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Surgical reconstruction with the remnant ligament improves joint position sense as well as functional ankle instability: a 1-year follow-up study.

Iwao K, Masataka D, Kohei F - ScientificWorldJournal (2014)

Bottom Line: Three months after surgery in the intervention group, the joint position sense was significantly different from those found preoperatively.Three months after surgery, however, the score significantly increased.The results showed that surgical reconstruction using the remnant ligament was effective not only for improving mechanical retensioning but also for ameliorating joint position sense and functional ankle instability.

View Article: PubMed Central - PubMed

Affiliation: Fukuhara Orthopedic Clinic, 4-4-8 Ujinanishi, Minami-ku, Hiroshima-shi 734-0014, Japan ; Graduate School of Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima-shi 734-855, Japan.

ABSTRACT

Introduction: Chronic functional instability--characterized by repeated ankle inversion sprains and a subjective sensation of instability--is one of the most common residual disabilities after an inversion sprain. However, whether surgical reconstruction improves sensorimotor control has not been reported to date. The purpose of this study was to assess functional improvement of chronic ankle instability after surgical reconstruction using the remnant ligament.

Materials and methods: We performed 10 cases in the intervention group and 20 healthy individuals as the control group. Before and after surgical reconstruction, we evaluated joint position sense and functional ankle instability by means of a questionnaire.

Results and discussion: There was a statistically significant difference between the control and intervention groups before surgical reconstruction. Three months after surgery in the intervention group, the joint position sense was significantly different from those found preoperatively. Before surgery, the mean score of functional ankle instability in the intervention group was almost twice as low. Three months after surgery, however, the score significantly increased. The results showed that surgical reconstruction using the remnant ligament was effective not only for improving mechanical retensioning but also for ameliorating joint position sense and functional ankle instability.

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Related in: MedlinePlus

Goniometer footplate (a) and angles for the measurement of joint position sense (b).
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fig2: Goniometer footplate (a) and angles for the measurement of joint position sense (b).

Mentions: The goniometer footplate (Nakamura Brace Co., Shimane, Japan; Figure 2) described by Nakasa et al. was used to assess joint position sense [8]. The subjects took off their shoes and socks. Then, they sat down with the knee flexed at 70°, one at a time, on the goniometer footplate at a plantar flexion angle of 20°. The goniometer footplate can rotate internally, which means that the axis of the foot movement is aligned with the axis of the ankle inversion movement. The center of rotation of the goniometer footplate is just below the tuberosity of the calcaneus. When the subjects moved their ankle to the index angle of inversion, they were asked to memorize the angle. Then, the ankle was returned to the 0° position. After that the subjects were blindfolded to eliminate visual input, and they moved their ankle actively to match the previous index angle. The index angle was decided using a table of random numbers to 1 of 6 positions (5°, 10°, 15°, 20°, 25°, 30°), always starting from 0°. The absolute difference between the index angle and replication angle was recorded as the joint position error. The absolute error of joint position sense was measured in triplicate. The mean of the 3 trials was used for analysis.


Surgical reconstruction with the remnant ligament improves joint position sense as well as functional ankle instability: a 1-year follow-up study.

Iwao K, Masataka D, Kohei F - ScientificWorldJournal (2014)

Goniometer footplate (a) and angles for the measurement of joint position sense (b).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4221900&req=5

fig2: Goniometer footplate (a) and angles for the measurement of joint position sense (b).
Mentions: The goniometer footplate (Nakamura Brace Co., Shimane, Japan; Figure 2) described by Nakasa et al. was used to assess joint position sense [8]. The subjects took off their shoes and socks. Then, they sat down with the knee flexed at 70°, one at a time, on the goniometer footplate at a plantar flexion angle of 20°. The goniometer footplate can rotate internally, which means that the axis of the foot movement is aligned with the axis of the ankle inversion movement. The center of rotation of the goniometer footplate is just below the tuberosity of the calcaneus. When the subjects moved their ankle to the index angle of inversion, they were asked to memorize the angle. Then, the ankle was returned to the 0° position. After that the subjects were blindfolded to eliminate visual input, and they moved their ankle actively to match the previous index angle. The index angle was decided using a table of random numbers to 1 of 6 positions (5°, 10°, 15°, 20°, 25°, 30°), always starting from 0°. The absolute difference between the index angle and replication angle was recorded as the joint position error. The absolute error of joint position sense was measured in triplicate. The mean of the 3 trials was used for analysis.

Bottom Line: Three months after surgery in the intervention group, the joint position sense was significantly different from those found preoperatively.Three months after surgery, however, the score significantly increased.The results showed that surgical reconstruction using the remnant ligament was effective not only for improving mechanical retensioning but also for ameliorating joint position sense and functional ankle instability.

View Article: PubMed Central - PubMed

Affiliation: Fukuhara Orthopedic Clinic, 4-4-8 Ujinanishi, Minami-ku, Hiroshima-shi 734-0014, Japan ; Graduate School of Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima-shi 734-855, Japan.

ABSTRACT

Introduction: Chronic functional instability--characterized by repeated ankle inversion sprains and a subjective sensation of instability--is one of the most common residual disabilities after an inversion sprain. However, whether surgical reconstruction improves sensorimotor control has not been reported to date. The purpose of this study was to assess functional improvement of chronic ankle instability after surgical reconstruction using the remnant ligament.

Materials and methods: We performed 10 cases in the intervention group and 20 healthy individuals as the control group. Before and after surgical reconstruction, we evaluated joint position sense and functional ankle instability by means of a questionnaire.

Results and discussion: There was a statistically significant difference between the control and intervention groups before surgical reconstruction. Three months after surgery in the intervention group, the joint position sense was significantly different from those found preoperatively. Before surgery, the mean score of functional ankle instability in the intervention group was almost twice as low. Three months after surgery, however, the score significantly increased. The results showed that surgical reconstruction using the remnant ligament was effective not only for improving mechanical retensioning but also for ameliorating joint position sense and functional ankle instability.

Show MeSH
Related in: MedlinePlus