TY - JOUR
T1 - Gravity stress tibiotalar laxity evaluation with a biomedical gyroscopes device – cadaver study with progressive sectioning of lateral ankle ligaments
AU - Guerra-Pinto, F.
AU - Cunha, J.
AU - Sousa, L.
AU - Gomes, T. M.
AU - Andrade, R.
AU - Oliva, X. M.
AU - Consciência, J. G.
AU - Fernandes, P. R.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Purpose: Despite the evidence on the role of gravity stress test to access the instability of other ankle injuries, there is limited literature regarding gravity stress on the lateral ankle ligament’s insufficiency. The objective of our study was to objectively measure the tibiotalar angular movement under gravity stress after progressive sectioning of the lateral ankle ligaments. Methods: We performed sequential sectioning of the anterior talofibular (ATFL), calcaneofibular (CFL), and posterior talofibular ligaments (PTFL) in twelve ankle specimens. Under gravity stress, we measured the angular movement of the talus in relation to the tibia. The measuring device is based on a three-axis gyroscope and accelerometer. Results: Comparing to the intact condition, the plantar flexion increased on average 1.78° (95% confidence interval [CI] 1.15;2.42), 5.13° (95%CI 3.10;7.16) and 8.63° (95%CI 6.05;11.22), the rotation increased by 1.00° (95 CI -0.51;2.51), 3.68° (95%CI 1.97;5.40) and 15.62° (95%CI 10.09;21.14), and the varus increased 2.89° (95% CI 1.39, 4.39), 8.12° (95% CI 5.16, 11.07) and 11.68° (95% CI 7.91, 15.46), after sectioning the ATFL, CFL, and PTFL, respectively. The overall changes were statistically significant. Conclusions: There was a significant tibiotalar laxity after sectioning of lateral ankle ligaments when the foot position is influenced only by gravity. The tibiotalar angular displacement was significant when the CFL and PTFL were cut which suggests that the gravity test could be used to assess combined lateral ankle ligament injury. This evidence might be a step forward in the development of lateral ankle ligaments gravity stress tests. Level of evidence: 5 (cadaver study)
AB - Purpose: Despite the evidence on the role of gravity stress test to access the instability of other ankle injuries, there is limited literature regarding gravity stress on the lateral ankle ligament’s insufficiency. The objective of our study was to objectively measure the tibiotalar angular movement under gravity stress after progressive sectioning of the lateral ankle ligaments. Methods: We performed sequential sectioning of the anterior talofibular (ATFL), calcaneofibular (CFL), and posterior talofibular ligaments (PTFL) in twelve ankle specimens. Under gravity stress, we measured the angular movement of the talus in relation to the tibia. The measuring device is based on a three-axis gyroscope and accelerometer. Results: Comparing to the intact condition, the plantar flexion increased on average 1.78° (95% confidence interval [CI] 1.15;2.42), 5.13° (95%CI 3.10;7.16) and 8.63° (95%CI 6.05;11.22), the rotation increased by 1.00° (95 CI -0.51;2.51), 3.68° (95%CI 1.97;5.40) and 15.62° (95%CI 10.09;21.14), and the varus increased 2.89° (95% CI 1.39, 4.39), 8.12° (95% CI 5.16, 11.07) and 11.68° (95% CI 7.91, 15.46), after sectioning the ATFL, CFL, and PTFL, respectively. The overall changes were statistically significant. Conclusions: There was a significant tibiotalar laxity after sectioning of lateral ankle ligaments when the foot position is influenced only by gravity. The tibiotalar angular displacement was significant when the CFL and PTFL were cut which suggests that the gravity test could be used to assess combined lateral ankle ligament injury. This evidence might be a step forward in the development of lateral ankle ligaments gravity stress tests. Level of evidence: 5 (cadaver study)
KW - Ankle sprain
KW - Anterior talofibular ligament
KW - Diagnosis device
KW - Instability test
KW - Lateral ligaments
KW - Talocrural joint axis
UR - http://www.scopus.com/inward/record.url?scp=85088303469&partnerID=8YFLogxK
U2 - 10.1186/s40634-020-00269-z
DO - 10.1186/s40634-020-00269-z
M3 - Article
C2 - 32696272
AN - SCOPUS:85088303469
SN - 2197-1153
VL - 7
JO - Journal of Experimental Orthopaedics
JF - Journal of Experimental Orthopaedics
IS - 1
M1 - 53
ER -