Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2017

Open Access 01-12-2017 | Research article

Quantitative magnetic resonance imaging (MRI) analysis of anterior talofibular ligament in lateral chronic ankle instability ankles pre- and postoperatively

Authors: Wei Liu, Hong Li, Yinghui Hua

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

Login to get access

Abstract

Background

The aim of this study was to quantitatively evaluate and characterize the dimension and signal intensity of anterior talofibular ligament (ATFL) using 3.0 T MRI in the mechanical ankle instability group pre- and postoperatively.

Methods

A total of 97 participants were recruited retrospectively in this study, including 56 with mechanical chronic ankle instability (CAI group) and 41 without ankle instability (Control group). All the subjects accepted MRI preoperatively. Among the 56 CAI patients, 25 patients, who accepted modified Broström repair of ATFL, underwent a MRI scan at follow-up. The ATFL dimension (length and width) and signal/noise ratio (SNR) were measured based on MRI images. The results of the MRI studies were then compared between groups.

Results

The CAI group had a significantly higher ATFL length (p = 0.03) or ATFL width (p < 0.001) compared with the control group. The mean SNR value of the CAI group was significantly higher than that of the control group (p = 0.006). Furthermore, the mean SNR value of the ATFL after repair surgery (8.4 ± 2.4) was significantly lower than that of the ATFL before surgery (11.2 ± 3.4) (p < 0.001). However, no significant change of ATFL length or ATFL width were observed after repair surgery.

