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At least 235 records · Page 13Linked to original sources
PubMed2002

Involvement of sensory nerves and immune cells in osteophyte formation in the ankle joint of adjuvant arthritic rats.

To study the mechanism of osteophyte formation in the ankle joints of adjuvant arthritic (AA) rats, the localization of peripheral nerves and immune cells in the synovia were investigated in both axotomized AA rats, whose sciatic nerves were resected before adjuvant injection, and sham-operated ones, using immunohistochemistry for low-affinity nerve growth factor receptor (p75NGFR), growth-associated protein (GAP)-43, calcitonin gene-related peptide (CGRP), helper T cell (W3/25), monocyte/macrophage (ED1), and transforming growth factor (TGF)-beta1 and its receptor, TGF-betaRII. In sham-operated AA rats, dense plexuses of CGRP-positive fibers were observed in the inflamed synovia close to the osteophytes. Most of the CGRP-positive fibers were also positive for p75NGFR and GAP-43. These fibers appeared to be newly sprouted sensory nerves. In axotomized AA rats, the synovia were supplied with no CGRP-positive fibers and the sizes of the osteophytes were smaller than those in sham-operated animals. The ratio of the number of both W3/25- and ED1-positive cells in the inflamed synovia of sham-operated rats peaked at weeks 2-3 after adjuvant injection. The peak, however, lasted until week 4 in axotomized ones. In both animal groups, the macrophages and the osteoblasts were stained for TGF-beta1. The osteoblasts covering the osteophytes were also stained for TGF-betaRII. The present findings suggest that the sensory nerves and the macrophages may be involved in osteophyte formation in the ankle joints of AA rats.

Animals↗
PubMed2006

The effect of rotationplasty on the ankle joint: long-term results.

In patients with rotationplasty the biomechanical conditions in the ankle joint are altered dramatically. By displacement and reduction of the weight-bearing area of the joint, the stress affecting its cartilage is increased. The use of an exoprothesis results in skin and soft tissue irritation. Due to these biomechanical changes, a prearthrotic deformity or skin problems could be expected. The current study examines changes in 21 patients treated with rotationplasty (mean follow-up 13.5 years) because of a malignant bone tumour or a femoral segmental defect. Local tenderness, skin and soft tissue changes, problems with exoprostheses, and pain was assessed by clinical examination and documented. Osseous changes were evaluated by plain X-ray. A MRI-scan was also obtained in five patients. Hardened skin and blisters were located at the main loading areas of the rotated foot. These changes could be reduced by optimizing the exoprosthetic fit. Radiographically, a slight asymptomatic attenuation of the articular space was observed in four patients and a slight coexistent subchondral sclerosis with small osteophytes in one patient. No degenerative changes were observed on X-ray and no cartilaginous changes were observed on MRI. The results suggest that the foot is able to adapt to the load changes after this procedure and that rotationplasty does not cause an inevitable arthrosis in the ankle joint.

Adaptation, Physiological↗
PubMed1996

[Modification of the flexibility of the upper and lower ankle joint by medical compression stockings].

Using a special measurement equipment the motility range of the ankle joint and the talo-calcaneo-navicular joint in healthy young volunteers was compared with and without compression hosiery. There was no limitation in joint motility using the stockings of moderate compression (german compression class 1 and 2) but a reduced motility using strong compression hosiery (german compression class 3 and 4) was found especially in the ankle joint. This difference was significant in the products of two manufacturers.

Adolescent↗
PubMed1995

Mechanical and electromyographic analysis of reciprocal inhibition at the human ankle joint.

1. The purpose of the present study is to investigate how reciprocal inhibition influences the mechanical and electromyographic (EMG) properties of the ankle plantar flexors in humans during a voluntary contraction. 2. At different levels of maintained plantar flexion contractions ranging from 0 to 20 Nm, the size of the soleus EMG stretch reflex and the ankle joint stiffness (ration between the torque increment and the amplitude of the stretch) were measured in response to an imposed dorsiflexion. At matched plantar flexion contraction levels, stretch responses were compared before and after reversible block of the common peroneal nerve (CPN). Stretch responses were also measured during an attempted voluntary fictive dorsiflexion after CPN block. 3. In the preactivated soleus muscles, the phasic EMG response to stretch consisted of two peaks labeled M1 and M2. After CPN block, the M1 short-latency stretch reflex on average increased by 25 +/- 5.7%, mean +/- SD (P < 0.001), and the M2 stretch reflex increased on average by 29 +/- 13.0% (P = 0.002). 4. The total stiffness of the ankle joint during a stretch is the sum of the nonreflex and the reflex mediated stiffness. The total stiffness after CPN block increased on average by 13 +/- 2.7% (P = 0.002) and the estimated reflex stiffness by 33 +/- 6.5% (P < 0.001). 5. When the subjects were asked to make a strong dorsiflexion after CPN block, the soleus stretch reflex was depressed to the extent that the reflex mediated mechanical effect around the ankle joint was abolished.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Changes in posttraumatic ankle joint mobility, pain, and edema following intermittent pneumatic compression therapy.

