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At least 37 records · Page 2Linked to original sources
PubMed1991

Traumatic osteoarthrosis of the ankle joint secondary to ankle fractures.

Arthritis, in one form or another, is one of the most common disorders that affect man. Whether the etiology is systemic, neurologic, or traumatic, the one common finding is the destruction of joint cartilage. Although there have been massive amounts of literature concerning osteoarthritis, little has been written about arthritis of the ankle joint. Current concepts in the pathology, terminology, symptomatology, and treatment of the arthritic ankle are discussed.

Ankle Injuries↗
PubMed1992

Ligament strain and ankle joint opening during ankle distraction.

To determine the efficacy of ankle distraction and to investigate possible complications of the procedure, the strain on four ankle ligaments and the tibiotalar joint opening resulting from distraction force and various foot positions were studied. We mounted strain gauges on the deltoid, calcaneofibular, tibiofibular, and anterior talofibular ligaments of six fresh human cadaver ankles. An Acufex ankle distractor was used to apply forces of 45, 90, 135, and 180 N at 20 degrees dorsiflexion, neutral, and 10 degrees plantar flexion. The ankle distractor proved to be effective in opening the joint space for better visualization, but complications of pin bending, excessive ligament strain, and bony destruction did occur within the clinically recommended range. Based on the observed results, the safest method of distraction was to use forces < 135 N in the neutral position.

Ankle Joint↗
PubMed2000

Biomechanics of the ankle joint. A perspective on total ankle replacement.

The biomechanics of the ankle present a unique set of challenges for arthroplasty surgery. Its biomechanics are not simple. Although the ankle joint may seem like a hinge, it is not in a line perpendicular to the tibia. The axis of rotation does not stay constant during range of motion, despite a relative congruency of this joint. Allowing for rotational forces must be accomplished, while maintaining the stability of the joint and its components. Success of the arthroplasty depends on how successful designs can dissipate these rotational forces, while maintaining the stability of the joint. It is not yet clear from the biomechanical analysis of the normal ankle joint that this dissipation of forces has been accomplished successfully in modern implants, although early results in the semiconstrained designs are encouraging. Careful assessment of long-term follow-up will determine how close the present designs are to mimicking the unique requirements of the arthritic foot and ankle. Further work on the biomechanics of these replacements would be beneficial.

Ankle Joint↗
PubMed1992

[Diagnostic arthroscopy and arthroscopic surgery of the upper ankle joint].

Arthroscopy of the ankle joint was limited to the anterior compartments for a long time. The key to the entire diagnostic and therapeutic arthroscopy procedure on the ankle joint was the distension of the joint space through modern distraction techniques. The distraction devices available make arthroscopic surgery of the ankle joint as effective as in other joints like the knee and shoulder. Distension of the joint space allows visualization of all compartments, including the posterior ankle. In the case of hidden cartilage pathology of the posterior talus, an osteotomy linked with hardware removal through a second operation can be avoided today. The indications for arthroscopy of the ankle are pain, swelling, instability, hemarthrosis and joint locking. Generally, arthroscopy of the ankle joint is performed utilizing three general portals: anterolateral, anteromedial and posterolateral. Arthroscopic standard equipment, including the small joint set, is sufficient to treat the major part of ankle pathology through the standard portals. Arthroscopic ankle joint debridement in degenerative arthritis, removal of osteophytes, elimination of loose bodies and the management of soft tissue and bony impingement are possible. A complete synovectomy can be performed, including the posterior compartments. The treatment of osteochondritis dissecans is facilitated through the transmalleolar approach in combination with the distraction device. Arthroscopic ankle arthrodesis is possible and induces less trauma because an arthrotomy can be avoided. In our opinion diagnostic arthroscopy and arthroscopic surgery of the ankle joint is a procedure of great benefit for the patients if the indications are strictly adherred to.

Ankle Injuries↗
PubMedDate not supplied

[Computer-assisted analysis of the kinematics of the upper ankle joint].

Usually the upper ankle joint is described as a typical hinge though it had been often remarked that the axis of rotation moves considerably with regard to the angular adjustment between the tibia and the trochlea tali. In the present study the relation between the movements in the upper ankle joint and the geometry of the lateral ligaments was analysed. The contours and elected landmarks of 6 dissected ankle joints were measured using a digitizer which allowed the computerized scanning of motion x-rays. In addition the proximal and distal insertion planes of the lateral ligaments were registered. Mathematical procedures were applied on the experimental data to predict the kinematic principles. The model of an hinged joint could not reproduce the motion curve which was actually found. Using the model of a link chain with four pivots, which was determined by the course of the talofibular and the calcaneofibular ligament, a good correlation with the experimental results was evident. This model implies a rotary and gliding component in the movement of the tibia against the trochlea tali. Beside the correspondence with the data of the present study the model allows an easy explanation of many other well known morphologic phenomena of the upper ankle joint for which a stringent interpretation was not yet available.

Ankle Joint↗
PubMed1996

[Arthrodesis of the ankle joint].

