A 27-year-old male started to have his ankles swollen during his military service. He was examined at a military hospital where electromyoneurography showed the signs of distal sensory-motor polyneuropathy with axon d...A 27-year-old male started to have his ankles swollen during his military service. He was examined at a military hospital where electromyoneurography showed the signs of distal sensory-motor polyneuropathy with axon demyelinization and weak myopathic changes, whereas histopathological examination of gastrocnemius muscle biopsy revealed some mild and nonspecific myopathy. Besides, he was found to have subcutaneous ankle tissue edemas and hypertransaminasemia. Due to these reasons, he was dismissed from the military service and examined at another hospital where bone osteodensitometry revealed low bone mineral density of the spine. However, his medical problems were not resolved and after the second discharge from hospital he was desperately seeing doctors from time to time. Finally, at our institution he was shown to have celiac disease (CD) by positive serology (antitissue transglutaminase and antiendomysial antibodies) and small bowel mucosal histopathological examination, which showed total small bowel villous atrophy. Three months after the initiation of gluten-free diet, his ankle edema disappeared, electromyoneurographic signs of polyneuropathy improved and liver aminotransferases normalized. Good knowledge of CD extraintestinal signs and serologic screening are essential for early CD recognition and therapy.展开更多
Arthroscopy of the ankle with micro-fracture technique is one way to initially treat symptomatic talar dome lesions. Human amniotic allograft has been used in similar bone, soft tissue and cartilage defects to aid in ...Arthroscopy of the ankle with micro-fracture technique is one way to initially treat symptomatic talar dome lesions. Human amniotic allograft has been used in similar bone, soft tissue and cartilage defects to aid in healing of tissue using graft cells that have not differentiated into a particular cell line. Patients were taken from the primary surgeon’s practice to include those who had undergone arthroscopy with micro-fracture technique for treatment of a talar dome lesion less than 2 cm2. 101 patient surgeries were completed arthroscopically without additional major procedures. 54 surgeries were completed with human amniotic allograft;47 were completed without (control group). Modified ACFAS ankle scores were taken pre-operatively, 3, 12 and 24 months post-operatively. Visual analog pain scores were taken pre-operatively and 24 months post-operatively. Results comparing pre-operative modified ACFAS scores between the control and graft groups were not significantly different (p = 0.14). There was a significant improvement in both groups’ scores following ankle arthroscopy with micro-fracture as expected. However, the amniotic tissue group did significantly better when comparing the post-operative scores between the control and graft group. Pain scores comparing control and amniotic patient groups were significant (p < 0.001) with amniotic allograft patients achieving a greater improvement in pain reduction than the control both early and at 24 months. There were no complications, wound dehiscence or infections recorded. Combining ankle arthroscopy/micro-fracture technique with human amniotic allograft on talar dome lesions, less than 2 cm2, significantly improves the patients’ pain and ACFAS scores.展开更多
This paper posits the discovery of the new elementary particles from the energy spectrum for the knees-ankles-toe of cosmic rays. The energy spectrum from 109 eV to 1020 eV appears to follow a single power law except ...This paper posits the discovery of the new elementary particles from the energy spectrum for the knees-ankles-toe of cosmic rays. The energy spectrum from 109 eV to 1020 eV appears to follow a single power law except few breaks at the knees-ankles-toe. The power index increases at the first knee and the second knee, and decreases at the ankle. Above 4 × 1019 eV, the power index increases as the “toe”. The fine structure of the cosmic ray spectrum shows that an ankle with decrease in power index is in between the first knee and the second knee, resulting in two knees, two ankles, and one toe. This paper posits that the knees-ankles-toe are explained by the very high-energy fermions and bosons in the periodic table of elementary particles that places all known leptons, quarks, gauge bosons, and the Higgs boson in the table with the calculated masses in good agreement with observed values. In the periodic table, some high-energy dimensional fermions (Fd where d= dimensional orbital number from 5 to 11) and bosons (Bd) are involved in the knees-ankles-toe. At the knees and the toe, some parts of the energies from the energy sources of cosmic rays are spent to generate Fd and Bd, resulting in the increase of power index. The ankles are the the middle points (midpoints) between the adjacent dimensional fermions and bosons. At a midpoint, the energy is too high to keep the thermally unstable high-energy dimensional particle,resulting in the decay and the decrease of power index. The calculated masses of B8, the midpoint, F9, the midpoint, and B9, are 1.7 × 1015, 2 × 1016, 2.4 × 1017, 2.8 × 1018, and 3.2 × 1019 eV, respectively, which are in good agreement with observed 3 × 1015, 2 × 1016, 3 × 1017, 3 × 1018, and 4 × 1019 eV for the first knee, the first ankle, the second knee, the second ankle, and the toe, respectively. The mass of F10 is 4.4 × 1021 eV beyond the GZK limit, so F10 and above are not observed.展开更多
BACKGROUND Ankle fractures are well-documented in snow sports,but concomitant Achilles tendon and peroneal tendon ruptures are rare.This case report presents a previously unreported combination of Achilles tendon rupt...BACKGROUND Ankle fractures are well-documented in snow sports,but concomitant Achilles tendon and peroneal tendon ruptures are rare.This case report presents a previously unreported combination of Achilles tendon rupture,peroneal tendon rupture,and fibular fracture in a snowboarder,highlighting the complex nature of diagnosis,management,and rehabilitation.CASE SUMMARY A 50-year-old male snowboarder presented with severe right ankle pain following a high speed tumbling crash.Initial evaluation revealed an Achilles tendon rupture and a non-displaced distal lateral malleolus fracture.Subsequent magnetic resonance imaging confirmed complete tears of the Achilles tendon and both peroneus longus and brevis tendons,along with a Weber A lateral malleolus fracture.Surgical intervention included a 4-suture core Kraków repair of the Achilles tendon with calcaneal docking,open reduction and internal fixation of the distal fibula fracture,and primary repair of both peroneal tendons.Postoperatively,a modified Achilles repair protocol was implemented.At 16 weeks post-surgery,radiographs showed a well-healed fibular fracture,and physical examination confirmed intact Achilles and peroneal tendon repairs.By 6 months,the patient had regained full daily and work activities,including recreational pursuits.CONCLUSION This case underscores the importance of maintaining a high index of suspicion for concomitant injuries in high-energy ankle trauma during snow sports.Timely advanced imaging and a comprehensive surgical approach are crucial for optimal outcomes in such complex cases.展开更多
