Examination of anterior talofibular ligament thickness and the number of previous ankle sprains in collegiate athletes
Date
2018
Authors
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Publisher
University of Delaware
Abstract
Context: In an athletic population, acute ankle sprains are the most common and most prevalent musculoskeletal injury, accounting for up to 40% of all injuries. Research has shown that acute and untreated ankle sprains can lead to chronic ankle instability, which refers to repetitive episodes of instability resulting in recurrent injuries and loss of function. Many ankle sprains occur due to inversion of the ankle, which over-stresses the anterior talofibular ligament (ATFL). Repetitive damage to the ligament, and subsequent inflammation responses results in the formation of scar tissue. Although it has been shown that sprains lead to scar tissue formation, it is unknown whether the frequency of recurrent sprains corresponds with increased tissue thickness as well a loss on function. Objective: The purpose of this study was to determine if the number of previous ankle sprains influences the thickness of the ATFL and function. Design: Retrospective cohort. Participants: 121 NCAA DI student-athletes (178 ankles) (18.6 + 1.1 yrs, 82.0 + 20.7 kg, 180.0 + 10.6 cm) from the University of Delaware was collected for this study. The participants were divided into groups: 0 ankle sprains, 1 ankle sprain, and 2+ ankle sprains. Methods: Each participant completed the Cumberland Ankle Instability Tool (CAIT) and an injury history questionnaire to report the number of sprains they have experienced throughout their lifetime. Thickness of the ATFL was measured by musculoskeletal ultrasound (MSUS) using a GE LOGIQ e. Statistical Analysis: A one-way ANOVA was performed to determine the difference between those with or without a history of previous ankle sprains and ATFL thickness, along with a post-hoc test with a Bonferroni adjustment to determine whether statistically significant differences exist. A one-way ANOVA was also performed to determine if there were statistical differences between gender and ATFL thickness. A Spearman’s rho correlation coefficient was used to determine a relationship between the number of sprains and CAIT scores, CAIT scores and ATFL thickness, number of sprains and ATFL thickness, and gender and ATFL thickness. The independent variable was group (0,1, 2+). The dependent variable was thickness of the ATFL in millimeters (mm). Results: There were no statistically significant differences between groups (0, 1, 2+) and ATFL thickness (1.59 + 0.15 mm vs. 1.63 + 0.15 mm vs. 1.61 + 0.14 mm, respectively). There were no statistical differences between gender 0.62 (0.49) and ATFL thickness: 1.6 (0.15) (p= 0.97, F= 2.791). There was a statistically significant correlation between the number of sprains: 1.18 (1.14) and CAIT scores: 27 (3.7) (p< 0.001, -0.614) and there was a statistically significant correlation between gender: 0.62 (0.49) and thickness: 1.6 (0.15) (p= 0.047, 0.149). There was no statistically significant correlation between the ATFL thickness: 1.6 (0.15) and CAIT scores: 27 (3.7) (p< 0.263, -0.084) or between number of sprains: 1.18 (1.14) and thickness: 1.6 (0.15) (p= 0728, 0.026). Conclusions: We did not find a statistically significant difference in ligament thickness between groups; however, we found that ligament thickness increases after one lateral ankle sprain. We also found a statistically significant correlation between number of sprains and CAIT scores, suggesting that the numbers of sprains affect joint stability. These findings indicate that after just one lateral ankle sprain, morphological changes occur. These changes could result in deficits to the stabilizing properties of the ligament, leaving it more susceptible to re-injury and compromising joint stability. ☐ Key Words: Anterior Talofibular Ligament, lateral ankle sprain, chronic ankle instability, diagnostic ultrasound
Description
Keywords
Health and environmental sciences, Anterior talofibular ligament, Chronic ankle instability, Diagnostic ultrasound, Lateral ankle sprain