Division of Orthopaedic Surgery, Department of Radiology, Duke University, Durham, NC 27710, USA.
Am J Sports Med. 2009 Nov;37(11):2241-8. doi: 10.1177/0363546509337578. Epub 2009 Jul 21.
Previous studies have suggested that injury to the anterior talofibular ligament (ATFL) may be linked to altered kinematics and the development of osteoarthritis of the ankle joint. However, the effects of ATFL injury on the in vivo kinematics of the ankle joint are unclear.
Based on the orientation of the ATFL fibers, ATFL deficiency leads to increased anterior translation and increased internal rotation of the talus relative to the tibia.
Descriptive laboratory study.
The ankles of 9 patients with unilateral ATFL injuries were compared as they stepped onto a level surface. Kinematic measurements were made as a function of increasing load. With use of magnetic resonance imaging and orthogonal fluoroscopy, the in vivo kinematics of the tibiotalar joint were measured in the ATFL-deficient and intact ankles of the same individuals.
A statistically significant increase in internal rotation, anterior translation, and superior translation of the talus was measured in ATFL-deficient ankles, as compared with the intact contralateral controls. For example, at 100% body weight, ATFL-deficient ankles demonstrated an increase of 0.9 +/- 0.5 mm in anterior translation (P = .008), an increase of 5.7 degrees +/- 3.6 degrees in internal rotation (P = .008), and a slight increase of 0.2 +/- 0.2 mm in the superior translation (P = .02) relative to the intact contralateral ankles.
Deficiency of the ATFL increases anterior translation, internal rotation, and superior translation of the talus.
Altered kinematics may contribute to the degenerative changes observed with chronic lateral ankle instability. These findings might help to explain the degenerative changes frequently observed on the medial talus in patients with chronic ATFL insufficiency and so provide a baseline for improving ankle ligament reconstructions aimed at restoring normal joint motion.
先前的研究表明，距腓前韧带（ATFL）的损伤可能与运动学改变和踝关节骨关节炎的发展有关。然而，ATFL 损伤对踝关节的体内运动学的影响尚不清楚。
根据 ATFL 纤维的方向，ATFL 缺失会导致距骨相对于胫骨向前移位增加和内旋增加。
描述性实验室研究。
比较了 9 例单侧 ATFL 损伤患者单足登上水平表面时的踝关节。随着负荷的增加进行运动学测量。使用磁共振成像和正交透视，测量了同一患者 ATFL 缺失和完整踝关节的距下关节体内运动学。
与对侧正常对照相比，ATFL 缺失踝关节的内旋、前向移位和距骨上移位均有统计学显著增加。例如，在 100%体重时，ATFL 缺失踝关节的前向移位增加了 0.9±0.5 毫米（P=.008），内旋增加了 5.7 度±3.6 度（P=.008），距骨上移位略有增加 0.2±0.2 毫米（P=.02）。
ATFL 缺失增加了距骨的前向移位、内旋和上移位。
运动学改变可能导致慢性外侧踝关节不稳定患者观察到的退行性变化。这些发现可能有助于解释慢性 ATFL 不足患者中经常观察到的内侧距骨退行性变化，并为旨在恢复正常关节运动的踝关节韧带重建提供基线。