Complex trimalleolar ankle fractures are a major orthopaedic challenge,with an incidence of 4.22 per 10000 person-years in the United States and an annual cost of 3.4 billion dollars.This review synthesizes current ev...Complex trimalleolar ankle fractures are a major orthopaedic challenge,with an incidence of 4.22 per 10000 person-years in the United States and an annual cost of 3.4 billion dollars.This review synthesizes current evidence on diagnostic protocols and management strategies,highlighting optimal approaches and emerging trends.Initial care emphasizes soft tissue assessment,often guided by the Tscherne classification,and fracture classification systems.External fixation may be required in open injuries,while early open reduction and internal fixation within six days is linked to improved outcomes.Minimally invasive techniques for the lateral malleolus,including intramedullary nailing and locking plates,are effective,while medial malleolus fractures are commonly managed with screw fixation or tension-band wiring.Posterior malleolus fragments involving more than 25%of the articular surface usually warrant fixation.Alternatives to syndesmotic screws,such as cortical buttons or high-strength sutures,reduce the need for secondary procedures.Arthroscopic-assisted open reduction and internal fixation benefits younger,active patients by enabling concurrent management of intra-articular and ligamentous injuries.Postoperative care prioritizes early weight-bearing and validated functional scores.Despite advances,complications remain common,and further research is needed to refine surgical strategies and improve outcomes.展开更多
BACKGROUND In an era leaning toward a personalized alignment of total knee arthroplasty,coronal plane alignment of the knee(CPAK)phenotypes for each population are studied;furthermore,other possible variables affectin...BACKGROUND In an era leaning toward a personalized alignment of total knee arthroplasty,coronal plane alignment of the knee(CPAK)phenotypes for each population are studied;furthermore,other possible variables affecting the alignment,such as ankle joint alignment,should be considered.AIM To determine CPAK distribution in the North African(Egyptian)population with knee osteoarthritis and to assess ankle joint line orientation(AJLO)adaptations across different CPAK types.METHODS A cross-sectional study was conducted on patients with primary knee osteoarthritis and normal ankle joints.Radiographic parameters included the mechanical lateral distal femoral angle,medial proximal tibial angle,and the derived calculations of joint line obliquity(JLO)and arithmetic hip-knee-ankle angle(aHKA).The tibial plafond horizontal angle(TPHA)was used for AJLO assessment,where 0°is neutral(type N),<0°is varus(type A),and>0°is valgus(type B).The nine CPAK types were further divided into 27 subtypes after incorporating the three AJLO types.RESULTS A total of 527 patients(1054 knees)were included for CPAK classification,and 435 patients(870 knees and ankles)for AJLO assessment.The mean age was 57.2±7.8 years,with 79.5%females.Most knees(76.4%)demonstrated varus alignment(mean aHKA was-5.51°±4.84°)and apex distal JLO(55.3%)(mean JLO was 176.43°±4.53°).CPAK types I(44.3%),IV(28.6%),and II(10%)were the most common.Regarding AJLO,70.2%of ankles exhibited varus orientation(mean TPHA was-5.21°±6.45°).The most frequent combined subtypes were CPAK type I-A(33.7%),IV-A(21.5%),and I-N(6.9%).A significant positive correlation was found between the TPHA and aHKA(r=0.40,P<0.001).CONCLUSION In this North African cohort,varus knee alignment with apex distal JLO and varus AJLO predominated.CPAK types I,IV,and II were the most common types,while subtypes I-A,IV-A,and I-N were commonly occurring after incorporating AJLO types;furthermore,the AJLO was significantly correlated to aHKA.展开更多
Background Kashin-Beck disease （KBD） is a chronic,degenerative osteoarthropathy that causes severe skeletal deformation.Although many researchers have proven that almost all KBD patients who showed an increaseing pr...Background Kashin-Beck disease （KBD） is a chronic,degenerative osteoarthropathy that causes severe skeletal deformation.Although many researchers have proven that almost all KBD patients who showed an increaseing proximo-distal gradient had radiographic abnormalities of the ankle,few detailed description of radiographic changes in the ankles of patients with KBD has been reported,especially for variable measurements of ankle changes.The purpose of this study was to demonstrate the radiographic characteristics of the ankles of adult KBD patients.Methods One hundred and eighteen adult KBD patients from september to October 2010 in Rongtang county in China were examined with lateral radiographs of the right ankle.The morphological abnormalities in the talus,calcaneus,navicular bone,distal tibia,and joint space were analyzed,and the calcaneus length,height,length-height ratio,tuber angle,front angle,plantar angle,and distal tibia anteroposterior （AP） length were measured using Riepert＇s method.Results Eighty-one patients （68.6％） had abnormal ankle radiographs; 72 （88.9％） patients had talus changes,69 （85.2％） patients had calcaneus changes,28 （34.6％） patients had navicular bone changes,and 48 （59.2％） patients had distal tibia changes.For 118 KBD patients,the average calcaneus length was 7.4 cm,height was 4.3 cm,and the length-height ratio was 1.7.The calcaneus tuber angle was 28.2°,front angle was 38.0° and the plantar angle was 74.2°.The distal tibia anteroposterior length was 4.05 cm.Compared with 50 normal adults （control group）,significant differences were found for the calcaneus length,the calcaneus length-height ratio,and the distal tibia AP length.Conclusions Patients with KBD have characteristic abnormalities on ankle radiographs; talus depression and deformity,calcaneus shortening deformity,and distal tibia deformity with AP length widening were the most typical changes.展开更多
Purpose We aimed to investigate the effects of running shoe longitudinal bending stiffness(LBS)and midsole energy return on running economy and ankle mechanics and energetics.Methods PubMed,Scopus,SPORTDiscus,Embase,C...Purpose We aimed to investigate the effects of running shoe longitudinal bending stiffness(LBS)and midsole energy return on running economy and ankle mechanics and energetics.Methods PubMed,Scopus,SPORTDiscus,Embase,CINAHL,and Web of Science were systematically searched for this meta-analysis.Crossover studies comparing the effects of running shoe LBS and/or midsole energy return on at least 1 of the following outcomes:running economy,ankle plantarflexion moment,work,power,or angular velocity were included.Results Of the 2453 studies screened,48 were included(n=878).Results indicated that advanced footwear technologies(AFTs)significantly reduced oxygen consumption(standardized mean difference=–0.44,95%confidence interval:–0.60 to–0.28),p<0.001)as well as peak ankle moments and positive/negative ankle work and power.However,neither LBS nor midsole energy return alone significantly affected oxygen consumption,ankle moments,positive and negative work,or positive power.The effects of AFTs were moderated by the training status and speed of the runner.The quality of evidence for all outcomes were low or very low for all outcomes except the effect of LBS on negative ankle work.Conclusion AFT may improve running economy by minimizing ankle moments,work,and power.The absence of significant independent effects of LBS and midsole energy return suggests that the benefits of AFTs arise from the interaction of these properties.Further research is necessary to understand the mechanisms for improved running performance in AFTs.展开更多
Appreciation of soft-tissue thickness(STT)at surgical sites is an increasingly recognized aspect of arthroplasty procedures as it may potentially impacting postoperative outcomes.Recent research has focused on the pre...Appreciation of soft-tissue thickness(STT)at surgical sites is an increasingly recognized aspect of arthroplasty procedures as it may potentially impacting postoperative outcomes.Recent research has focused on the predictive value of preoperative STT measurements for complications following various forms of arthroplasty,particularly infections,across procedures such as total knee,hip,shoulder,and ankle replacements.Several studies have indicated that increased STT is associated with a higher risk of complications,including infection and wound healing issues.The assessment of STT before surgery could play a crucial role in identifying patients at a higher risk of complications and may be instru-mental in guiding preoperative planning to optimize outcomes in arthroplasty procedures.Standardized measurement techniques and further research are essential to enhance the reliability and clinical utility of STT assessment for arthro-plasty surgery.展开更多