Conclusions

CAI ankles had a higher ATFL length or width as well as higher signal intensity compared with stable ankles. After repair surgery, the mean SNR value of the ATFL decreased, indicating the relaxed ATFL becomes tight postoperatively.
Literature
1.
go back to reference Gribble PA, Terada M, Beard MQ, Kosik KB, Lepley AS, McCann RS, Pietrosimone BG, Thomas AC. Prediction of lateral ankle sprains in football players based on clinical tests and body mass index. Am J Sports Med. 2016;44:460–7.CrossRefPubMed Gribble PA, Terada M, Beard MQ, Kosik KB, Lepley AS, McCann RS, Pietrosimone BG, Thomas AC. Prediction of lateral ankle sprains in football players based on clinical tests and body mass index. Am J Sports Med. 2016;44:460–7.CrossRefPubMed
2.
go back to reference Roemer FW, Jomaah N, Niu J, Almusa E, Roger B, D'Hooghe P, Geertsema C, Tol JL, Khan K, Guermazi A. Ligamentous injuries and the risk of associated tissue damage in acute ankle sprains in athletes: a cross-sectional MRI study. Am J Sports Med. 2014;42:1549–57.CrossRefPubMed Roemer FW, Jomaah N, Niu J, Almusa E, Roger B, D'Hooghe P, Geertsema C, Tol JL, Khan K, Guermazi A. Ligamentous injuries and the risk of associated tissue damage in acute ankle sprains in athletes: a cross-sectional MRI study. Am J Sports Med. 2014;42:1549–57.CrossRefPubMed
3.
go back to reference Janssen KW, Hendriks MR, van Mechelen W, Verhagen E. The cost-effectiveness of measures to prevent recurrent ankle sprains: results of a 3-arm randomized controlled trial. Am J Sports Med. 2014;42:1534–41.CrossRefPubMed Janssen KW, Hendriks MR, van Mechelen W, Verhagen E. The cost-effectiveness of measures to prevent recurrent ankle sprains: results of a 3-arm randomized controlled trial. Am J Sports Med. 2014;42:1534–41.CrossRefPubMed
4.
go back to reference Takao M, Miyamoto W, Matsui K, Sasahara J, Matsushita T. Functional treatment after surgical repair for acute lateral ligament disruption of the ankle in athletes. Am J Sports Med. 2012;40:447–51.CrossRefPubMed Takao M, Miyamoto W, Matsui K, Sasahara J, Matsushita T. Functional treatment after surgical repair for acute lateral ligament disruption of the ankle in athletes. Am J Sports Med. 2012;40:447–51.CrossRefPubMed
5.
go back to reference Kim SH, Kim J, Choi YE, Lee HR. Healing disturbance with suture bridge configuration repair in rabbit rotator cuff tear. J Shoulder Elb Surg. 2016;25:478–86.CrossRef Kim SH, Kim J, Choi YE, Lee HR. Healing disturbance with suture bridge configuration repair in rabbit rotator cuff tear. J Shoulder Elb Surg. 2016;25:478–86.CrossRef
6.
go back to reference Park HJ, Cha SD, Kim SS, Rho MH, Kwag HJ, Park NH, Lee SY. Accuracy of MRI findings in chronic lateral ankle ligament injury: comparison with surgical findings. Clin Radiol. 2012;67:313–8.CrossRefPubMed Park HJ, Cha SD, Kim SS, Rho MH, Kwag HJ, Park NH, Lee SY. Accuracy of MRI findings in chronic lateral ankle ligament injury: comparison with surgical findings. Clin Radiol. 2012;67:313–8.CrossRefPubMed
7.
go back to reference Kanamoto T, Shiozaki Y, Tanaka Y, Yonetani Y, Horibe S. The use of MRI in pre-operative evaluation of anterior talofibular ligament in chronic ankle instability. Bone Joint Res. 2014;3:241–5.CrossRefPubMedPubMedCentral Kanamoto T, Shiozaki Y, Tanaka Y, Yonetani Y, Horibe S. The use of MRI in pre-operative evaluation of anterior talofibular ligament in chronic ankle instability. Bone Joint Res. 2014;3:241–5.CrossRefPubMedPubMedCentral
8.
go back to reference van Putte-Katier N, van Ochten JM, van Middelkoop M, Bierma-Zeinstra SM, Oei EH. Magnetic resonance imaging abnormalities after lateral ankle trauma in injured and contralateral ankles. Eur J Radiol. 2015;84:2586–92.CrossRefPubMed van Putte-Katier N, van Ochten JM, van Middelkoop M, Bierma-Zeinstra SM, Oei EH. Magnetic resonance imaging abnormalities after lateral ankle trauma in injured and contralateral ankles. Eur J Radiol. 2015;84:2586–92.CrossRefPubMed
9.
go back to reference Kim YS, Kim YB, Kim TG, Lee SW, Park SH, Lee HJ, Choi YJ, Koh YG. Reliability and validity of magnetic resonance imaging for the evaluation of the anterior Talofibular ligament in patients undergoing ankle arthroscopy. Arthroscopy. 2015;31:1540–7.CrossRefPubMed Kim YS, Kim YB, Kim TG, Lee SW, Park SH, Lee HJ, Choi YJ, Koh YG. Reliability and validity of magnetic resonance imaging for the evaluation of the anterior Talofibular ligament in patients undergoing ankle arthroscopy. Arthroscopy. 2015;31:1540–7.CrossRefPubMed
