Weight, BMI and stability are risk factors associated with lateral ankle sprains and chronic ankle instability: a meta-analysis

Vuurberg, Gwendolyn; Altink, Nienke; Rajai, Morteza; Blankevoort, Leendert; Kerkhoffs, Gino M. M. J.

doi:10.1136/jisakos-2019-000305

Cited by 25 publications

(17 citation statements)

References 109 publications

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“…A common, general surrogate of physical health is BMI. Several authors have demonstrated higher BMI in young and middle-aged adults with ankle sprain history (Hershkovich et al, 2015 ; Vuurberg et al, 2019 ; Al Mahrouqi et al, 2020 ; Svorai Band et al, 2021 ). This is consistent with our statistically significant findings that BMI in the Ankle Sprain group was >1 point higher than the Controls, which was supported by the group difference exceeding the MDD.…”

Section: Discussionmentioning

confidence: 99%

Differences in health-related quality of life among patients after ankle injury

Gribble¹,

Kleis²,

Simon³

et al. 2022

Front. Sports Act. Living

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Ankle sprains are the most common injuries sustained in the physically active, often associated with pain and functional limitations long after initial recovery. In recent years, the impact of ankle sprains on general health and health-related quality of life (HRQoL) has been noted in athletes, but is not well-documented in the general population. We examined differences in HRQoL and general health between individuals with ankle sprain history and healthy controls. Those with ankle sprain reported significantly higher body mass index and general body pain, and lower SF-8 physical component scores than healthy controls. Additionally, there is some indication that physical activity is lower in those with ankle sprain history. This is an important step in illustrating the adverse sequelae of ankle sprains on population health and HRQoL.

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Section: Discussionmentioning

confidence: 99%

Differences in health-related quality of life among patients after ankle injury

Gribble¹,

Kleis²,

Simon³

et al. 2022

Front. Sports Act. Living

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“…The influence was supposed to be limited, however. Vuurberg et al [ 41 ] already demonstrated that BMI in patients with CAI is significantly higher than that of healthy controls. In addition, this statistically significant difference was minimal (mean 22.76 vs 22.11), so the influence of BMI should be limited.…”

Section: Discussionmentioning

confidence: 99%

Quantitative analysis with load–displacement ratio measured via digital arthrometer in the diagnostic evaluation of chronic ankle instability: a cross-sectional study

et al. 2022

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Background Arthrometry has been introduced to evaluate the laxity of ankle joint in recent years. However, its role in the diagnosis of chronic ankle instability is still debatable. Therefore, we assessed the diagnostic accuracy of a digital arthrometer in terms of sensitivity and specificity. Methods According to the inclusion and exclusion criteria proposed by the International Ankle Consortium, we recruited 160 uninjured ankles (control group) and 153 ankles with chronic ankle instability (CAI group). Ankle laxity was quantitively measured by a validated digital arthrometer. Data of loading force and joint displacement were recorded in a continuous manner. Differences between the control and CAI groups were compared using 2-tailed independent t test. A receiver operating characteristic curve analysis was used to calculate area under a curve, sensitivity and specificity. Results Load–displacement curves of the two groups were depicted. Differences of joint displacement between the control and CAI groups were compared at 30, 45, 60, 75, 90, 105 and 120 N, which were all of statistical significance (all p < 0.001) with the largest effect size at 90 N. Statistical significance was found in the differences between the two groups in load–displacement ratio at 10–120 N, 10–40 N, 40–80 N and 80–120 N (all p < 0.001), with the largest effect size at 10–40 N. Load–displacement ratio at the interval of 10–40 N had the highest area under a curve (0.9226), with sensitivity and specificity of 0.804 and 0.863, respectively, when the cutoff point was 0.1582 mm/N. Conclusion The digital arthrometer measurement could quantitively analyze the ankle laxity with high diagnostic accuracy. The load–displacement ratio would be a reliable and promising approach for chronic ankle instability diagnosis. Level of evidence level II.

