Association of ankle joint cartilage health and functional measures in patients with chronic ankle instability

Lateral ankle sprains (LASs) are the most common musculoskeletal disorder documented in physically active populations, creating acute pain, disability and loss of function. Unfortunately, the majority of patients with a history of LAS will sustain at least one additional LAS; with many developing physical and subjective functional limitations, with ongoing “giving-way” in the affected ankle, resulting in the defined condition of chronic ankle instability (CAI). The evidence is growing that an important consequence of LAS, and the subsequent high rate of CAI, is ankle joint post-traumatic osteoarthritis (PTOA), subsequently increasing the number of disability-affected life years. Patients with a history of LAS make up the majority of the surgical cases for end-stage ankle joint PTOA. Emerging information demonstrates that CAI represents an important period in the early stages of ankle joint degeneration and may even be a key mediator driving the disease process. Recent studies have shown that ankle joint PTOA may not be isolated to middle aged and older adults, but alarmingly is being documented in young adults. Our recent preliminary survey data found that diagnosed ankle joint PTOA was self-reported by young adults only if they had a history of LAS; and the distribution of ankle joint PTOA in young adults was similar to that of middle-aged adults, suggesting an early onset of joint degenerative disease in LAS patients. However, none of these studies have combined documentation of ankle joint PTOA with patient self-reported or physical function outcomes. Continued work in this area is needed to elucidate fully the paradigms between LAS, CAI and ankle joint PTOA that is likely to initiate in early adulthood, and how this degenerative disease is impacting patient function. This information will support increased efforts to prevent and properly manage LAS and CAI to reduce the early onset of this degenerative disease. Our overall goal is to reduce disability and promote healthy physically active lifestyles in patients that have suffered lower extremity musculoskeletal injury. Specifically, we are interested in mitigating the consequences of LAS and CAI. Our overall hypothesis is that young adults with CAI experience early onset of ankle joint PTOA that is impacting their function and quality of life.