Related Experiment Video
Updated: Jul 10, 2026
A Mouse Model of Ankle-Subtalar Complex Joint Instability
Published on: October 28, 2022
Combined multi-ligament instability in patients with chronic symptoms following rotational ankle injuries. A
Cesar de Cesar Netto1, Erik Jesus Huanuco Casas2, Aly Fayed3
1Department of Orthopaedic Surgery - Division of Foot and Ankle Surgery - Duke University Health DUMC Box 104002, IPE - 311 Trent Drive, Durham, NC 27710, USA; Department of Orthopedics and Rehabilitation - University of Iowa - Carver College of Medicine, 200 Hawkins Dr, John PappaJohn Pavillion (JPP), Iowa City, IA52242-0000, USA.
Purpose:
To prospectively quantify isolated versus combined ligamentous instability in symptomatic patients after rotational ankle injuries (RAI) and assess changes in patient-reported outcomes (PROs) after targeted surgical stabilization.
Methods:
Adults with pain and/or subjective instability > 6 months after RAI who failed nonoperative care were enrolled. All underwent diagnostic ankle arthroscopy and open stabilization based on standardized intraoperative criteria for lateral, syndesmotic, and deep deltoid instability; combined patterns were classified. PROs and complications were recorded.
Results:
Twenty-nine patients (30 ankles; 36.1 years, BMI 31.2 kg/m2) after RAI were included, mean 45.2-month follow-up. Instability patterns were multidirectional (lateral/deltoid/syndesmotic) in 60%, rotational (lateral/deltoid) in 20%, anterolateral (lateral/syndesmotic) in 13%, and anteromedial (deltoid/syndesmotic) in 3.5%; isolated lateral occurred in 3.5%. Collected PROs showed improvement (ps<0.04) and three complications occurred (10%).
Conclusion:
In symptomatic patients after RAI, multi-ligament ankle instability predominated, most commonly multidirectional or rotational patterns. Intraoperative-guided comprehensive stabilization yielded PRO improvements with a low complication rate.
Study Design:
Level II. Prospective cohort study.