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“… 8 , 28 , 29 , 40 There are concerns about the strength of this procedure for some patients, particularly those with GLL, increased body mass, and long-standing instability, as well as those who participate in competition at an elite level. 38 , 55 , 60 Alternative procedures have reconstructed the LCL complex using an autologous graft, but this is associated with the risk of graft-site morbidity. 12 , 25 Another option is to augment an imbrication of the LCL complex using a synthetic ligament.…”

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confidence: 99%

“…21,35 Although most ankle sprains completely heal with appropriate nonoperative management, up to 40% of those who sustain them develop chronic ankle instability (CAI). 7,55 CAI has been associated with many long-term sequelae, such as altered ankle kinematics, 46 chondral injuries, 48,57 and early-onset osteoarthrosis of the ankle joint. 20,48,54 For these reasons, surgical repair of the ruptured LCL complex is indicated when nonoperative management has failed.…”

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confidence: 99%

“…1,4 Although contentious, several studies have revealed that individuals with higher body weight and body mass index and those with generalized ligamentous laxity (GLL) are at increased risk of ankle sprains. 2,5,6,43,55 GLL is characterized by abnormally increased range of motion (ROM) at multiple joints compared with that of the general population and is related to conditions with abnormal collagen laxity such as Marfan syndrome. 59 The prevalence is between 5% and 15% of the population, and most cases have no known genetic aberrancy.…”

mentioning

confidence: 99%

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Ligament Augmentation Reconstruction System (LARS) for Ankle Lateral Ligament Reconstruction in Higher-Risk Patients: A 5-Year Prospective Cohort Study

Porter

Trajkovska

Georgousopoulou

2022

Orthopaedic Journal of Sports Medicine

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Background: The modified Broström-Gould (MBG) procedure is the gold standard for patients with chronic ankle instability (CAI), but it is relatively contraindicated for patients with higher body weight or generalized ligamentous laxity (GLL). The use of the ligament augmentation reconstruction system (LARS) is an alternative. Hypothesis: It was hypothesized that clinical outcomes would be similar in patients with increased body weight (>90 kg) or GLL, relative to controls. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 66 patients satisfying the inclusion criteria were invited to participate and were divided into 3 groups: controls (no risk factors for inferior clinical outcome), patients with body weight >90 kg, and patients with GLL (Beighton score, ≥5 of 9). All patients underwent imbrication of the lateral collateral ligament complex augmented with the LARS. Primary outcomes of interest were Tegner activity scale (TAS) and Foot and Ankle Outcome Score (FAOS) subscale scores. Secondary outcomes were recurrence of ankle instability, the need for further surgery, and/or complications. Patients were reviewed at 2 and 5 years postoperatively, and outcomes between groups were compared using repeated-measures analysis of variance. Results: Complete data were available for 63 patients (21 patients in each group). TAS improved in all groups from preoperatively to 2 years and 5 years postoperatively ( P < .001 for all). Relative to the controls, the TAS scores were lower in the >90-kg group at 2 years and 5 years ( P < .001 for both periods), while the GLL group had similar scores to controls at both postoperative periods. Both the >90-kg and the GLL groups showed no significant difference in improvement on any FAOS subscale scores relative to the controls, at both 2 and 5 years postoperatively. There were no recurrences, repeat surgeries, or major complications. Conclusion: Relative to controls, patients with body weight >90 kg or GLL had similar FAOSs, and TAS scores were lower in the >90-kg group, at 2 and 5 years, after the use of the LARS to augment lateral collateral ligament imbrication for CAI. Use of the LARS in this manner is a viable option in patients for whom the MBG procedure is relatively contraindicated.

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Weight, BMI and stability are risk factors associated with lateral ankle sprains and chronic ankle instability: a meta-analysis

Cited by 25 publications

References 109 publications

Differences in health-related quality of life among patients after ankle injury

Differences in health-related quality of life among patients after ankle injury

Quantitative analysis with load–displacement ratio measured via digital arthrometer in the diagnostic evaluation of chronic ankle instability: a cross-sectional study

Ligament Augmentation Reconstruction System (LARS) for Ankle Lateral Ligament Reconstruction in Higher-Risk Patients: A 5-Year Prospective Cohort Study

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