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Dissertation
Mechanical instability of the ankle joint complex: diagnosis and evaluation of its effect on the kinematics of the ankle joint complex during level walking
Doctor of Philosophy (Ph.D.), Drexel University
1997
DOI:
https://doi.org/10.17918/00009561
Abstract
Injury to human ankle joint complex (a combination of the ankle and subtalar joints) is a common occurrence. Despite the type of treatment for acute injury, about 10%-30% of the patients develop chronic ankle instability. Upon long-term follow up many complaints were revealed from patients with chronic ankle instability. Current diagnostic methods are neither reliable nor accurate in detecting the mechanical instability of the ankle joint complex. Clinical studies have suggested that secondary osteoarthritis (OA) of the ankle might be caused by the abnormal joint motion due to ligamentous deficit in chronic unstable ankle, but there has been no diagnostic technique available which could objectively determine abnormal joint motion during gait for those ankles with mechanical instability. The main objectives of this study were (1) to develop an objective and reliable diagnostic tool for assessment of mechanical instability in ankle joint complex with acute injury as well as chronic symptoms, and (2) to develop a quantitative diagnostic tool for evaluation of abnormal joint kinematics during gait in the ankle joint complex with chronic mechanical instability. Total 27 patients were classified into the acute injury and the chronic instability groups. In the acute injury group, there was no significant differences in the mean ankle flexibility (in all motion directions) between the injured and intact ankles. In the chronic ankle instability group, there was a significant difference in the mean anterior drawer flexibility between the involved and intact ankles. The results indicated that mechanical instability of the ankle joint complex is correlated to ankle chronic instability, but it is not the only cause of ankle chronic instability. The results also demonstrated that mechanical instability of the ankle joint complex mostly occurred in the anterior translational motion due to the permanent damage to the anterior talar-fibular ligament. Ten healthy subjects and four patients with ankle mechanical instability in the chronic instability group were tested for ankle kinematics with gait analysis. Normative subjects had similar kinematic pattern in dorsiflexion/plantar flexion and limited range of translational motions in the ankle joint complex during gait. However, three patients with anterior drawer instability were found to have excessive anterior/posterior and medial/lateral translations in the involved ankles compared to the intact sides, and to normal ankles. The results indicated that patients with chronic mechanical instability might have excessive joint translations during level walking, which may lead to secondly ankle osteoarthritis.
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Details
- Title
- Mechanical instability of the ankle joint complex
- Creators
- Wen Liu
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- xvi, 169 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- College of Engineering (1970-2026); Drexel University
- Other Identifier
- 991021888947104721