Arthrodesis of the ankle joint is still an important operation in the treatment of painful arthrosis, chronic infection, and malalignment instability when these cases have been treated unsuccessfully with other therapeutic procedures. To date, prosthetic replacement of the ankle joint has been an alternative only in rheumatoid patients. Concerning the long-term results, ankle arthrodesis is much better than alloarthroplasty. Because of the good functional results achievable by arthrodesis when done in the right position, there is less often a need for prosthetic replacement than in the hip or knee joint. A patient with a fused ankle joint is only limited when running. Compression arthrodesis is possible at present with various operative techniques utilizing external fixators, ring fixators and open reduction internal fixation with plates and screws. The last procedure can be carried out arthroscopically. With these techniques, fusion of the ankle joint in the correct position is possible in nearly all situations, e.g., infection, malalignment, osteoporosis, soft tissue damage. The main complication of ankle arthrodesis is pseudarthrosis (up to 35%) and postoperative infection (3%-25%). An important late sequela is arthrosis in the joints adjacent to the fused ankle joint (10-60%).

Ankle Joint↗
PubMed1994

Arthroscopic arthroplasty of the ankle joint.

Anterior ankle impingement syndrome is characterized by pain, edema, and limited ankle dorsiflexion. The article examines this syndrome in detail from a variety of perspectives, including indications and contraindications, physical examination, various diagnostic modalities, surgical anatomy, surgical approach, procedures for arthroscopy, and complications.

Ankle Injuries↗
PubMedDate not supplied

[The ankle joint in fibula malformations].

The ankle joints of 109 extremities with fibula reductions wer examined. The authors' findings led them to conclude that the shape of the ankle joint must be regarded as the result of an adaptation to altered functions. Ball-shaped ankle joints are frequently found in cases of hypoplasia of the fibula; partial and subtotal aplasias of the fibula are more likely to be associated with a valgus deformity of the ankle joint (known as Volkmann's ankle joint deformity) or, if more severe, with kyphosis of the tibia. If there is no laterodorsal restraint by coarse fibrous strands in cases of fibular aplasia, it is also possible that ball-shaped ankle joints will develop.

Adolescent↗
PubMed2005

Differences between measured and resultant joint moments during isometric contractions at the ankle joint.

The purpose of this study was to examine two hypotheses: (a) during voluntary and electrically induced isometric contractions the moments measured at the dynamometer are different from the resultant moments in the same plane around the ankle joint and (b) at a given resultant moment during electrically induced isometric contractions the ankle angle while loading is different from the ankle angle while unloading. Twenty-seven long distance runners participated in the study. All subjects performed isometric maximal voluntary contractions (MVC) and contractions induced by electrostimulation at four different ankle-knee angle combinations on a Biodex-dynamometer. The kinematics of the leg were recorded using the vicon 624 system with eight cameras operating at 120 Hz. The main findings were: (a) the resultant moment at the ankle joint and the moment measured by the Biodex-dynamometer during isometric contractions are different, (b) during a plantar flexion effort the ankle angle changes significantly, whereas the knee angle shows only small and in most cases not significant changes, and (c) at identical resultant ankle joint moments the ankle angles are different between the loading and the unloading phases. The observed differences may lead to erroneous conclusions concerning the following: (a) diagnostic of muscle architecture, (b) estimation of the moment-ankle angle relationship and (c) estimation of the strain and hysteresis of tendons and aponeuroses.

Ankle Joint↗
PubMed1983

[Contact surfaces and anatomical joint surfaces of the upper ankle joint--methods for the determination of facet size and case representation].

The cartilage surfaces of six ankle joints were stained according to a triple dyeing technique. Using a load appliance and a pressure of 1600 N the largest possible weight-bearing areas were stained without damaging the ligaments. The joints were either plantar-flexed, in a 0 degree position or in dorsal extension. The contact areas of the joint, including both the cartilage surfaces and the ligaments, showed characteristic forms according to the joint's position. By projecting the respective contact areas of the tibial plateau onto the upper side of the trochlea tali we were able to estimate the cartilage weight-bearing area in the proper sense. According to this method, the upper side of the trochlea tali, without the facet of Fawcett, proved to have the largest weight-bearing area when in the 0 degree position, namely 56.4 +/- 4.9% of the anatomical joint surface. The next largest area, 51.9 +/- 4.8%, was found when the joint was in dorsal extension and the smallest, 47.1 +/- 3.6%, when plantar-flexed. The size of the anatomical joint surfaces and some morphometric values of the upper side of the trochlea tali were measured using 21 specimens.

Adult↗
PubMedDate not supplied

[Joint loose bodies in both upper ankle joints in neural muscular atrophy of the Charcot-Marie-Tooth-Hoffmann type (hereditary motor sensory neuropathy I)].

A case is reported in which a patient with Charcot-Marie-Tooth-Hoffmann disease (HMSN I) complained about bilateral ankle pain, stiffness and swelling. Radiologically multiple loose bodies in both ankle joints were detectable. The etiology of loose bodies or secondary chondromatosis is still unclear. Different reasons are discussed. Regarding the case reported on here we discuss possible etiological connections and pathophysiological pathways that may explain influence of Charcot-Marie-Tooth-Hoffmann disease (hereditary motor sensory neuropathy I) on the development of loose bodies at both ankle joints.

Adult↗