Chronic ankle instability is a common problem that may follow an ankle sprain. Until a patient has developed chronic ankle instability they are ineligible for surgical treatment although early surgical treatment yields better results compared to surgical treatment of subjects that have experienced recurrent ankle sprains. However, treating all patients with an ankle sprain surgically is not an option due to the high amount of unnecessary invasive interventions. The objective of this study is to identify which patients will develop chronic ankle instability and to develop a model to predict which patients should receive early surgical treatment. In this prospective observational cohort all patients (older than 18 years) that report at the emergency department of the participating hospitals after a lateral ankle sprain, of whom an x-ray is made after positive Ottawa Ankle Rules and on which there is no visible fracture or other pathology. The main study parameter is a significant difference in patient characteristics, foot and ankle configuration and joint pathology between patients who develop chronic ankle instability and patients who do not experience recurrent ankle sprains and restriction during daily live after an initial sprain.
Study Type
OBSERVATIONAL
Enrollment
460
Flevoziekenhuis
Almere Stad, Netherlands
Slotervaart MC
Amsterdam, Netherlands
VUmc
Amsterdam, Netherlands
AMC
Amsterdam, Netherlands
The primary outcome measure is a prediction model based several factors. One of these is ankle joint alignment.
Ankle alignment is assessed as the medial distal tibial angle on a standard anteroposterior x-ray
Time frame: 2 years anticipated
The primary outcome measure is a prediction model based several factors. One of these is fibular position in relation to the tibia.
Position of the fibula is assessed on a lateral x-ray.
Time frame: 2 years anticipated
The primary outcome measure is a prediction model based several factors. One of these is the tibiotalar contact ratio.
The tibiotalar contact ratio is assessed as an angle originating from the center of the talus to the anterior and posterior edges of the distal tibia.
Time frame: 2 years anticipated
The primary outcome measure is a prediction model based several factors. One of these is sex.
Sex is registrated as male-female and has proven to be of prognostic value in previous research
Time frame: 2 years anticipated
The primary outcome measure is a prediction model based several factors. One of these is height.
Height is registrated in centimeters and has proven to be of prognostic value in previous research
Time frame: 2 years anticipated
The primary outcome measure is a prediction model based several factors. One of these is Body Mass Index (BMI).
BMI is registrated and has proven to be of prognostic value in previous research
Time frame: 2 years anticipated
The primary outcome measure is a prediction model based several factors. One of these is sports intensity.
Sports intensity is registrated using the ankle activity score taking type of sports into account and has proven to be of prognostic value in previous research.
Time frame: 2 years anticipated
The primary outcome measure is a prediction model based several factors. One of these is talar curvature.
The talar curvature is defined as the angle between the talar neck, most proximal talar part articulating with the tibia and the most distal part of the talus
Time frame: 2 years anticipated
The primary outcome measure is a prediction model based several factors. One of these is the height of the medial malleolus.
The medial malleolus is thought to restrict inversion motion, therefore the height is assessed using the angle between the tibiotalar joint and most distal part of the medial malleolus
Time frame: 2 years anticipated
Inter- and intrarater reliability of the prognostic factors assessed on ankle x-rays
Assessment of reliability of the bone geometric factors on anteroposterior and lateral x-rays
Time frame: at about 6 months, when 40 patients are included
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