Mechanical joint laxity associated with chronic ankle instability: a systematic review

Area of Science:

• Orthopedics
• Sports Medicine
• Biomechanics

Background:

• Untreated lateral ankle sprains can lead to chronic mechanical joint laxity.
• Joint laxity is commonly assessed using manual stress tests, stress radiography, and instrumented ankle arthrometers.

Purpose of the Study:

• To systematically review existing literature and determine the effect of chronic ankle instability (CAI) on sagittal and frontal plane mechanical joint laxity.

Main Methods:

• A comprehensive literature search was conducted using MEDLINE, CINAHL, and the Cochrane Database of Systematic Reviews.
• Included studies were case-controlled, measured mechanical joint laxity using specific devices, assessed anteroposterior inversion/eversion laxity, and provided group means and standard deviations.
• Eight studies were included in the final analysis after initial screening of 1378 articles, with quality assessed using the PEDro scale.

Main Results:

• Chronic ankle instability (CAI) demonstrated the most significant effect on inversion joint laxity, with effect sizes ranging from 0.84 to 2.61.
• Anterior joint laxity was the second most affected by CAI, with effects ranging from 0.32 to 1.82.
• CAI had a less pronounced influence on posterior and eversion joint laxity measurements.

Conclusions:

• Chronic ankle instability (CAI) exerts the greatest influence, with the highest variability, on anterior and inversion joint laxity.
• These findings align with the typical mechanisms involved in the initial ankle sprain injury.