BACKGROUND The anterior talofibular ligament(ATFL)is the most commonly injured ligament in ankle sprains.While most individuals recover with conservative management,some patients develop persistent pain and instabilit...BACKGROUND The anterior talofibular ligament(ATFL)is the most commonly injured ligament in ankle sprains.While most individuals recover with conservative management,some patients develop persistent pain and instability from chronic ATFL tears.Surgical repair is often required,and minimally invasive techniques are gaining popularity.AIM To evaluate the clinical outcomes of a novel,totally percutaneous(TP)modified Broström repair(MBR)for chronic ATFL insufficiency in a cohort of patients who failed conservative treatment.METHODS This retrospective study analyzed 20 patients(14 males,6 females;mean age,28.7 years)who underwent TP-MBR between 2023 and 2024 at a tertiary trauma center.All patients had persistent pain and instability for at least 3 months despite conservative treatment.Diagnosis was confirmed by magnetic resonance imaging,arthroscopy,and stress testing.TP-MBR was performed using suture anchors and percutaneous ligament advancement.Functional outcomes were assessed using American Orthopaedic Foot and Ankle Society score and Karlsson score at a mean follow-up of 1.5 years.RESULTS All procedures were completed successfully with no intraoperative complications.At a mean follow-up of 1.5 years,patients showed significant improvements in American Orthopaedic Foot and Ankle Society score(from 39.85 to 84.4;P<0.001)and Karlsson scores(from 43.8 to 87.4;P<0.001).All patients returned to pre-injury activity levels with resolution of instability.The technique resulted in minimal tissue trauma,reduced operative time,accelerated recovery,and excellent cosmetic outcomes.No recurrences or major complications occurred.CONCLUSION TP-MBR is a safe and effective alternative to open Broström repair for chronic ATFL tears.It offers the benefits of a minimally invasive approach,including less trauma and faster rehabilitation,making it a valuable option for appropriately selected patients.展开更多
Ankle snapping occurs when tendons or retinacular structures abruptly move or slip over adjacent anatomical structures,often due to anatomical variations,pathological conditions,or acute injury.This phenomenon can cau...Ankle snapping occurs when tendons or retinacular structures abruptly move or slip over adjacent anatomical structures,often due to anatomical variations,pathological conditions,or acute injury.This phenomenon can cause pain and discomfort,ranging from mild irritation to debilitating symptoms that potentially disrupt daily activities and athletic pursuits.Considering the anatomy of the ankle,these snapping phenomena can be categorized into four regional groups:(1)Lateral;(2)Medial;(3)Anterior;and(4)Posterior.Lateral ankle snapping,a common occurrence,typically results from peroneal tendon subluxation due to compromise of the superior and inferior peroneal retinacula,or from intrasheath subluxation,characterized by abnormal tendon motion within an otherwise intact retromalleolar groove and retinaculum.Medial ankle snapping primarily affects the posterior tibial tendon and can involve the flexor digitorum longus tendon.Anterior ankle snapping results from abnormal gliding of the tibialis anterior tendon,extensor digitorum longus tendon,peroneus tertius tendon,and inferior extensor retinaculum.Posterior ankle snapping typically involves the plantaris tendon and flexor hallucis longus(hallux saltans).This mini-review comprehensively explores these snapping phenomena and their related pathologies in the foot and ankle,emphasizing the crucial roles of anatomical knowledge,thorough clinical assessment,and appropriate diagnostic and treatment approaches.展开更多
BACKGROUND Ankle normative values are limited compared to isokinetic knee assessments.Chronic ankle instability correlates with agonist-antagonist imbalances,decreased evertor/invertor ratio,and plantar flexion defici...BACKGROUND Ankle normative values are limited compared to isokinetic knee assessments.Chronic ankle instability correlates with agonist-antagonist imbalances,decreased evertor/invertor ratio,and plantar flexion deficits.Strengthening programs targeting evertor/invertor and dorsiflexor/plantar flexor balance help reduce injury recurrence.Bilateral neuromuscular deficits compromise the contralateral side,rendering healthy limbs unsuitable as recovery references.Defining normative healthy ankle parameters is crucial for establishing precise limits in nonsurgical treatments and sports return criteria.While the limb symmetry index(LSI)is used for knees with a cutoff of>90%,no such standardization exists for the ankle.AIM To comprehensively evaluate isokinetic ankle strength profiles in non-athletic individuals.METHODS This is a cross-sectional study.Two hundred ankles were evaluated using the Biodex 3 System to assess eversion,inversion,dorsiflexion,and plantar flexion.Healthy individuals with an active lifestyle and no previous injuries were evaluated.The Maximum Torque,Agonist/Antagonist Ratio,LSI,and Muscular Deficiency Index(MDI)and the correlation with demographic variables were evaluated.RESULTS The mean age(mean±SD)was 38.5±13.5 years,and the body mass index(BMI)was 25.8±4.2 in 69 men and 31 women.The mean maximum torque values by gender were(mean±SD):22.3±6.6 female(F)and 33.4±9.9 male(M)N/m for eversion;30.10±10.0(F)and 37.0±11.6 N/m(M)for inversion,37.4±10.0(F)and 53.6±13.0 N/m(M)for dorsiflexion,and 100.4±37.2(F)and 158.1±33.4(M)N/m for flexion.There was no correlation between age or BMI and maximum torque.The evertors/invertors ratio was 88.8%,and the dorsiflexors/plantar flexors ratio was 36.1%.The MDI and LSI were balanced between sides for every movement,having an average global difference of less than 10%.CONCLUSION These findings provide gender-specific normative isokinetic values for the ankle in healthy,physically active adults.These reference parameters—especially LSI and MDI above 90%—can support clinical decision-making in rehabilitation planning and return-to-sport assessment,offering objective benchmarks for functional recovery.展开更多
BACKGROUND Poor musculoskeletal recovery following foot and ankle injury can result in chronic instability and persistent muscle weakness.Preliminary evidence has shown that blood flow restriction(BFR)rehabilitation c...BACKGROUND Poor musculoskeletal recovery following foot and ankle injury can result in chronic instability and persistent muscle weakness.Preliminary evidence has shown that blood flow restriction(BFR)rehabilitation can increase muscle strength and stability,helping to restore physical function and prevent repeated injury.AIM To determine whether BFR is more effective than traditional rehabilitation in improving muscle strength,size,and stability after foot and ankle injury.METHODS A systematic review and meta-analysis were performed.Articles were retrieved from MEDLINE,EMBASE,and CENTRAL databases.Included studies compared the effectiveness of BFR rehabilitation to traditional foot and ankle rehabilitation exercises.Eligible patients were those with a history of foot or ankle injury.Muscle strength,size,and dynamic balance were assessed by comparing impro vements in peak torque,cross-sectional area,and percent muscle activation.Methodological quality assessments were performed using the PEDro scale and Methodological Index for Non-Randomized Studies(MINORS).RESULTS Ten studies met the inclusion criteria.Five studies were of good to excellent quality according to the PEDro scale,and 5 studies were of moderate quality as per the MINORS criteria.Two studies compared the effect of BFR and non-BFR rehabilitation on muscle strength;the overall mean difference between the BRF and non-BFR groups was 0.09[95%CI:(0.05,0.12),P<0.0001].Two studies analyzed muscle activation following BFR and non-BFR rehabilitation;the overall mean difference between the BRF and non-BFR groups was 0.09[95%CI:(0.05,0.12),P<0.0001].Data on dynamic balance was synthesized from two studies;the mean difference between the BFR and control groups was 1.23[95%CI:(-1.55,4.01);P=0.39].CONCLUSION BFR rehabilitation is more effective than non-BFR rehabilitation at improving muscle strength and activation following foot and ankle injury.Additional studies are needed to develop a standardized BFR training protocol.展开更多
