Stemcelldoc's Weblog

March 25, 2012

Anterior Talofibular Ligament: Ankle Stability

At the Centeno-Schultz Clinic stability is a key concept in the treatment of orthopedic injuries.  Stability is one of  many critical concepts discussed in Ortho 2.0.  Joint instability can lead to injury, acceleration of cartilage and meniscus degeneration and an alternation in bio mechanics.

The anterior talofibular ligament (ATF)  is a key lateral ligament in the  ankle.  Ligaments are dense fibrous tissue that connect one bone to another.  Treatment options for ligament laxity include prolotherapy, platelet derived growth factors and autologous stem cell therapy.

The anterior talofibular ligament has the following characteristics:

It connects anterior fibula to neck of talus.

In dorsiflexion, its fibers are oriented 75 deg to the floor

In plantar flexion, its fibers approach vertical orientation.

The ATF ligament prevents the foot from sliding forward in relation to the shin

It is the weakest of the ankle ligaments and it’s because of this it is the one that is most commonly injured.

The  anterior drawer and talar tilt tests are common tests used at the Centeno-Schultz Clinic to evaluate lateral ligament laxity.

Below is an ultrasound image of the ATF.  F=fibula and T=Talus.  The arrows identify the  anterior talofibular ligament.

November 29, 2010

Ankle Pain: An issue of stability

Ligaments connect bone to bone.  They provide essential support to a given joint.  Conceptually they are the duct tape which provide for a strong foundation.   If the ligament is torn, stretched or injured it can become loose thereby compromising the support of a joint.  An unstable joint can be painful. Treatment options at the Centeno-Schultz Clinic for instability include x-ray or ultrasound guided prolotherapy, PRP or one or more of the Regenexx family therapies.

CR is 21y/o patient with ankle pain following a high-speed rear-end motor vehicle injury.  At time of impact he has his right foot on the brake.  Conservative therapy in the form of NSAIDs, physical therapy and massage failed to improve the debilitating ankle pain.  On physical exam the ankle was noted to be loose.  After three prolotherapy injections into the  lateral ankle igaments as well as the intersosseus ligaments he reports 90% improvement.  If left untreated unstable joints often undergo an acceleration of the degenerative process due to uneven and tear.

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