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Related Concept Videos

Ankle Joint01:10

Ankle Joint

1.6K
The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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A Mouse Model of Ankle-Subtalar Complex Joint Instability
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A Smaller Tibiotalar Sector Is a Risk Factor for Recurrent Anterolateral Ankle Instability after a Modified

Flamur Zendeli1, Patrick Pflüger1, Arnd F Viehöfer1

  • 1Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

Foot & Ankle International
|February 23, 2024
PubMed
Summary

A smaller tibiotalar sector (TTS) angle is a key risk factor for recurrent ankle instability. This morphologic characteristic also predicts poorer functional outcomes after surgery for chronic lateral ankle instability.

Keywords:
chronic lateral ankle instabilitylateral ligament repairrecurrent ankle instabilitytibiotalar sector

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Area of Science:

  • Orthopedic surgery
  • Sports medicine
  • Radiology

Background:

  • Recurrent ankle instability is a common complication following initial ankle injuries.
  • Existing research identifies demographic and clinical factors, but the role of ankle joint morphology is less understood.
  • Chronic lateral ankle instability often requires surgical intervention, such as the modified Broström-Gould procedure.

Purpose of the Study:

  • To investigate the influence of specific ankle joint morphologic characteristics on the development of recurrent ankle instability.
  • To assess the relationship between these morphologic features and functional outcomes after surgical repair for chronic lateral ankle instability.

Main Methods:

  • A retrospective cohort study evaluated 58 patients (58 ankles) who underwent a modified Broström-Gould procedure for chronic lateral ankle instability.
  • Preoperative radiographs were analyzed to measure key parameters, including talar width, tibial anterior surface angle, talar height, talar radius, tibiotalar sector (TTS) angle, and tibial lateral surface angle.
  • Patients were assessed for recurrent ankle instability and functional outcomes using the Karlsson Score at a minimum 2-year follow-up.

Main Results:

  • A significantly lower tibiotalar sector (TTS) angle was observed in patients who experienced recurrent ankle instability (69.8° vs. 79.3°).
  • The TTS angle was confirmed as an independent risk factor for recurrent instability (OR=1.64, P=.003).
  • Patients with a TTS angle below 72° (low-TTS group) exhibited a substantially higher rate of recurrent instability (58% vs. 8%) and poorer functional outcomes (Karlsson Score: 65 vs. 85).

Conclusions:

  • A smaller tibiotalar sector (TTS) angle is a significant independent risk factor for recurrent ankle instability.
  • This morphologic characteristic is associated with inferior functional outcomes following the modified Broström-Gould procedure for chronic lateral ankle instability.
  • Preoperative radiographic assessment of the TTS angle may aid in identifying patients at higher risk for recurrent instability.