BACKGROUND Psychological comorbidities,such as anxiety and depression,in patients with chronic ankle instability(CAI)may impede ankle function improvement,although the precise nature of this association warrants furth...BACKGROUND Psychological comorbidities,such as anxiety and depression,in patients with chronic ankle instability(CAI)may impede ankle function improvement,although the precise nature of this association warrants further investigation.AIM To analyze the correlation of anxiety and depression with ankle function in patients with CAI and discussing the risk factors.METHODS This study included 116 patients with CAI,who were admitted to our hospital from July 2022 to July 2024.Anxiety and depression states of patients were assessed with the self-rating anxiety scale(SAS)and self-rating depression scale(SDS),respectively,and their ankle joint function was assessed with the anklehindfoot function score of the American Orthopedic Foot and Ankle Society.Further,the ankle function of patients with CAI with different anxiety and depression states was discussed.Furthermore,the Pearson correlation coefficient was used to analyze the correlation of anxiety and depression with ankle joint function in such patients.Univariate and multivariate analyses were conducted to investigate the factors affecting ankle joint function in patients with CAI.RESULTS Among the 116 patients with CAI,97,13,5,and 1 cases demonstrated none,mild,moderate,and severe anxiety,whereas 95,15,6,and 0 cases showed none,mild,moderate,and severe depression,respectively.The average ankle joint function score was 74.82±6.93 points.The ankle joint function in patients with CAI presented a significant downward tendency as the degree of anxiety and depression increased.Correlation analysis revealed that both the SAS and SDS scores of patients with CAI were significantly negatively correlated with the ankle joint function score.Univariate and multivariate analyses indicated that the risk factors affecting patients’ankle joint function included early functional rehabilitation,visual analog scale,and SDS.CONCLUSION A substantial number of patients with CAI suffer from anxiety and depression,and these negative emotions,to a certain extent,harm the smooth rehabilitation of ankle joint function.展开更多
This article offers additional clinical and biomechanical insights into using the peroneus longus tendon(PLT)autograft in posterior cruciate ligament recon-struction.While recent studies report favorable knee outcomes...This article offers additional clinical and biomechanical insights into using the peroneus longus tendon(PLT)autograft in posterior cruciate ligament recon-struction.While recent studies report favorable knee outcomes,concerns remain regarding donor site morbidity.The PLT plays a key role in foot biomechanics,and its harvesting may lead to subtle changes,as suggested by imaging and pe-dobarographic studies.Tendon regeneration may limit long-term morbidity,but further studies are needed.We recommend that future research include gait analysis,long-term follow-up,and insights from anterior cruciate ligament li-terature.展开更多
BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rate...BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rates remain significant.AIM To determine whether ankle symptoms are associated with inferior results of functional recovery of the knee following TKA.METHODS This prospective study included all patients with advanced knee osteoarthritis who underwent a primary unilateral TKA between August 2019 and December 2019 with data documented by the treating surgeon and outpatient physical therapists.Patients were categorized based on ankle symptoms using the Ame-rican Orthopaedic Foot and Ankle Society(AOFAS)score:(1)Group 1(AOFAS≤85,n=30);and(2)Group 2(AOFAS>85,n=49).Active range of motion(ROM),the Knee Injury and Osteoarthritis Outcome Score(KOOS),and the visual ana-logue scale(VAS)were compared between two groups.RESULTS Postoperative KOOS,ROM,and VAS significantly improved in both groups(P<0.001).However,at three months,KOOS(P=0.02)and extension motion(P=0.01)improvements were significantly greater in group 2.CONCLUSION These findings suggest that preoperative ankle symptoms may negatively impact early knee functional recovery,particularly in KOOS scores and extension motion.展开更多
Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three st...Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.展开更多
With the continuous escalation of modern war,soldiers need to transport more combat materials to the combat area.The limited load-bearing capacity of soldiers seriously restricts their carrying capacity and mobility.I...With the continuous escalation of modern war,soldiers need to transport more combat materials to the combat area.The limited load-bearing capacity of soldiers seriously restricts their carrying capacity and mobility.It is urgent to develop a power-assisted exoskeleton robot suitable for individual combat.In the past,most power-assisted exoskeleton robots were driven by motors.This driving method has an excellent power-assisted effect,but the endurance is often insufficient.In view of this shortcoming,this study designed an ankle exoskeleton robot based on an active-passive combined drive through simulation analysis of human motion.It used OpenSim software to simulate and verify that the addition of spring could achieve a good effect.At the same time,according to the gait characteristics of the human body,the gait planning of an exoskeleton robot was carried out.Afterwards,theoretical analysis explained that the cooperation among spring,motor and wearer could be realized in this gait.Finally,the assisting ability and driving coordination of the active-passive combination driven ankle exoskeleton robot were verified through experiments.展开更多
Background:The anterior talofibular ligament(ATFL)and the calcaneofibular ligament(CFL)are vulnerable to be torn or ruptured during lateral ankle sprain(LAS),especially in people with chronic ankle instability(CAI).Th...Background:The anterior talofibular ligament(ATFL)and the calcaneofibular ligament(CFL)are vulnerable to be torn or ruptured during lateral ankle sprain(LAS),especially in people with chronic ankle instability(CAI).This study aims to determine whether landing with a larger toe-out angle would influence ATFL and CFL strains in people with CAI,aiming to contribute to the development of effective landing strategies to reduce LAS risk.Methods:Thirty participants with CAI(22 males and 8 females,age:21.2±1.2 years,height:176.9±9.0 cm,body mass:70.6±12.1 kg,mean±SD)were recruited.Each participant landed on a specialized trap-door device with their unaffected limbs on a support platform and their affected limbs on a movable platform,which could be flipped 24°inward and 15°forward to mimic LAS conditions.Two landing conditions were tested—i.e.,natural landing(NL,with natural toe-out angle at landing)and toe-out landing(TL,with toe-out angle increased to over 150%of that under the NL conditions).Kinematic data were captured using a 12-camera motion analysis system,and ATFL and CFL strains were calculated using a 3D rigid-body foot model.Paired sample t tests and Pearson's correlations were used to analyze data.Results:Compared to NL conditions,ATFL strain decreased(p<0.001,d=2.42)while CFL strain remained unchanged(p=0.229,d=0.09)under TL conditions.The toe-out angle was negatively and strongly correlated with ATFL strain(r=-0.743,p<0.001)but not with CFL strain(r=0.153,p=0.251).Compared to NL conditions,participants exhibit a lower ankle inversion angle(p<0.001,d=0.494),a higher plantarflexion angle(p<0.001,d=1.101),and no significant difference in external rotation angle(p=0.571,d=0.133)under TL conditions.Conclusion:Toe-out landing may reduce ATFL strain while maintaining CFL strain in people with CAI,thereby reducing the risk of LAS.展开更多