The changes in posttraumatic ankle joint mobility, pain, and edema following intermittent pneumatic compression (IPC) therapy were examined in patients with lower leg fractures after six to 12 weeks of immobilization in a cast. The study group consisted of 22 patients with distal fractures of the lower leg. Each patient was given IPC treatment on five consecutive days for 75 minutes daily. The control group consisted of 12 patients with lower leg fractures who were not given any treatment. Ankle joint mobility in the study group increased by 11.9 degrees (SE = 1.5), but by only 1.0 degree (SE = 0.8) in the control group. The difference is highly significant (p less than 0.001). The study group also experienced markedly greater pain relief than did the control patients. The reduction of edema was 170 ml (SE = 23) in the study group and only 15 ml (SE = 12) in the control group (p less than 0.001). This study suggests that IPC treatment promotes the rehabilitation of the posttraumatic conditions.

Adult↗
PubMedDate not supplied

Chondral and osteochondral lesions of the talus associated with capsuloligamentous lesions of the ankle joint.

The author reports 46 cases of chondral and osteochondral lesion of the talus observed in 256 patients treated surgically between 1974 and 1986 for capsulo-ligamentous lesions of the ankle joint. Four cases were observed in the 18 patients operated for pure lesion of the medial collateral ligament; the remaining 42 cases in the 238 patients operated for lesions of the lateral ligaments. The lesions observed, which were substantially symmetrical in the two sides of the talus, were: cartilage contusion: 20 cases; cartilage chapping: 13 cases; osteochondral fracture with no fragment displacement: 6 cases; osteochondral detachment with loosening of the detached fragment: 7 cases. The author emphasizes the problem of the frequency of lesions of the talus associated with capsulo-ligamentous lesions of the ankle joint (18% in his experience), and that of the site of osteochondral lesions on the lateral side of the trochlea. Finally, the author lists the reasons for which it is his belief that it is essential to know whether or not a capsulo-ligamentous lesion of the ankle joint is associated with osteocartilaginous lesions of the talus.

Adolescent↗
PubMed2004

Arthrogenic muscle response to a simulated ankle joint effusion.

BACKGROUND: Arthrogenic muscle inhibition (AMI) is a continuing reflex reaction of the musculature surrounding a joint after distension or damage to the structures of that joint. This phenomenon has been well documented after knee joint injury and has been generalised to occur at other joints of the human body, yet minimal research has been conducted in this regard. The response of the muscles crossing the ankle/foot complex after ankle injury and effusion is not well understood. AMI may occur after an ankle sprain contributing to residual dysfunction. OBJECTIVE: To determine if AMI is present in the soleus, peroneus longus, and tibialis anterior musculature after a simulated ankle joint effusion. METHODS: Eight neurologically sound volunteers (mean (SD) age 23 (4) years, height 171 (6) cm, mass 73 (10) kg) participated. Maximum H-reflex and maximum M-wave measurements were collected using surface electromyography after delivery of a percutaneous stimulus to the sciatic nerve before its bifurcation into the common peroneal and posterior tibial nerves. RESULTS: The H-reflex and M-wave measurements in all muscles increased (p< or =0.05) after the simulated ankle joint effusion. CONCLUSIONS: Simulated ankle joint effusion results in facilitation of the soleus, peroneus longus, and tibialis anterior motoneurone pools. This may occur to stabilise the foot/ankle complex in order to maintain posture and/or locomotion.

Adult↗
PubMed2003

[Regional circulation in gunshot wounds of the ankle joint and foot].

Problems of treatment of battle injuries of the ankle joint and foot are discussed. These injuries are characterized with severe disturbances of regional circulation and microcirculation causing hypoxia and metabolic disorders both in soft tissues and in bones. Digital substraction angiography (DSA) was used in 7 wounded (7.53%) of all patients with battle injuries of the foot and ankle joint. Combined treatment including surgery, drugs, physical and exercise therapy, hyperbaric oxygenation was used in all the patients. Prolonged intraarterial infusion of drugs was carried out in 4 of 7 patients. It is concluded that early evaluation of regional circulation permits to clarify expediency of applied combined treatment. Injury of three arteries is the indication for amputation, but even one functioning artery enables use of combined therapy with intraarterial infusion for extremity salvage.

Amputation, Surgical↗
PubMed1990

[Risk of arthrosis of the upper ankle joint in long distance runners: controlled follow-up of former elite athletes].

