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Chronic Ankle Instability - Mechanical vs. Functional
Markus Wenning1, Hagen Schmal2,3
1Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-Universität Freiburg Medizinische Fakultät, Freiburg, Deutschland.
Zeitschrift Fur Orthopadie Und Unfallchirurgie
|February 14, 2022
Summary
Differentiating mechanical and functional ankle instability is key for effective treatment. Accurate diagnosis guides patients toward appropriate therapies, from conservative management to surgical reconstruction.
Area of Science:
- Orthopedics
- Sports Medicine
- Biomechanics
Background:
- Chronic ankle instability results from mechanical, functional, and perceived factors.
- Distinguishing the dominant cause (functional vs. mechanical) is crucial for personalized treatment.
Purpose of the Study:
- To highlight the importance of differential diagnostics in chronic ankle instability.
- To review current diagnostic methods for mechanical and functional ankle instability.
- To guide therapeutic recommendations based on diagnosis.
Main Methods:
- Physical examination for mechanical instability.
- Advanced imaging (stress-ultrasound, 3D stress-MRI) and arthroscopy for mechanical assessment.
- Balance tests (Y-Balance Test), posturography, gait analysis, and isokinetic testing for functional assessment.
Main Results:
- Quantifying mechanical ankle instability remains challenging despite various diagnostic tools.
- Functional instability can be assessed through non-instrumented and instrumented tests.
- Conservative management (sensorimotor, strength, balance training) is standard but may not suffice for mechanical deficits.
Conclusions:
- Differential diagnostics are essential to identify patients needing mechanical interventions like bracing or surgery.
- A comprehensive approach combining mechanical and functional assessments ensures optimal patient outcomes.
- Tailoring therapy based on the dominant instability type improves treatment efficacy.