A running injury can be a major setback,even something as seemingly minor as an injured ankle can ruin your marathon plans.I always try various methods to avoid running injuries,such as keeping myself well-watered,wea...A running injury can be a major setback,even something as seemingly minor as an injured ankle can ruin your marathon plans.I always try various methods to avoid running injuries,such as keeping myself well-watered,wearing comfortable running shoes and selecting the right running ground.Recently,researchers have been exploring how diet affects the risk of running injuries,and the results are quite interesting.展开更多
文摘A 27-year-old male started to have his ankles swollen during his military service. He was examined at a military hospital where electromyoneurography showed the signs of distal sensory-motor polyneuropathy with axon demyelinization and weak myopathic changes, whereas histopathological examination of gastrocnemius muscle biopsy revealed some mild and nonspecific myopathy. Besides, he was found to have subcutaneous ankle tissue edemas and hypertransaminasemia. Due to these reasons, he was dismissed from the military service and examined at another hospital where bone osteodensitometry revealed low bone mineral density of the spine. However, his medical problems were not resolved and after the second discharge from hospital he was desperately seeing doctors from time to time. Finally, at our institution he was shown to have celiac disease (CD) by positive serology (antitissue transglutaminase and antiendomysial antibodies) and small bowel mucosal histopathological examination, which showed total small bowel villous atrophy. Three months after the initiation of gluten-free diet, his ankle edema disappeared, electromyoneurographic signs of polyneuropathy improved and liver aminotransferases normalized. Good knowledge of CD extraintestinal signs and serologic screening are essential for early CD recognition and therapy.
文摘Arthroscopy of the ankle with micro-fracture technique is one way to initially treat symptomatic talar dome lesions. Human amniotic allograft has been used in similar bone, soft tissue and cartilage defects to aid in healing of tissue using graft cells that have not differentiated into a particular cell line. Patients were taken from the primary surgeon’s practice to include those who had undergone arthroscopy with micro-fracture technique for treatment of a talar dome lesion less than 2 cm2. 101 patient surgeries were completed arthroscopically without additional major procedures. 54 surgeries were completed with human amniotic allograft;47 were completed without (control group). Modified ACFAS ankle scores were taken pre-operatively, 3, 12 and 24 months post-operatively. Visual analog pain scores were taken pre-operatively and 24 months post-operatively. Results comparing pre-operative modified ACFAS scores between the control and graft groups were not significantly different (p = 0.14). There was a significant improvement in both groups’ scores following ankle arthroscopy with micro-fracture as expected. However, the amniotic tissue group did significantly better when comparing the post-operative scores between the control and graft group. Pain scores comparing control and amniotic patient groups were significant (p < 0.001) with amniotic allograft patients achieving a greater improvement in pain reduction than the control both early and at 24 months. There were no complications, wound dehiscence or infections recorded. Combining ankle arthroscopy/micro-fracture technique with human amniotic allograft on talar dome lesions, less than 2 cm2, significantly improves the patients’ pain and ACFAS scores.
文摘This paper posits the discovery of the new elementary particles from the energy spectrum for the knees-ankles-toe of cosmic rays. The energy spectrum from 109 eV to 1020 eV appears to follow a single power law except few breaks at the knees-ankles-toe. The power index increases at the first knee and the second knee, and decreases at the ankle. Above 4 × 1019 eV, the power index increases as the “toe”. The fine structure of the cosmic ray spectrum shows that an ankle with decrease in power index is in between the first knee and the second knee, resulting in two knees, two ankles, and one toe. This paper posits that the knees-ankles-toe are explained by the very high-energy fermions and bosons in the periodic table of elementary particles that places all known leptons, quarks, gauge bosons, and the Higgs boson in the table with the calculated masses in good agreement with observed values. In the periodic table, some high-energy dimensional fermions (Fd where d= dimensional orbital number from 5 to 11) and bosons (Bd) are involved in the knees-ankles-toe. At the knees and the toe, some parts of the energies from the energy sources of cosmic rays are spent to generate Fd and Bd, resulting in the increase of power index. The ankles are the the middle points (midpoints) between the adjacent dimensional fermions and bosons. At a midpoint, the energy is too high to keep the thermally unstable high-energy dimensional particle,resulting in the decay and the decrease of power index. The calculated masses of B8, the midpoint, F9, the midpoint, and B9, are 1.7 × 1015, 2 × 1016, 2.4 × 1017, 2.8 × 1018, and 3.2 × 1019 eV, respectively, which are in good agreement with observed 3 × 1015, 2 × 1016, 3 × 1017, 3 × 1018, and 4 × 1019 eV for the first knee, the first ankle, the second knee, the second ankle, and the toe, respectively. The mass of F10 is 4.4 × 1021 eV beyond the GZK limit, so F10 and above are not observed.
文摘BACKGROUND Ankle fractures are well-documented in snow sports,but concomitant Achilles tendon and peroneal tendon ruptures are rare.This case report presents a previously unreported combination of Achilles tendon rupture,peroneal tendon rupture,and fibular fracture in a snowboarder,highlighting the complex nature of diagnosis,management,and rehabilitation.CASE SUMMARY A 50-year-old male snowboarder presented with severe right ankle pain following a high speed tumbling crash.Initial evaluation revealed an Achilles tendon rupture and a non-displaced distal lateral malleolus fracture.Subsequent magnetic resonance imaging confirmed complete tears of the Achilles tendon and both peroneus longus and brevis tendons,along with a Weber A lateral malleolus fracture.Surgical intervention included a 4-suture core Kraków repair of the Achilles tendon with calcaneal docking,open reduction and internal fixation of the distal fibula fracture,and primary repair of both peroneal tendons.Postoperatively,a modified Achilles repair protocol was implemented.At 16 weeks post-surgery,radiographs showed a well-healed fibular fracture,and physical examination confirmed intact Achilles and peroneal tendon repairs.By 6 months,the patient had regained full daily and work activities,including recreational pursuits.CONCLUSION This case underscores the importance of maintaining a high index of suspicion for concomitant injuries in high-energy ankle trauma during snow sports.Timely advanced imaging and a comprehensive surgical approach are crucial for optimal outcomes in such complex cases.