To study the potential influence of long-term, high-intensity physical training on premature osteoarthrosis of the ankle joint, we re-examined former members of the Swiss National team from 1973 in retrospective cohort study in 1988. Twenty-seven track and field long-distance runners and orienteers (mean age 42 [95% confidence interval 41-43] years), 9 bobsledders (42 [39-46] years) and a control group of 23 healthy normal men (35 [33-36] years) were investigated. Physiological and exercise characteristics of all subjects had been recorded in 1973, and in 1988 these measurements were repeated together with a rheumatological and radiological examination of the ankle joint. A four-point scale of radiological joint state was used, taking into account the degree of subchondral sclerosis, osteophyte formation and joint space narrowing. In univariate analysis, the long-distance runners, and among them especially the orienteers (n = 10), showed significantly (both p less than 0.05) more radiological signs of degenerative ankle disease than controls. After adjustment for age, this difference disappeared. Age was itself significantly and positively related to radiological degenerative ankle disease (r less than 0.38; p less than 0.01). Orienteers reported significantly more frequently (60 vs 12%; p less than 0,01) functional instability of the ankle joint than track and field runners. Functional and mechanical (clinical) instability were interrelated in our material (r = 0.33; p less than 0.05) but neither of them was significantly related to radiological signs of degenerative ankle disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Diagnosis and therapy of fibular ligament injuries in the ankle joint in children].

Turn fibular ligaments of the ankle go often undetected when not accompanied by osseous lesions. The significance of injuries to the major supporting ligaments of the ankle is underestimated in children. Next to the clinical findings stress radiographs of the ankle joint in two projections are mandatory. Measurements of anterior and lateral displacement under stress and displacement index need to be compared with the healthy ankle. Diagnosis of a fibular ligament rupture is based on clinical findings and on differences between the measurement results (injured compared to healthy) by way of three different techniques. Rupture of a fibular ligament is an absolute indication for surgery--even in children.

Adolescent↗
PubMed1998

Tenodeses destroy the kinematic coupling of the ankle joint complex. A three-dimensional in vitro analysis of joint movement.

To study the effect of ligament injuries and surgical repair we investigated the three-dimensional kinematics of the ankle joint complex and the talocrural and the subtalar joints in seven fresh-frozen lower legs before and after sectioning and reconstruction of the ligaments. A foot movement simulator produced controlled torque in one plane of movement while allowing unconstrained movement in the remainder. After testing the intact joint the measurements were repeated after simulation of ligament injuries by cutting the anterior talofibular and calcaneofibular ligaments. The tests were repeated after the Evans, Watson-Jones and Chrisman-Snook tenodeses. The range of movement (ROM) was measured using two goniometer systems which determined the relative movement between the tibia and talus (talocrural ROM) and between the talus and calcaneus (subtalar ROM). Ligament lesions led to increased inversion and internal rotation, predominantly in the talocrural joint. The reconstruction procedures reduced the movement in the ankle joint complex by reducing subtalar movement to a non-physiological level but did not correct the instability of the talocrural joint.

Aged↗
PubMed1998

[Standardized ultrasound examination of the ankle joint. Clarification of ultrasound standard image sections by corresponding MRI sections].

AIM: The sonographical examination of the ankle was demonstrated in five standard cross-sections presented by the DEGUM (German Society for the Development of Ultrasonography in the Locomotor Apparatus) and compared with corresponding MRI cross-sections. METHOD: The sonographical examination was done in a real-time method with an ultrasound unit Type Versa (Siemens, Erlangen, Germany) and with a linear transducer (frequency 7.5 Mhz). The MRI tomographies were taken in two planes with the unit Type Magnetom (Siemens, Erlangen, Germany) with a 1.5 Tesla head-coil in T1- and T2-weighted spin echo sequences. RESULTS: Focus on the ventral, lateral and dorsal region provided a good overview of the superior ankle joint and the periarticular soft tissues. CONCLUSION: Being a cross-sectional method, the sonographical examination of the ankle joint offers additional information with regard to pathological changes of the joint and the periarticular soft-tissues.

Adult↗
PubMed1999

Lubrication of the human ankle joint in walking with the synovial fluid filtrated by the cartilage with the surface zone worn out: steady pure sliding motion.

A mixture model of synovial fluid filtration by cartilage in the human ankle joint during walking is presented for steady sliding motion of the articular surfaces. In the paper the cartilage surface zone is assumed worn out. The same model has been recently applied to the squeeze-film problem for the human hip joint loaded by the body weight during standing (Hlavácek, Journal of Biomechanics 26, 1145-1150, 1151-1160, 1993; Hlavácek and Novák, Journal of Biomechanics 28, 1193-1198, 1199-1205, 1995). The linear biphasic model for cartilage (elastic porous matrix + ideal fluid) due to Prof. V. C. Mow and his co-workers and the biphasic model for synovial fluid (viscous fluid + ideal fluid), as used in the above-mentioned squeeze-film problem, are applied. For the physiologic parameters of the ankle joint during walking, a continuous synovial fluid film about 1 microm thick is maintained under steady entraining motion according to the classical model without the fluid transport across the articular surface. This is not the case in the filtration model with the cartilage surface zones worn out. On the contrary, this filtration model indicates that synovial fluid is intensively filtrated by such cartilage, so that no continuous fluid film is maintained and a synovial gel layer, about 10(-8) m thick, develops over the majority of the contact. Thus, if the cartilage surface zones are worn out, boundary lubrication should prevail in the ankle joint under steady sliding motion for the mean values of loading and the sliding velocity encountered in walking cycle.

