Influence of anterior talofibular ligament injury and mechanical ankle anterior displacement on symptoms in individuals with chronic ankle instability

J Athl Train. 2024 Mar 6. doi: 10.4085/1062-6050-0582.23. Online ahead of print.

Abstract

Context: Repeated ankle sprains can lead to injuries, including those of the anterior talofibular ligament; however, the extent to which these ligament injuries are associated with symptoms of chronic ankle instability remains unclear.

Objective: To examine the influence of anterior talofibular ligament injury and ankle anterior displacement on symptoms of chronic ankle instability.

Design: Case-Control Study.

Setting: A university laboratory.

Patients or other participants: A total of 426 college students completed a questionnaire survey on the history of ankle sprain. Thirty-four (24 males, 10 females; age = 20.6 ± 0.5 years), 49 (38 males, 11 females; age = 20.2 ± 1.2 years), and 39 (24 males, 15 females; age = 20.1 ± 1.1 years) participants were enrolled in the healthy, coper, and chronic ankle instability groups, respectively.

Data collection and analysis: One examiner measured the anterior talofibular ligament delineation using ultrasound and anterior ankle displacement using a capacitance-type sensor device. The Cumberland Ankle Instability Tool was applied to assess pain and perceived instability.

Results: The anterior talofibular ligament was normal significantly more frequently in healthy participants and abnormal significantly more frequently in patients with chronic ankle instability (p < 0.001). Anterior ankle displacement was significantly greater in the coper and chronic ankle instability groups than in healthy individuals (p < 0.001), but no significant difference was observed between the coper and chronic ankle instability groups. There was no significant correlation between the anterior ankle displacement and Cumberland Ankle Instability Tool scores (p = 0.709) in participants with previous ankle sprains.

Conclusion: Observation of an abnormal anterior talofibular ligament on ultrasonography is associated with anterior displacement of the ankle joint. However, it is assumed that the influence of anterior ankle displacement due to damage to the anterior talofibular ligament on the pain and perceived instability in chronic ankle instability is small.

Keywords: ankle injury; anterior drawer test; pain; ultrasonography.