文摘Complex trimalleolar ankle fractures are a major orthopaedic challenge,with an incidence of 4.22 per 10000 person-years in the United States and an annual cost of 3.4 billion dollars.This review synthesizes current evidence on diagnostic protocols and management strategies,highlighting optimal approaches and emerging trends.Initial care emphasizes soft tissue assessment,often guided by the Tscherne classification,and fracture classification systems.External fixation may be required in open injuries,while early open reduction and internal fixation within six days is linked to improved outcomes.Minimally invasive techniques for the lateral malleolus,including intramedullary nailing and locking plates,are effective,while medial malleolus fractures are commonly managed with screw fixation or tension-band wiring.Posterior malleolus fragments involving more than 25%of the articular surface usually warrant fixation.Alternatives to syndesmotic screws,such as cortical buttons or high-strength sutures,reduce the need for secondary procedures.Arthroscopic-assisted open reduction and internal fixation benefits younger,active patients by enabling concurrent management of intra-articular and ligamentous injuries.Postoperative care prioritizes early weight-bearing and validated functional scores.Despite advances,complications remain common,and further research is needed to refine surgical strategies and improve outcomes.
基金approved by Institutional Review Board of Faculty of Medicine in Assiut University,No.04-2024-300470.
文摘BACKGROUND In an era leaning toward a personalized alignment of total knee arthroplasty,coronal plane alignment of the knee(CPAK)phenotypes for each population are studied;furthermore,other possible variables affecting the alignment,such as ankle joint alignment,should be considered.AIM To determine CPAK distribution in the North African(Egyptian)population with knee osteoarthritis and to assess ankle joint line orientation(AJLO)adaptations across different CPAK types.METHODS A cross-sectional study was conducted on patients with primary knee osteoarthritis and normal ankle joints.Radiographic parameters included the mechanical lateral distal femoral angle,medial proximal tibial angle,and the derived calculations of joint line obliquity(JLO)and arithmetic hip-knee-ankle angle(aHKA).The tibial plafond horizontal angle(TPHA)was used for AJLO assessment,where 0°is neutral(type N),<0°is varus(type A),and>0°is valgus(type B).The nine CPAK types were further divided into 27 subtypes after incorporating the three AJLO types.RESULTS A total of 527 patients(1054 knees)were included for CPAK classification,and 435 patients(870 knees and ankles)for AJLO assessment.The mean age was 57.2±7.8 years,with 79.5%females.Most knees(76.4%)demonstrated varus alignment(mean aHKA was-5.51°±4.84°)and apex distal JLO(55.3%)(mean JLO was 176.43°±4.53°).CPAK types I(44.3%),IV(28.6%),and II(10%)were the most common.Regarding AJLO,70.2%of ankles exhibited varus orientation(mean TPHA was-5.21°±6.45°).The most frequent combined subtypes were CPAK type I-A(33.7%),IV-A(21.5%),and I-N(6.9%).A significant positive correlation was found between the TPHA and aHKA(r=0.40,P<0.001).CONCLUSION In this North African cohort,varus knee alignment with apex distal JLO and varus AJLO predominated.CPAK types I,IV,and II were the most common types,while subtypes I-A,IV-A,and I-N were commonly occurring after incorporating AJLO types;furthermore,the AJLO was significantly correlated to aHKA.
文摘Background Kashin-Beck disease （KBD） is a chronic,degenerative osteoarthropathy that causes severe skeletal deformation.Although many researchers have proven that almost all KBD patients who showed an increaseing proximo-distal gradient had radiographic abnormalities of the ankle,few detailed description of radiographic changes in the ankles of patients with KBD has been reported,especially for variable measurements of ankle changes.The purpose of this study was to demonstrate the radiographic characteristics of the ankles of adult KBD patients.Methods One hundred and eighteen adult KBD patients from september to October 2010 in Rongtang county in China were examined with lateral radiographs of the right ankle.The morphological abnormalities in the talus,calcaneus,navicular bone,distal tibia,and joint space were analyzed,and the calcaneus length,height,length-height ratio,tuber angle,front angle,plantar angle,and distal tibia anteroposterior （AP） length were measured using Riepert＇s method.Results Eighty-one patients （68.6％） had abnormal ankle radiographs; 72 （88.9％） patients had talus changes,69 （85.2％） patients had calcaneus changes,28 （34.6％） patients had navicular bone changes,and 48 （59.2％） patients had distal tibia changes.For 118 KBD patients,the average calcaneus length was 7.4 cm,height was 4.3 cm,and the length-height ratio was 1.7.The calcaneus tuber angle was 28.2°,front angle was 38.0° and the plantar angle was 74.2°.The distal tibia anteroposterior length was 4.05 cm.Compared with 50 normal adults （control group）,significant differences were found for the calcaneus length,the calcaneus length-height ratio,and the distal tibia AP length.Conclusions Patients with KBD have characteristic abnormalities on ankle radiographs; talus depression and deformity,calcaneus shortening deformity,and distal tibia deformity with AP length widening were the most typical changes.
基金supported by a National Health and Medical Research Council(NHMRC)Investigator Grant Emerging Leadership Level 1(Grant No.2017012).
文摘Purpose We aimed to investigate the effects of running shoe longitudinal bending stiffness(LBS)and midsole energy return on running economy and ankle mechanics and energetics.Methods PubMed,Scopus,SPORTDiscus,Embase,CINAHL,and Web of Science were systematically searched for this meta-analysis.Crossover studies comparing the effects of running shoe LBS and/or midsole energy return on at least 1 of the following outcomes:running economy,ankle plantarflexion moment,work,power,or angular velocity were included.Results Of the 2453 studies screened,48 were included(n=878).Results indicated that advanced footwear technologies(AFTs)significantly reduced oxygen consumption(standardized mean difference=–0.44,95%confidence interval:–0.60 to–0.28),p<0.001)as well as peak ankle moments and positive/negative ankle work and power.However,neither LBS nor midsole energy return alone significantly affected oxygen consumption,ankle moments,positive and negative work,or positive power.The effects of AFTs were moderated by the training status and speed of the runner.The quality of evidence for all outcomes were low or very low for all outcomes except the effect of LBS on negative ankle work.Conclusion AFT may improve running economy by minimizing ankle moments,work,and power.The absence of significant independent effects of LBS and midsole energy return suggests that the benefits of AFTs arise from the interaction of these properties.Further research is necessary to understand the mechanisms for improved running performance in AFTs.
