Influence of Anterior Talofibular Ligament Injury and Ankle Anterior Displacement on Symptoms in Individuals With Chronic Ankle Instability

Context: Repeated ankle sprains can lead to injuries, including those of the anterior talofibular ligament (ATFL); however, the extent to which these ligament injuries are associated with symptoms of chronic ankle instability (CAI) remains unclear.

Objective: To examine the influence of ATFL injury and ankle anterior displacement on symptoms of CAI.

Design: Case-control study.

Setting: University laboratory.

Patients Or Other Participants: A total of 122 of 426 college students who completed a questionnaire on the history of ankle sprain were enrolled in healthy (n = 34; 24 men, 10 women; age = 20.6 ± 0.5 years), coper (n = 49; 38 men, 11 women; age = 20.2 ± 1.2 years), and CAI groups (n = 39; 24 men, 15 women; age = 20.1 ± 1.1 years).

Main Outcome Measure(s): One examiner measured the ATFL delineation using ultrasound and anterior ankle displacement using a capacitance-type sensor device. The Cumberland Ankle Instability Tool was applied to assess pain and perceived instability.

Results: The ATFL was normal more frequently in the healthy group and abnormal more frequently in the CAI group (χ2 = 18.45, P < .001). Anterior ankle displacement was greater in the coper and CAI groups than in the healthy group (both, P < .001), but no difference was observed between the coper and CAI groups (P = .16). We observed no correlation between the anterior ankle displacement and Cumberland Ankle Instability Tool scores (r = -0.004, P = .71) in participants with previous ankle sprains.

Conclusions: Observation of an abnormal ATFL on ultrasonography was associated with anterior displacement of the ankle joint. However, the influence of anterior ankle displacement due to damage to the ATFL on the pain and perceived instability in CAI was assumed to be small.