Ankle Joint↗
PubMed2001

[Intra-articular and plantar pressure distribution of the ankle joint complex in relation to foot position].

Ankle injuries are often followed by degenerative changes in the hindfoot joints. Knowledge about the pressure distribution of the intact ankle joint may help to understand the mechanisms leading to cartilage damage. Therefore, we determined the intraarticular and plantar pressure distribution of the ankle joint complex and the Chopart joints with varying foot positions. 12 human lower leg specimens were axially loaded in a foot-loading simulator with full body weight (600 N). A capacitive pressure distribution platform was used to determine plantar pressure patterns. The intraarticular loading situation was measured with Fuji Prescale film. 3 different foot positions (neutral, 10 degrees dorsiflexion, 10 degrees plantarflexion) were investigated. Dorsiflexion led to an increase of the intraarticular contact area, force and mean pressure in the hindfoot. Plantarflexion instead increased loading in the Chopart joints. In the plantar pressure distribution force and peak pressure under the hindfoot increased with dorsiflexion. With plantarflexion area, force and peak pressure under mid- and forefoot increased. With our study we could demonstrate that the loading situation of the ankle joint complex is significantly influenced by the foot position. These findings may help to understand the development and localisation of arthritic changes due to posttraumatic changes of the joint loading characteristics.

Ankle Injuries↗
PubMed1987

[Comparative study of the stabilizing effect of conservative-functional measures of the unstable upper ankle joint].

In a comparative study the value of castless immobilisation methods for stabilising the lateral ankle instability was examined. For this the dimension of the lateral talar tilt as a sign for chronic lateral ankle instability in 32 sportsmen with chronic ankle instability was checked initially. Afterwards the reduction of this instability due to the application of the tape-bandage and the "ankle-brace" was tested under the same standardised conditions. In regard to the reduction of the lateral talar tilt a reduction of this instability of the ankle joint is possible significantly. But compared to the normal talar tilt showing a stable ankle joint, it is not possible to reach this in all cases of ankle instability. So for treatment of the lateral ligament rupture it is necessary to use the usual cast for stabilising the joint after ligament suture before reduction of the time of immobilisation is possible. The use in cases of chronic instability or as a precaution method is not restricted when a sufficient active stabilisation is possible.

Ankle Injuries↗
PubMed1979

[Registration of fibular movements in vivo in relation to the tibia at the level of the ankle joint].

Fibular movements in relation to the tibia are known on extension and dorsiflexion of the ankle-joint and have been proved by experiences on cadaveric preparates using outstanding points of relation. To registrate fibular movements in vivo a special trigonometric system has been developed permitting calculation of definite movement in frontal and sagittal plane as well as a rotation around axis. Twelve healthy volunteers were examined in this way during extension and dorsiflexion of the ankle, with and without weight-bearing. The results showed that we should not consider isolated fibular movement but analyse simultaneous complexity of movements in a graphic comparison. Under these conditions we observe a very high significance of fibular movements depending each of other. The emphasis can be designed in a field covering all the points reached by fibular movement in frontal and sagittal plane of the twelve healthy volunteers during movement of the ankle; it shows that the fibula functions like a guide-stick for ankle movement. Reflecting on the designed fields of healthy persons, some patients with posttraumatic pathological alterations of the ankle-joint have been analysed.

Ankle Injuries↗
PubMed2005

[The reorientational rearthrodesis of the upper ankle joint following failed arthrodesis].

There are three important principles for the correction of nonunion and/or malunion of the ankle joint: (1) reorientation back to anatomic shape and to the normal biomechanical axis of the ankle and foot; (2) respect for the biology of bone by resecting all sclerotic bone and/or transplantation of autogenous bone graft; and (3) achievement of optimal biomechanical stability by using the four-screw technique, a limited-contact dynamic-compression plate or a blade plate. CT scanning is the most reliable method for detecting nonunion of the ankle joint after arthrodesis. According to Saltzman, in order to understand the pathology of malunions and nonunions and to plan their correction, weight-bearing anteroposterior radiographs with a 20 degrees internal rotation of the feet, precise lateral views, and rear views of both sides are highly recommended.

Adult↗