Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 21, Issue 6, pp 1396–1403 | Cite as

Quantitative evaluation of the viscoelastic properties of the ankle joint complex in patients suffering from ankle sprain by the anterior drawer test

  • Che-Yu Lin
  • Yio-Wha Shau
  • Chung-Li Wang
  • Huei-Ming Chai
  • Jiunn-Horng KangEmail author



Biological tissues such as ligaments exhibit viscoelastic behaviours. Injury to the ligament may induce changes of these viscoelastic properties, and these changes could serve as biomarkers to detect the injury. In the present study, a novel instrument was developed to non-invasive quantify the viscoelastic properties of the ankle in vivo by the anterior drawer test. The purpose of the study was to investigate the reliability of the instrument and to compare the viscoelastic properties of the ankle between patients suffering from ankle sprain and controls.


Eight patients and eight controls participated in the present study. The reliability test was performed on three randomly chosen subjects. In patient and control test, both ankles of each subject were tested to evaluate the viscoelastic properties of the ankle. The viscosity index was defined for quantitatively evaluating the viscosity of the ankle. Greater viscosity index was associated with lower viscosity. Injured and uninjured ankles of patient and both ankles of controls were compared.


The instrument exhibited excellent test–retest reliability (r > 0.9). Injured ankles exhibited significantly less viscosity than uninjured ankles, since injured ankles of patients had significantly higher viscosity index (8,148 ± 5,266) compared with uninjured ankles of patients (948 ± 617; p = 0.008) and controls (1,326 ± 613; p < 0.001).


The study revealed that the viscoelastic properties of the ankle can serve as sensitive and useful clinical biomarkers to differentiate between injured and uninjured ankles. The method may provide a clinical examination for objectively evaluating lateral ankle ligament injuries.


Ankle sprain Anterior drawer test Viscoelastic properties Relaxation 



Intra-class correlation coefficient


Injured ankles


Uninjured ankles


Left ankles


Right ankles


Difference between both ankles of patients


Difference between both ankles of controls





We like to thank Professor Wen-Fang Wu of Department of Mechanical Engineering at National Taiwan University for his advice on statistics. We thank Men-Hsien Lee of Institute of Applied Mechanics at National Taiwan University and Chiu-Fu Hung of Department of Mechanical Engineering at National Taiwan University for their help with the development of the instrument.

Conflict of interest

  The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Che-Yu Lin
    • 1
  • Yio-Wha Shau
    • 1
    • 2
  • Chung-Li Wang
    • 3
    • 4
  • Huei-Ming Chai
    • 5
  • Jiunn-Horng Kang
    • 6
    • 7
    Email author
  1. 1.Institute of Applied Mechanics, College of EngineeringNational Taiwan UniversityTaipeiTaiwan
  2. 2.Biomedical Technology and Device Research LaboratoriesIndustrial Technology Research InstituteHsinchuTaiwan
  3. 3.Department of Orthopedic SurgeryNational Taiwan University HospitalTaipeiTaiwan
  4. 4.Department of Orthopedics, School of Medicine, College of MedicineNational Taiwan UniversityTaipeiTaiwan
  5. 5.School and Graduate Institute of Physical Therapy, College of MedicineNational Taiwan UniversityTaipeiTaiwan
  6. 6.Department of Physical Medicine and RehabilitationTaipei Medical University HospitalTaipeiTaiwan
  7. 7.Department of Physical Medicine and Rehabilitation, School of Medicine, College of MedicineTaipei Medical UniversityTaipeiTaiwan

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