10.
go back to reference Park HJ, Lee SY, Park NH, Rho MH, Chung EC, Park JH, Park SJ. Three-dimensional isotropic T2-weighted fast spin-echo (VISTA) ankle MRI versus two-dimensional fast spin-echo T2-weighted sequences for the evaluation of anterior talofibular ligament injury. Clin Radiol. 2015;71:349–55.CrossRef Park HJ, Lee SY, Park NH, Rho MH, Chung EC, Park JH, Park SJ. Three-dimensional isotropic T2-weighted fast spin-echo (VISTA) ankle MRI versus two-dimensional fast spin-echo T2-weighted sequences for the evaluation of anterior talofibular ligament injury. Clin Radiol. 2015;71:349–55.CrossRef
11.
go back to reference Lee KM, Chung CY, Kwon SS, Chung MK, Won SH, Lee SY, Park MS. Relationship between stress ankle radiographs and injured ligaments on MRI. Skelet Radiol. 2013;42:1537–42.CrossRef Lee KM, Chung CY, Kwon SS, Chung MK, Won SH, Lee SY, Park MS. Relationship between stress ankle radiographs and injured ligaments on MRI. Skelet Radiol. 2013;42:1537–42.CrossRef
12.
go back to reference Dimmick S, Kennedy D, Daunt N. Evaluation of thickness and appearance of anterior talofibular and calcaneofibular ligaments in normal versus abnormal ankles with MRI. J Med Imaging Radiat Oncol. 2008;52:559–63.CrossRefPubMed Dimmick S, Kennedy D, Daunt N. Evaluation of thickness and appearance of anterior talofibular and calcaneofibular ligaments in normal versus abnormal ankles with MRI. J Med Imaging Radiat Oncol. 2008;52:559–63.CrossRefPubMed
13.
go back to reference Delfaut EM, Demondion X, Boutry N, Cotten H, Mestdagh H, Cotten A. Multi-fasciculated anterior talo-fibular ligament: reassessment of normal findings. Eur Radiol. 2003;13:1836–42.CrossRefPubMed Delfaut EM, Demondion X, Boutry N, Cotten H, Mestdagh H, Cotten A. Multi-fasciculated anterior talo-fibular ligament: reassessment of normal findings. Eur Radiol. 2003;13:1836–42.CrossRefPubMed
14.
go back to reference Perrich KD, Goodwin DW, Hecht PJ, Cheung Y. Ankle ligaments on MRI: appearance of normal and injured ligaments. AJR Am J Roentgenol. 2009;193:687–95.CrossRefPubMed Perrich KD, Goodwin DW, Hecht PJ, Cheung Y. Ankle ligaments on MRI: appearance of normal and injured ligaments. AJR Am J Roentgenol. 2009;193:687–95.CrossRefPubMed
15.
go back to reference Maffulli N, Del Buono A, Maffulli GD, Oliva F, Testa V, Capasso G, Denaro V. Isolated anterior talofibular ligament Brostrom repair for chronic lateral ankle instability: 9-year follow-up. Am J Sports Med. 2013;41:858–64.CrossRefPubMed Maffulli N, Del Buono A, Maffulli GD, Oliva F, Testa V, Capasso G, Denaro V. Isolated anterior talofibular ligament Brostrom repair for chronic lateral ankle instability: 9-year follow-up. Am J Sports Med. 2013;41:858–64.CrossRefPubMed
16.
go back to reference Huang B, Kim YT, Kim JU, Shin JH, Park YW, Kim HN. Modified Brostrom procedure for chronic ankle instability with generalized joint Hypermobility. Am J Sports Med. 2016;44:1011–6.CrossRefPubMed Huang B, Kim YT, Kim JU, Shin JH, Park YW, Kim HN. Modified Brostrom procedure for chronic ankle instability with generalized joint Hypermobility. Am J Sports Med. 2016;44:1011–6.CrossRefPubMed
17.
go back to reference Li X, Killie H, Guerrero P, Busconi BD. Anatomical reconstruction for chronic lateral ankle instability in the high-demand athlete: functional outcomes after the modified Brostrom repair using suture anchors. Am J Sports Med. 2009;37:488–94.CrossRefPubMed Li X, Killie H, Guerrero P, Busconi BD. Anatomical reconstruction for chronic lateral ankle instability in the high-demand athlete: functional outcomes after the modified Brostrom repair using suture anchors. Am J Sports Med. 2009;37:488–94.CrossRefPubMed
18.
go back to reference Matheny LM, Johnson NS, Liechti DJ, Clanton TO. Activity level and function after lateral ankle ligament repair versus reconstruction. Am J Sports Med. 2016;44:1301–8.CrossRefPubMed Matheny LM, Johnson NS, Liechti DJ, Clanton TO. Activity level and function after lateral ankle ligament repair versus reconstruction. Am J Sports Med. 2016;44:1301–8.CrossRefPubMed
19.
