independent sample t-test, and the significance level was to p < .05. Results: In the hip and knee joint angle, the CAI group showed a smaller flexion angle than the control group, and the knee joint valgus angle was significantly larger. In the case of ankle joint, the CAI group showed a large inversion angle at all events. In the kinetic variables, the vGRF was significantly greater in the CAI group than control group at IC and mGRF. In COP Y, the CAI group showed a lateral shifted center of pressure. Conclusion: Our results indicated that chronic ankle instability decreases the flexion angle of the hip and knee joint, increases the valgus angle of the knee joint, and increases the inversion angle of the ankle joint during landing. In addition, an increase in the maximum vertical ground reaction force and a lateral shifted center of pressure were observed. This suggests that chronic ankle instability increases the risk of non-contact knee injury as well as the risk of lateral ankle sprain during forward jump landing.

• Journal of Korean Foot and Ankle Society
• /
• v.25 no.1
• /
• pp.25-31
• /
• 2021

The open Broström procedure is considered the surgery of choice for treating chronic lateral ankle instability. The role of arthroscopy has gained popularity in the surgical treatment of chronic lateral ankle instability, partly for the ability to manage the intra-articular pathology combined with ankle instability. Arthroscopic techniques can be divided broadly into the arthroscopic-assisted Broström technique and arthroscopic all-inside ligament repair. The clinical results of these arthroscopic techniques are similar to open procedures. The arthroscopic technique may be an excellent alternative to the open Broström procedure in treating chronic lateral ankle instability when applying the appropriate indications.

• Journal of Korean Foot and Ankle Society
• /
• v.22 no.2
• /
• pp.55-61
• /
• 2018

Chronic lateral ankle instability is a major complication of acute ankle sprains, which can cause discomfort in both daily and sports activity. In addition, it may result in degenerative changes to the ankle joint in the long term. An accurate diagnostic approach and successful treatment plan can be established based on a comprehensive understanding of the concept of functional and mechanical instability. The patients' history and correct physical examination would be the first and most important step. The hindfoot alignment, competence of the lateral ligaments, and proprioceptive function should be evaluated. Additional information can be gathered using standard and stress radiographs. In addition, concomitant pathologic conditions can be investigated by magnetic resonance imaging. Conservative rehabilitation composed of the range of motion, muscle strengthening, and proprioceptive exercise is the main treatment for functional instability and mechanical instability. Regarding the mechanical instability, surgical treatment can be considered for irresponsible patients after a sufficient period of rehabilitation. Anatomic repair (modified $Brostr{\ddot{o}}m$ operation) is regarded as the gold standard procedure. In cases with poor prognostic factors, an anatomical reconstruction or additional procedures can be chosen. For combined intra-articular pathologies, arthroscopic procedures should be conducted, and arthroscopic lateral ligament repair has recently been introduced. Regarding the postoperative management, early functional rehabilitation with short term immobilization is recommended.

• Journal of Korean Foot and Ankle Society
• /
• v.25 no.1
• /
• pp.6-9
• /
• 2021

The term chronic lateral ankle instability (CLAI) embraces a spectrum of conditions that involve functional and mechanical instability, both in athletes and lower-demand patients. The hallmarks of CLAI are recurrent sprains, persistent pain, and repeated episodes of the ankle giving way. CLAI is the main complication of acute ankle sprains, which can cause discomfort in daily and sports activity. Approximately 10% to 30% of patients with acute ligament ruptures will develop chronic instability over the course of a year from the index injury. An accurate diagnostic approach and successful treatment plan should be established based on a comprehensive understanding of the concept of functional and mechanical instability. Unfortunately, the optimal modality for the management of CLAI is unclear. Even after conservative treatment or surgical intervention, it could result in degenerative changes to the ankle joint in the long term. Thus far, the incidence of ligamentous posttraumatic ankle osteoarthritis was reported to be 13% to 78%. The mean latency time between injury and osteoarthritis was at least 10 to 34.3 years. CLAI is an important pathological condition that can cause discomfort or dysfunction in daily activity in the short term, resulting in joint destruction in the long term. Therefore, it is important to understand the various complications that can occur when CLAI is not treated properly.

• Journal of Korean Foot and Ankle Society
• /
• v.5 no.1
• /
• pp.5-12
• /
• 2001

Purpose: To find out the priority of which procedure has had a better outcome both clinically and radiographically between the two groups, one is treated by primary repair and the other by modified Brostr$\ddot{o}$m's procedure, by comparing the postoperative ankle joint stability and the patient's degree of satisfaction. Material and methods: 16 cases were taken into consideration whose number of severed ligaments were at least two or more of the lateral collateral ligaments of the ankle, and also were confirmed intraoperatively. Among them, 8 cases were treated with primary repair and the other 8 cases were treated with primary repair and the other 8 cases by modified Brostr$\ddot{o}$m's procedure. Results: There was no distinguishable difference for the patient's degree of satisfaction between the two procedures above mentioned. In 3 cases treated with primary repair, functional instability was observed. In case of postoperative ankle joint stability, 7 of 8 cases treated by modified Brostr$\ddot{o}$m's procedure has revealed increased joint stability. And 3 of 8 cases which were treated by primary repair have showed postoperative residual instability. Conclusion: Actually, the severed ligament can not maintain its normal strength though several months has elapsed, and possible residual instability could be remained. Therefore, it can be expected that modified Brostr$\ddot{o}$m's procedure also would be a .good method in obtaining suitable ankle joint stability as well as subtalar joint stability because of its reinforcement using extensor retinaculum.

• Journal of Korean Foot and Ankle Society
• /
• v.20 no.4
• /
• pp.192-195
• /
• 2016

Diffuse pigmented villonodular synovitis (PVNS) involving ankle joint needs complete mass excision and total synovectomy to reduce recurrence rate, while surrounding ligaments can be easily damaged. So the concurrent ligament reconstruction should be considered for post-excisional instability in subtalar joint as well as lateral ankle joint. We describe our experience in the management of a diffuse type PVNS, invades lateral talocrural joint extended to subtalar joint and introduce a new technique of all-in-one reconstruction for anterior talofibular,calcaneofibular and cervical ligament. Our new reconstruction technique applying modified Chrisman and Snook technique is useful in stabilization for deficiencies of the ligament complexafter PVNS excisionat lateral ankle and subtalar joint.

• Journal of Korean Foot and Ankle Society
• /
• v.25 no.1
• /
• pp.1-5
• /
• 2021

Physical examination and surgical findings and symptoms are often inconsistent with magnetic resonance imaging (MRI) findings when diagnosing chronic ankle lateral ligament instability, and confirmed surgical findings are used as the gold standard in most clinical studies. Anterior drawer testing is considered unreliable because normal findings are highly variable, and its accuracy ranges from 50% to 100%. Furthermore, radiographic stress imaging, such as in anterior drawer stress view, is performed under manual stress or using a stress device, and its findings also vary widely and confuse when interpreting stress views. The average accuracy of MRI findings is around 85% (range, 66%~91.7%), and thus, cannot be used as a primary indicator for surgery. For patients with suspected lateral ankle ligament instability, based on symptoms and physical examination findings, MRI may be useful for identifying lesions in ankle joints and for differentiating them from other conditions.