Changes in joint position sense after surgically treated chronic lateral ankle instability

Abstract

Background: A search of the literature shows that the effect of surgery on ankle proprioception has been hardly investigated. Objective: To examine the effect of anatomical reconstruction of the anterolateral capsuloligamentous complex on ankle joint position sense. Methods: A prospective study using the ''slope box'' test. Ten consecutive patients were included in the study, and 10 healthy athletes represented the control group. Results: Similar test-retest reliability rates (overall reliability 0.92; p = 0.0013) were obtained to those of the original designers of the method. There were no significant differences with respect to side dominance (p = 0.9216). Investigation of the characteristics of mean absolute estimate errors showed that the controls tested became error prone in the range of slope altitudes 7.5-25˚in every direction, compared with the range 0-5˚(range of p values 0.00003-0.00072). The results of the intervention group showed that, for the two main directions of interest (anterior and lateral), preoperative differences in mean absolute estimate errors between injured (anterior 3.91 (2.81)˚; lateral 4.06 (2.85)˚) and healthy (anterior 2.94 (2.21)˚, lateral 3.19 (2.64)˚) sides (anterior, p = 0.0124; lateral, p = 0.0250) had disappeared (postoperative differences: anterior, p = 0.6906; lateral, p = 0.4491). The afflicted ankle had improved significantly after surgery in both important directions (anterior, p,0.0001; lateral, p = 0.0023). Conclusions: The study shows that differences in joint position sense between healthy and injured ankles disappeared as the result of surgery. Preoperative data show that proprioceptive malfunction is a cause of functional instability. If treatment is by means of surgery, the retensioning of the original anterolateral structures is inevitable, even if other grafting or surgical techniques are used.

Muscle Latency and Proprioception in Non-Dominant and Dominant Legs of Healthy Sedentary Individuals

“…Aydın et al (46) also observed no significant differences between nondominant and dominant ankles with respect to the ability to sense passive movement and the active angle-reproduction test results in sedentary subjects, who were included in the study as a control group. Our results correlate with the results of these studies, with no differences found between the limbs with respect to joint position sense and kinesthesia (45,46) in active individuals [teenage female gymnasts (46), a mixed group of male and female elite athletes (22,23), and female handball players (47)]. Interestingly, there were also no differences between the ankle joints with respect to joint position sense.…”

“…All of the participants had no mechanical ankle instability prior to participating in the study according to anterior drawer and talar tilt tests performed by the same clinician. To be consistent with previous research studies, the leg that the participant uses to naturally kick a ball was defined as the dominant leg (11,15,18,(20)(21)(22)(23). The order of testing (non-dominant or dominant limb first) was randomly determined.…”

Changes in joint position sense after conservatively treated chronic lateral ankle instability

“…After 6 weeks, non-responding patients can be identified. In this group of patients, if there is also a mechanical component of ankle instability present, the problem should be addressed surgically, preferably by means of anatomical reconstruction (in itself or combined with another stabilising method), which according to our previous corresponding study has the advantage of the reinforcement of the static proprioceptive sensory system [8].…”

“…It has a reliability of 0.91-0.92 [8,21]. The test was acknowledged by numerous biomechanical experts ever since [1,15,20].…”

Sports Injuries of the Ankle

“…Increased ligament laxity does not always result in symptomatic instability. These observations have led to the concept that functional instability (FI) resulting from a neuromuscular defi cit is implicated along with mechanical instability in people with symptoms of chronic ankle instability (Halasi et al 2005 ;Hertel 2002 ;Hubbard et al 2007 ).…”