Article Text

Download PDFPDF
Changes in joint position sense after surgically treated chronic lateral ankle instability
  1. T Halasi,
  2. Á Kynsburg,
  3. A Tállay,
  4. I Berkes
  1. Department of Sports Surgery, National Institute for Sports Medicine, Budapest, Hungary
  1. Correspondence to:
    Dr Halasi
    Department of Sports Surgery, National Institute for Sports Medicine, Budapest 1123, Hungary;


Background: A search of the literature shows that the effect of surgery on ankle proprioception has been hardly investigated.

Objective: To examine the effect of anatomical reconstruction of the anterolateral capsuloligamentous complex on ankle joint position sense.

Methods: A prospective study using the “slope box” test. Ten consecutive patients were included in the study, and 10 healthy athletes represented the control group.

Results: Similar test-retest reliability rates (overall reliability 0.92; p  =  0.0013) were obtained to those of the original designers of the method. There were no significant differences with respect to side dominance (p  =  0.9216). Investigation of the characteristics of mean absolute estimate errors showed that the controls tested became error prone in the range of slope altitudes 7.5–25° in every direction, compared with the range 0–5° (range of p values 0.00003–0.00072). The results of the intervention group showed that, for the two main directions of interest (anterior and lateral), preoperative differences in mean absolute estimate errors between injured (anterior 3.91 (2.81)°; lateral 4.06 (2.85)°) and healthy (anterior 2.94 (2.21)°, lateral 3.19 (2.64)°) sides (anterior, p  =  0.0124; lateral, p  =  0.0250) had disappeared (postoperative differences: anterior, p  =  0.6906; lateral, p  =  0.4491). The afflicted ankle had improved significantly after surgery in both important directions (anterior, p<0.0001; lateral, p  =  0.0023).

Conclusions: The study shows that differences in joint position sense between healthy and injured ankles disappeared as the result of surgery. Preoperative data show that proprioceptive malfunction is a cause of functional instability. If treatment is by means of surgery, the retensioning of the original anterolateral structures is inevitable, even if other grafting or surgical techniques are used.

  • proprioception
  • ankle instability
  • lateral ligaments
  • anatomical reconstruction
  • joint position sense

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.