文摘Appreciation of soft-tissue thickness(STT)at surgical sites is an increasingly recognized aspect of arthroplasty procedures as it may potentially impacting postoperative outcomes.Recent research has focused on the predictive value of preoperative STT measurements for complications following various forms of arthroplasty,particularly infections,across procedures such as total knee,hip,shoulder,and ankle replacements.Several studies have indicated that increased STT is associated with a higher risk of complications,including infection and wound healing issues.The assessment of STT before surgery could play a crucial role in identifying patients at a higher risk of complications and may be instru-mental in guiding preoperative planning to optimize outcomes in arthroplasty procedures.Standardized measurement techniques and further research are essential to enhance the reliability and clinical utility of STT assessment for arthro-plasty surgery.
文摘BACKGROUND The anterior talofibular ligament(ATFL)is the most commonly injured ligament in ankle sprains.While most individuals recover with conservative management,some patients develop persistent pain and instability from chronic ATFL tears.Surgical repair is often required,and minimally invasive techniques are gaining popularity.AIM To evaluate the clinical outcomes of a novel,totally percutaneous(TP)modified Broström repair(MBR)for chronic ATFL insufficiency in a cohort of patients who failed conservative treatment.METHODS This retrospective study analyzed 20 patients(14 males,6 females;mean age,28.7 years)who underwent TP-MBR between 2023 and 2024 at a tertiary trauma center.All patients had persistent pain and instability for at least 3 months despite conservative treatment.Diagnosis was confirmed by magnetic resonance imaging,arthroscopy,and stress testing.TP-MBR was performed using suture anchors and percutaneous ligament advancement.Functional outcomes were assessed using American Orthopaedic Foot and Ankle Society score and Karlsson score at a mean follow-up of 1.5 years.RESULTS All procedures were completed successfully with no intraoperative complications.At a mean follow-up of 1.5 years,patients showed significant improvements in American Orthopaedic Foot and Ankle Society score(from 39.85 to 84.4;P<0.001)and Karlsson scores(from 43.8 to 87.4;P<0.001).All patients returned to pre-injury activity levels with resolution of instability.The technique resulted in minimal tissue trauma,reduced operative time,accelerated recovery,and excellent cosmetic outcomes.No recurrences or major complications occurred.CONCLUSION TP-MBR is a safe and effective alternative to open Broström repair for chronic ATFL tears.It offers the benefits of a minimally invasive approach,including less trauma and faster rehabilitation,making it a valuable option for appropriately selected patients.
文摘Ankle snapping occurs when tendons or retinacular structures abruptly move or slip over adjacent anatomical structures,often due to anatomical variations,pathological conditions,or acute injury.This phenomenon can cause pain and discomfort,ranging from mild irritation to debilitating symptoms that potentially disrupt daily activities and athletic pursuits.Considering the anatomy of the ankle,these snapping phenomena can be categorized into four regional groups:(1)Lateral;(2)Medial;(3)Anterior;and(4)Posterior.Lateral ankle snapping,a common occurrence,typically results from peroneal tendon subluxation due to compromise of the superior and inferior peroneal retinacula,or from intrasheath subluxation,characterized by abnormal tendon motion within an otherwise intact retromalleolar groove and retinaculum.Medial ankle snapping primarily affects the posterior tibial tendon and can involve the flexor digitorum longus tendon.Anterior ankle snapping results from abnormal gliding of the tibialis anterior tendon,extensor digitorum longus tendon,peroneus tertius tendon,and inferior extensor retinaculum.Posterior ankle snapping typically involves the plantaris tendon and flexor hallucis longus(hallux saltans).This mini-review comprehensively explores these snapping phenomena and their related pathologies in the foot and ankle,emphasizing the crucial roles of anatomical knowledge,thorough clinical assessment,and appropriate diagnostic and treatment approaches.
文摘BACKGROUND Ankle normative values are limited compared to isokinetic knee assessments.Chronic ankle instability correlates with agonist-antagonist imbalances,decreased evertor/invertor ratio,and plantar flexion deficits.Strengthening programs targeting evertor/invertor and dorsiflexor/plantar flexor balance help reduce injury recurrence.Bilateral neuromuscular deficits compromise the contralateral side,rendering healthy limbs unsuitable as recovery references.Defining normative healthy ankle parameters is crucial for establishing precise limits in nonsurgical treatments and sports return criteria.While the limb symmetry index(LSI)is used for knees with a cutoff of>90%,no such standardization exists for the ankle.AIM To comprehensively evaluate isokinetic ankle strength profiles in non-athletic individuals.METHODS This is a cross-sectional study.Two hundred ankles were evaluated using the Biodex 3 System to assess eversion,inversion,dorsiflexion,and plantar flexion.Healthy individuals with an active lifestyle and no previous injuries were evaluated.The Maximum Torque,Agonist/Antagonist Ratio,LSI,and Muscular Deficiency Index(MDI)and the correlation with demographic variables were evaluated.RESULTS The mean age(mean±SD)was 38.5±13.5 years,and the body mass index(BMI)was 25.8±4.2 in 69 men and 31 women.The mean maximum torque values by gender were(mean±SD):22.3±6.6 female(F)and 33.4±9.9 male(M)N/m for eversion;30.10±10.0(F)and 37.0±11.6 N/m(M)for inversion,37.4±10.0(F)and 53.6±13.0 N/m(M)for dorsiflexion,and 100.4±37.2(F)and 158.1±33.4(M)N/m for flexion.There was no correlation between age or BMI and maximum torque.The evertors/invertors ratio was 88.8%,and the dorsiflexors/plantar flexors ratio was 36.1%.The MDI and LSI were balanced between sides for every movement,having an average global difference of less than 10%.CONCLUSION These findings provide gender-specific normative isokinetic values for the ankle in healthy,physically active adults.These reference parameters—especially LSI and MDI above 90%—can support clinical decision-making in rehabilitation planning and return-to-sport assessment,offering objective benchmarks for functional recovery.
文摘BACKGROUND Poor musculoskeletal recovery following foot and ankle injury can result in chronic instability and persistent muscle weakness.Preliminary evidence has shown that blood flow restriction(BFR)rehabilitation can increase muscle strength and stability,helping to restore physical function and prevent repeated injury.AIM To determine whether BFR is more effective than traditional rehabilitation in improving muscle strength,size,and stability after foot and ankle injury.METHODS A systematic review and meta-analysis were performed.Articles were retrieved from MEDLINE,EMBASE,and CENTRAL databases.Included studies compared the effectiveness of BFR rehabilitation to traditional foot and ankle rehabilitation exercises.Eligible patients were those with a history of foot or ankle injury.Muscle strength,size,and dynamic balance were assessed by comparing impro vements in peak torque,cross-sectional area,and percent muscle activation.Methodological quality assessments were performed using the PEDro scale and Methodological Index for Non-Randomized Studies(MINORS).RESULTS Ten studies met the inclusion criteria.Five studies were of good to excellent quality according to the PEDro scale,and 5 studies were of moderate quality as per the MINORS criteria.Two studies compared the effect of BFR and non-BFR rehabilitation on muscle strength;the overall mean difference between the BRF and non-BFR groups was 0.09[95%CI:(0.05,0.12),P<0.0001].Two studies analyzed muscle activation following BFR and non-BFR rehabilitation;the overall mean difference between the BRF and non-BFR groups was 0.09[95%CI:(0.05,0.12),P<0.0001].Data on dynamic balance was synthesized from two studies;the mean difference between the BFR and control groups was 1.23[95%CI:(-1.55,4.01);P=0.39].CONCLUSION BFR rehabilitation is more effective than non-BFR rehabilitation at improving muscle strength and activation following foot and ankle injury.Additional studies are needed to develop a standardized BFR training protocol.
