Advertisement

Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 24, Issue 4, pp 1081–1085 | Cite as

The improvement of postural control in patients with mechanical ankle instability after lateral ankle ligaments reconstruction

  • Hong-Yun Li
  • Jie-Jiao Zheng
  • Jian Zhang
  • Ye-Hua Cai
  • Ying-Hui Hua
  • Shi-Yi Chen
Ankle

Abstract

Purpose

Lateral ankle sprain is the most common injury. A previous study demonstrated that patients with mechanical ankle instability suffered deficits in postural control, indicating that structural damage of the lateral ankle ligaments may produce a balance deficit. The purpose of this study was to confirm that lateral ligaments reconstruction could improve postural control in patients with mechanical ankle instability.

Methods

A total of 15 patients were included in the study. Each patient had a history of an ankle sprain with persistent symptoms of ankle instability and a positive anterior drawer test and had been treated nonoperatively for at least 3 months. All patients were diagnosed with lateral ankle ligaments tear by ultrasonography and magnetic resonance imaging. They underwent arthroscopic debridement and open lateral ankle ligaments reconstruction with a modified Broström procedure. One day before and 6 months after the operation, all of the participants underwent single-limb postural sway tests. The anterior drawer test and the American Orthopedic Foot and Ankle Society scale score were used to evaluate the clinical results in these patients.

Results

At 6 months after the operation, with the patients’ eyes closed, there was significantly decreased postural sway in the anteroposterior direction, the circumferential area, and the total path length on the operated ankles compared with those measurements before the operation. With eyes open, however, no difference was found in postural sway before and after the operation.

Conclusions

Postural control was improved by reconstructing the lateral ligaments.

Level of evidence

IV.

Keywords

Ankle instability Postural sway Mechanical Ligament reconstruction 

Notes

Acknowledgments

This work was supported by a grant awarded to Ying-Hui Hua from the National Natural Science Foundation of China (NSFC81101391).

