TY - JOUR
T1 - Lack of Definition of Chronic Ankle Instability With Arthrometer-Assisted Ankle Joint Stress Testing
T2 - A Systematic Review of In Vivo Studies
AU - Guerra-Pinto, Francisco
AU - Andrade, Renato
AU - Diniz, Pedro
AU - Luisa Neto, Ana
AU - Espregueira-Mendes, João
AU - Guimarães Consciência, José
N1 - Funding Information:
Financial Disclosure: None reported.
Publisher Copyright:
© 2021 the American College of Foot and Ankle Surgeons
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Despite extensive research on ankle instability a consensual and clear objective definition for pathological mechanical lateral ankle instability is yet to be determined. This systematic review aimed to summarize current available arthrometric devices, measuring methods and lateral ankle laxity outcomes in patients with chronic ankle instability that underwent objective arthrometric stress measurement. Sixty-eight studies comprising a total of 3,235 ankles with chronic ankle instability were included. Studies reported a wide range of arthrometric devices, testing position and procedures, and measuring methods. For the anterior drawer test, the average mean differences between injured and uninjured ankles ranged from -0.9 to 4.1 mm, and total translation in the injured ankle from 3.2 to 21.0 mm. Most common pathological threshold was ≥4 mm or ≥10 mm unilaterally and ≥3 mm bilaterally. For the talar tilt test, the average mean differences between injured and uninjured ankles ranged from 0.0° to 8.0°, and total tilt from injured ankle from 3.3 to 60.2°. Most common pathological threshold was ≥ 10° unilaterally and ≥ 6° mm bilaterally. It was found high heterogeneity in the scientific literature regarding the arthrometric devices, use of concomitant imaging and measuring methods of arthrometer-assisted anterior drawer and talar tilt tests which led to variable laxity outcomes in individuals with chronic ankle instability. Future studies should focus on standardizing the testing and measuring methods for an objective definition of mechanical ankle instability.
AB - Despite extensive research on ankle instability a consensual and clear objective definition for pathological mechanical lateral ankle instability is yet to be determined. This systematic review aimed to summarize current available arthrometric devices, measuring methods and lateral ankle laxity outcomes in patients with chronic ankle instability that underwent objective arthrometric stress measurement. Sixty-eight studies comprising a total of 3,235 ankles with chronic ankle instability were included. Studies reported a wide range of arthrometric devices, testing position and procedures, and measuring methods. For the anterior drawer test, the average mean differences between injured and uninjured ankles ranged from -0.9 to 4.1 mm, and total translation in the injured ankle from 3.2 to 21.0 mm. Most common pathological threshold was ≥4 mm or ≥10 mm unilaterally and ≥3 mm bilaterally. For the talar tilt test, the average mean differences between injured and uninjured ankles ranged from 0.0° to 8.0°, and total tilt from injured ankle from 3.3 to 60.2°. Most common pathological threshold was ≥ 10° unilaterally and ≥ 6° mm bilaterally. It was found high heterogeneity in the scientific literature regarding the arthrometric devices, use of concomitant imaging and measuring methods of arthrometer-assisted anterior drawer and talar tilt tests which led to variable laxity outcomes in individuals with chronic ankle instability. Future studies should focus on standardizing the testing and measuring methods for an objective definition of mechanical ankle instability.
KW - 4
KW - ankle laxity
KW - ankle mechanical instability
KW - anterior drawer test
KW - arthrometer
KW - chronic ankle instability
KW - stress radiography
KW - talar tilt test
UR - http://www.scopus.com/inward/record.url?scp=85107929250&partnerID=8YFLogxK
U2 - 10.1053/j.jfas.2020.04.026
DO - 10.1053/j.jfas.2020.04.026
M3 - Review article
C2 - 34134919
AN - SCOPUS:85107929250
VL - 60
SP - 1241
EP - 1253
JO - J. Foot Ankle Surg.
JF - J. Foot Ankle Surg.
SN - 1067-2516
IS - 6
ER -