文摘BACKGROUND Psychological comorbidities,such as anxiety and depression,in patients with chronic ankle instability(CAI)may impede ankle function improvement,although the precise nature of this association warrants further investigation.AIM To analyze the correlation of anxiety and depression with ankle function in patients with CAI and discussing the risk factors.METHODS This study included 116 patients with CAI,who were admitted to our hospital from July 2022 to July 2024.Anxiety and depression states of patients were assessed with the self-rating anxiety scale(SAS)and self-rating depression scale(SDS),respectively,and their ankle joint function was assessed with the anklehindfoot function score of the American Orthopedic Foot and Ankle Society.Further,the ankle function of patients with CAI with different anxiety and depression states was discussed.Furthermore,the Pearson correlation coefficient was used to analyze the correlation of anxiety and depression with ankle joint function in such patients.Univariate and multivariate analyses were conducted to investigate the factors affecting ankle joint function in patients with CAI.RESULTS Among the 116 patients with CAI,97,13,5,and 1 cases demonstrated none,mild,moderate,and severe anxiety,whereas 95,15,6,and 0 cases showed none,mild,moderate,and severe depression,respectively.The average ankle joint function score was 74.82±6.93 points.The ankle joint function in patients with CAI presented a significant downward tendency as the degree of anxiety and depression increased.Correlation analysis revealed that both the SAS and SDS scores of patients with CAI were significantly negatively correlated with the ankle joint function score.Univariate and multivariate analyses indicated that the risk factors affecting patients’ankle joint function included early functional rehabilitation,visual analog scale,and SDS.CONCLUSION A substantial number of patients with CAI suffer from anxiety and depression,and these negative emotions,to a certain extent,harm the smooth rehabilitation of ankle joint function.
文摘This article offers additional clinical and biomechanical insights into using the peroneus longus tendon(PLT)autograft in posterior cruciate ligament recon-struction.While recent studies report favorable knee outcomes,concerns remain regarding donor site morbidity.The PLT plays a key role in foot biomechanics,and its harvesting may lead to subtle changes,as suggested by imaging and pe-dobarographic studies.Tendon regeneration may limit long-term morbidity,but further studies are needed.We recommend that future research include gait analysis,long-term follow-up,and insights from anterior cruciate ligament li-terature.
文摘BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rates remain significant.AIM To determine whether ankle symptoms are associated with inferior results of functional recovery of the knee following TKA.METHODS This prospective study included all patients with advanced knee osteoarthritis who underwent a primary unilateral TKA between August 2019 and December 2019 with data documented by the treating surgeon and outpatient physical therapists.Patients were categorized based on ankle symptoms using the Ame-rican Orthopaedic Foot and Ankle Society(AOFAS)score:(1)Group 1(AOFAS≤85,n=30);and(2)Group 2(AOFAS>85,n=49).Active range of motion(ROM),the Knee Injury and Osteoarthritis Outcome Score(KOOS),and the visual ana-logue scale(VAS)were compared between two groups.RESULTS Postoperative KOOS,ROM,and VAS significantly improved in both groups(P<0.001).However,at three months,KOOS(P=0.02)and extension motion(P=0.01)improvements were significantly greater in group 2.CONCLUSION These findings suggest that preoperative ankle symptoms may negatively impact early knee functional recovery,particularly in KOOS scores and extension motion.
文摘Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.
基金the National Natural Science Foundation of China(No.52075264)。
文摘With the continuous escalation of modern war,soldiers need to transport more combat materials to the combat area.The limited load-bearing capacity of soldiers seriously restricts their carrying capacity and mobility.It is urgent to develop a power-assisted exoskeleton robot suitable for individual combat.In the past,most power-assisted exoskeleton robots were driven by motors.This driving method has an excellent power-assisted effect,but the endurance is often insufficient.In view of this shortcoming,this study designed an ankle exoskeleton robot based on an active-passive combined drive through simulation analysis of human motion.It used OpenSim software to simulate and verify that the addition of spring could achieve a good effect.At the same time,according to the gait characteristics of the human body,the gait planning of an exoskeleton robot was carried out.Afterwards,theoretical analysis explained that the cooperation among spring,motor and wearer could be realized in this gait.Finally,the assisting ability and driving coordination of the active-passive combination driven ankle exoskeleton robot were verified through experiments.
基金supported by the General Administration of Sport of China(23QN009)the National Natural Science Foundation of China(12102235)。
文摘Background:The anterior talofibular ligament(ATFL)and the calcaneofibular ligament(CFL)are vulnerable to be torn or ruptured during lateral ankle sprain(LAS),especially in people with chronic ankle instability(CAI).This study aims to determine whether landing with a larger toe-out angle would influence ATFL and CFL strains in people with CAI,aiming to contribute to the development of effective landing strategies to reduce LAS risk.Methods:Thirty participants with CAI(22 males and 8 females,age:21.2±1.2 years,height:176.9±9.0 cm,body mass:70.6±12.1 kg,mean±SD)were recruited.Each participant landed on a specialized trap-door device with their unaffected limbs on a support platform and their affected limbs on a movable platform,which could be flipped 24°inward and 15°forward to mimic LAS conditions.Two landing conditions were tested—i.e.,natural landing(NL,with natural toe-out angle at landing)and toe-out landing(TL,with toe-out angle increased to over 150%of that under the NL conditions).Kinematic data were captured using a 12-camera motion analysis system,and ATFL and CFL strains were calculated using a 3D rigid-body foot model.Paired sample t tests and Pearson's correlations were used to analyze data.Results:Compared to NL conditions,ATFL strain decreased(p<0.001,d=2.42)while CFL strain remained unchanged(p=0.229,d=0.09)under TL conditions.The toe-out angle was negatively and strongly correlated with ATFL strain(r=-0.743,p<0.001)but not with CFL strain(r=0.153,p=0.251).Compared to NL conditions,participants exhibit a lower ankle inversion angle(p<0.001,d=0.494),a higher plantarflexion angle(p<0.001,d=1.101),and no significant difference in external rotation angle(p=0.571,d=0.133)under TL conditions.Conclusion:Toe-out landing may reduce ATFL strain while maintaining CFL strain in people with CAI,thereby reducing the risk of LAS.
文摘A running injury can be a major setback,even something as seemingly minor as an injured ankle can ruin your marathon plans.I always try various methods to avoid running injuries,such as keeping myself well-watered,wearing comfortable running shoes and selecting the right running ground.Recently,researchers have been exploring how diet affects the risk of running injuries,and the results are quite interesting.