References

  1. 1.
    Aydogan U, Glisson RR, Nunley JA (2006) Extensor retinaculum augmentation reinforces anterior talofibular ligament repair. Clin Orthop Relat Res 442:210–215CrossRefPubMedGoogle Scholar
  2. 2.
    Ben Moussa Zouita A, Majdoub O, Ferchichi H, Grandy K, Dziri C, Ben Salah FZ (2013) The effect of 8-weeks proprioceptive exercise program in postural sway and isokinetic strength of ankle sprains of Tunisian athletes. Ann Phys Rehabil Med 56:634–643CrossRefPubMedGoogle Scholar
  3. 3.
    Brown CN, Padua DA, Marshall SW, Guskiewicz KM (2009) Variability of motion in individuals with mechanical or functional ankle instability during a stop jump maneuver. Clin Biomech 24:762–768 (Bristol, Avon) CrossRefGoogle Scholar
  4. 4.
    Chen H, Li HY, Zhang J, Hua YH, Chen SY (2014) Difference in postural control between patients with functional and mechanical ankle instability. Foot Ankle Int 35:1068–1074CrossRefPubMedGoogle Scholar
  5. 5.
    de Vries JS, Kingma I, Blankevoort L, van Dijk CN (2010) Difference in balance measures between patients with chronic ankle instability and patients after an acute ankle inversion trauma. Knee Surg Sports Traumatol Arthrosc 18:601–606CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Dickin DC, Doan JB (2008) Postural stability in altered and unaltered sensory environments following fatiguing exercise of lower extremity joints. Scand J Med Sci Sports 18:765–772CrossRefPubMedGoogle Scholar
  7. 7.
    Gehring D, Faschian K, Lauber B, Lohrer H, Nauck T, Gollhofer A (2014) Mechanical instability destabilises the ankle joint directly in the ankle-sprain mechanism. Br J Sports Med 48:377–382CrossRefPubMedGoogle Scholar
  8. 8.
    Gribble PA, Delahunt E, Bleakley C, Caulfield B, Docherty C, Fourchet F, Fong DT, Hertel J, Hiller C, Kaminski T, McKeon P, Refshauge K, van der Wees P, Vincenzino B, Wikstrom E (2013) Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. Br J Sports Med 48:1014–1018CrossRefPubMedGoogle Scholar
  9. 9.
    Guskiewicz KM, Perrin DH (1996) Research and clinical applications of assessing balance. J Sport Rehabil 5:45–63Google Scholar
  10. 10.
    Halasi T, Kynsburg A, Tallay A, Berkes I (2005) Changes in joint position sense after surgically treated chronic lateral ankle instability. Br J Sports Med 39:818–824CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Hertel J (2002) Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train 37:364–375PubMedPubMedCentralGoogle Scholar
  12. 12.
    Hertel J (2008) Sensorimotor deficits with ankle sprains and chronic ankle instability. Clin Sports Med 27:353–370CrossRefPubMedGoogle Scholar
  13. 13.
    Holmes A, Delahunt E (2009) Treatment of common deficits associated with chronic ankle instability. Sports Med 39:207–224CrossRefPubMedGoogle Scholar
  14. 14.
    Hua Y, Chen S, Li Y, Chen J, Li H (2010) Combination of modified Broström procedure with ankle arthroscopy for chronic ankle instability accompanied by intra-articular symptoms. Arthroscopy 26:524–528CrossRefPubMedGoogle Scholar
  15. 15.
    Hua Y, Yang Y, Chen S, Cai Y (2012) Ultrasonography examination for the diagnosis of chronic anterior talofibular ligament injury. Acta Radiol 53:1142–1145CrossRefPubMedGoogle Scholar
  16. 16.
    Huang PY, Chen WL, Lin CF, Lee HJ (2014) Lower extremity biomechanics in athletes with ankle instability after a 6-week integrated training program. J Athl Train 49:163–172CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Hubbard TJ, Hertel J (2006) Mechanical contributions to chronic lateral ankle instability. Sports Med 36:263–277CrossRefPubMedGoogle Scholar
  18. 18.
    Knapp D, Lee SY, Chinn L, Saliba SA, Hertel J (2011) Differential ability of selected postural-control measures in the prediction of chronic ankle instability status. J Athl Train 46:257–262PubMedPubMedCentralGoogle Scholar
  19. 19.
    Mäkinen TM, Rintamäki H, Korpelainen JT, Kampman V, Pääkkönen T, Oksa J, Palinkas LA, Leppäluoto J, Hassi J (2005) Postural sway during single and repeated cold exposures. Aviat Space Environ Med 76:947–953PubMedGoogle Scholar
  20. 20.
    McGuine TA, Keene JS (2006) The effect of a balance training program on the risk of ankle sprains in high school athletes. Am J Sports Med 34:1103–1111CrossRefPubMedGoogle Scholar
  21. 21.
    McKeon PO, Hertel J (2008) Systematic review of postural control and lateral ankle instability, part I: can deficits be detected with instrumented testing? J Athl Train 43:293–304CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Mitchell A, Dyson R, Hale T, Abraham C (2008) Biomechanics of ankle instability. Part 2: postural sway-reaction time relationship. Med Sci Sports Exerc 40:1522–1528CrossRefPubMedGoogle Scholar
  23. 23.
    Oae K, Takao M, Uchio Y, Ochi M (2010) Evaluation of anterior talofibular ligament injury with stress radiography, ultrasonography and MR imaging. Skeletal Radiol 39:41–47CrossRefPubMedGoogle Scholar
  24. 24.
    O’Loughlin PF, Murawski CD, Egan C, Kennedy JG (2009) Ankle instability in sports. Phys Sportsmed 37:93–103CrossRefPubMedGoogle Scholar
  25. 25.
    Qiu F, Cole MH, Davids KW, Hennig EM, Silburn PA, Netscher H, Kerr GK (2012) Enhanced somatosensory information decreases postural sway in older people. Gait Posture 35:630–635CrossRefPubMedGoogle Scholar
  26. 26.
    Riemann BL (2002) Is there a link between chronic ankle instability and postural instability? J Athl Train 37:386–393PubMedPubMedCentralGoogle Scholar
  27. 27.
    Sefton JM, Hicks-Little CA, Hubbard TJ, Clemens MG, Yengo CM, Koceja DM, Cordova ML (2009) Sensorimotor function as a predictor of chronic ankle instability. Clin Biomech 24:451–458 (Bristol, Avon) CrossRefGoogle Scholar
  28. 28.
    Takao M, Innami K, Matsushita T, Uchio Y, Ochi M (2008) Arthroscopic and magnetic resonance image appearance and reconstruction of the anterior talofibular ligament in cases of apparent functional ankle instability. Am J Sports Med 36:1542–1547CrossRefPubMedGoogle Scholar
  29. 29.
    Verhagen E, van der Beek A, Twisk J, Bouter L, Bahr R, van Mechelen W (2004) The effect of a proprioceptive balance board training program for the prevention of ankle sprains: a prospective controlled trial. Am J Sports Med 32:1385–1393CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2015

Authors and Affiliations

  • Hong-Yun Li
    • 1
  • Jie-Jiao Zheng
    • 2
  • Jian Zhang
    • 1
  • Ye-Hua Cai
    • 3
  • Ying-Hui Hua
    • 1
  • Shi-Yi Chen
    • 1
  1. 1.Sports Medicine Center of Fudan University, Department of Sports Medicine and Arthroscopy Surgery, Huashan HospitalFudan UniversityShanghaiChina
  2. 2.Department of Rehabilitation MedicineHuadong Hospital Affiliated to Fudan UniversityShanghaiChina
  3. 3.Department of UltrasonographyHuashan HospitalShanghaiChina

Personalised recommendations