go back to reference van Dijk CN, Mol BW, Lim LS, Marti RK, Bossuyt PM. Diagnosis of ligament rupture of the ankle joint. Physical examination, arthrography, stress radiography and sonography compared in 160 patients after inversion trauma. Acta Orthop Scand. 1996;67:566–70.CrossRefPubMed van Dijk CN, Mol BW, Lim LS, Marti RK, Bossuyt PM. Diagnosis of ligament rupture of the ankle joint. Physical examination, arthrography, stress radiography and sonography compared in 160 patients after inversion trauma. Acta Orthop Scand. 1996;67:566–70.CrossRefPubMed
20.
go back to reference Hua Y, Chen S, Li Y, Chen J, Li H. Combination of modified Brostrom procedure with ankle arthroscopy for chronic ankle instability accompanied by intra-articular symptoms. Arthroscopy. 2010;26:524–8.CrossRefPubMed Hua Y, Chen S, Li Y, Chen J, Li H. Combination of modified Brostrom procedure with ankle arthroscopy for chronic ankle instability accompanied by intra-articular symptoms. Arthroscopy. 2010;26:524–8.CrossRefPubMed
21.
go back to reference Hua Y, Chen S, Jin Y, Zhang B, Li Y, Li H. Anatomical reconstruction of the lateral ligaments of the ankle with semitendinosus allograft. Int Orthop. 2012;36:2027–31.CrossRefPubMedPubMedCentral Hua Y, Chen S, Jin Y, Zhang B, Li Y, Li H. Anatomical reconstruction of the lateral ligaments of the ankle with semitendinosus allograft. Int Orthop. 2012;36:2027–31.CrossRefPubMedPubMedCentral
22.
go back to reference Park HJ, Lee SY, Park NH, Rho MH, Chung EC, Park JH, Park SJ. Three-dimensional isotropic T2-weighted fast spin-echo (VISTA) ankle MRI versus two-dimensional fast spin-echo T2-weighted sequences for the evaluation of anterior talofibular ligament injury. Clin Radiol. 2016;71:349–55.CrossRefPubMed Park HJ, Lee SY, Park NH, Rho MH, Chung EC, Park JH, Park SJ. Three-dimensional isotropic T2-weighted fast spin-echo (VISTA) ankle MRI versus two-dimensional fast spin-echo T2-weighted sequences for the evaluation of anterior talofibular ligament injury. Clin Radiol. 2016;71:349–55.CrossRefPubMed
23.
go back to reference Taser F, Shafiq Q, Ebraheim NA. Anatomy of lateral ankle ligaments and their relationship to bony landmarks. Surg Radiol Anat. 2006;28:391–7.CrossRefPubMed Taser F, Shafiq Q, Ebraheim NA. Anatomy of lateral ankle ligaments and their relationship to bony landmarks. Surg Radiol Anat. 2006;28:391–7.CrossRefPubMed
24.
go back to reference Boonthathip M, Chen L, Trudell D, Resnick D. Lateral ankle ligaments: MR arthrography with anatomic correlation in cadavers. Clin Imaging. 2011;35:42–8.CrossRefPubMed Boonthathip M, Chen L, Trudell D, Resnick D. Lateral ankle ligaments: MR arthrography with anatomic correlation in cadavers. Clin Imaging. 2011;35:42–8.CrossRefPubMed
26.
go back to reference Kreitner KF, Ferber A, Grebe P, Runkel M, Berger S, Thelen M. Injuries of the lateral collateral ligaments of the ankle: assessment with MR imaging. Eur Radiol. 1999;9:519–24.CrossRefPubMed Kreitner KF, Ferber A, Grebe P, Runkel M, Berger S, Thelen M. Injuries of the lateral collateral ligaments of the ankle: assessment with MR imaging. Eur Radiol. 1999;9:519–24.CrossRefPubMed
27.
go back to reference Fleming BC, Vajapeyam S, Connolly SA, Magarian EM, Murray MM. The use of magnetic resonance imaging to predict ACL graft structural properties. J Biomech. 2011;44:2843–6.CrossRefPubMedPubMedCentral Fleming BC, Vajapeyam S, Connolly SA, Magarian EM, Murray MM. The use of magnetic resonance imaging to predict ACL graft structural properties. J Biomech. 2011;44:2843–6.CrossRefPubMedPubMedCentral
28.
go back to reference Biercevicz AM, Miranda DL, Machan JT, Murray MM, Fleming BC. In situ, noninvasive, T2*-weighted MRI-derived parameters predict ex vivo structural properties of an anterior cruciate ligament reconstruction or bioenhanced primary repair in a porcine model. Am J Sports Med. 2013;41:560–6.CrossRefPubMedPubMedCentral Biercevicz AM, Miranda DL, Machan JT, Murray MM, Fleming BC. In situ, noninvasive, T2*-weighted MRI-derived parameters predict ex vivo structural properties of an anterior cruciate ligament reconstruction or bioenhanced primary repair in a porcine model. Am J Sports Med. 2013;41:560–6.CrossRefPubMedPubMedCentral
Metadata
Title
Quantitative magnetic resonance imaging (MRI) analysis of anterior talofibular ligament in lateral chronic ankle instability ankles pre- and postoperatively
Authors
Wei Liu
Hong Li
Yinghui Hua
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-017-1758-z

Other articles of this Issue 1/2017

BMC Musculoskeletal Disorders 1/2017 Go to the issue