ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021
Ankle microinstability: arthroscopic findings reveal four types of lesion to the anterior talofibular ligament's superior fascicle.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Ultrasound identification and sonoanatomy of the inferior fascicle of the anterior talofibular ligament: a cadaveric study.Journal of ultrasound · 2026Article
- Mechanical Contribution of the Anterior Talofibular Ligament to Ankle Stability: 3D Anatomical Finite Element Analysis.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2026Article
- Suture tape augmentation in arthroscopic lateral ligament repair for chronic ankle instability yields similar clinical outcomes but faster return to sport compared to isolated repair.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Arthroscopic findings and accuracy of preoperative diagnosis in patients with chronic lateral ankle instability.Journal of experimental orthopaedics · 2026Article
- Suture-Button Repair Improves Outcomes in Arthroscopically Diagnosed Chronic Syndesmotic Injury Despite Low Imaging Sensitivity.Arthroscopy, sports medicine, and rehabilitation · 2025Article
- Differences in ankle stabilizing function between the upper and lower fiber bundles of the anterior talofibular ligament: an anatomical study.Scientific reports · 2025Article
- Clinical outcomes of arthroscopic all-inside anterior talofibular ligament trans- augmentation repair versus modified trans- augmentation repair for patients with chronic ankle instability.Journal of orthopaedic surgery and research · 2025Article
- What is the frequency of anterior syndesmosis injury in posterior malleolus fracture?Journal of orthopaedic surgery and research · 2025Article
- The impact of lateral ankle ligament injuries on ankle stability and talar cartilage stress: a finite element analysis of combined injury mechanisms.Frontiers in bioengineering and biotechnology · 2025Article
- The deltoid ligament is constantly formed by four fascicles reaching the navicular, spring ligament complex, calcaneus and talus.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2024Article
- Current concepts in ankle microinstability and ankle functional instability.Journal of clinical orthopaedics and trauma · 2024Article
- [Injuries of the ankle ligaments].Orthopadie (Heidelberg, Germany) · 2024Article
- Chronic lateral ankle ligament instability - Current evidence and recent management advances.Journal of clinical orthopaedics and trauma · 2024Article
- Modified classifications and surgical decision-making process for chronic anterior talofibular ligament injuries based on the correlation of imaging studies and arthroscopic findings.International orthopaedics · 2023Article
- The ATFL inferior fascicle, the CFL and the PTFL have a continuous footprint at the medial side of the fibula.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Biomechanical improvement of anterior talofibular ligament by augmentation repair of ligament advance reinforcement system: a cadaver study.BMC surgery · 2023Article
- The lowest point of fibula (LPF) could be used as a reliable bony landmark for arthroscopic anchor placement of lateral ankle ligaments ----compared with open Broström procedure.BMC musculoskeletal disorders · 2023Article
- Common Football Foot and Ankle Injuries: Non-Surgical and Surgical Management.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2023Article
- Individual fascicles of the ankle lateral ligaments and the lateral fibulotalocalcaneal ligament complex can be identified on 3D volumetric MRI.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Arthroscopic and Open Procedures Result in Similar Calcaneal Tunnels for Anatomical Reconstruction of Lateral Ankle Ligaments.Arthroscopy, sports medicine, and rehabilitation · 2023Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeATFL's superior fascicle injury has been considered to be the underlying cause in cases of ankle microinstability. As its clinical diagnosis can be difficult, arthroscopic examination may be the only objective diagnostic tool. The purpose of this study was to determine what types of injuries to the ATFL's superior fascicle are associated with ankle microinstability, and to provide the reader with an arthroscopic classification of the types of microinstability affecting the ankle.
methodsAnkle arthroscopy video records obtained during a four-year period from 232 patients with the diagnosis of ankle microinstability were reviewed. The characteristics of the ATFL's superior fascicle injury were identified, described and recorded along with any concomitant intra-articular pathology.
resultsFour different injury patterns were consistently seen affecting the ATFL's superior fascicle. These ranged from ligament attenuation associated with loss of tension (type I), through to partial detachment (type II) or total detachment (type III) from the fibula. Finally, a total or partial resorption of the ATFL's superior fascicle (type IV) was also observed. There was a statistically significant association between the type of injury identified and the rate of intra-articular pathology observed arthroscopically. Equally, the higher the type in the classification, the higher the rate of loose bodies, lateral talar OCD, deltoid "open book" tears, and anterior soft-tissue formation.
conclusionDifferent types of ATFL's superior fascicle injury can be observed in patients with ankle microinstability, ranging from ligament attenuation associated with a loss of tension (8.2%) to different degrees of partial (69.1%) and total (16.8%) ligament detachment from the fibula, or ligament remnant resorption (5.9%). As the type of injury progresses along with the proposed classification, the rate of intra-articular injuries also increases. The clinical relevance of this study is that a morphological ATFL's superior fascicle tear is recognized in patients with the diagnosis of ankle microinstability. LEVEL OF EVIDENCE: IV.
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