The Interosseous Talocalcaneal Ligament Injury Findings in Lateral Ankle Instability with Sinus Tarsi Pain

CATEGORY: Ankle, Arthroscopy, Sports INTRODUCTION/PURPOSE: Lateral ankle instability (LAI) with concomitant sinus tarsi pain is a quite common finding. However, there has been few studies evaluating the subtalar arthroscopic findings for LAI with sinus tarsi pain. The purpose of the study is to evaluate the ST arthroscopic findings of chronic ankle instability with sinus tarsi syndrome. We hypothesized that chronic ankle instability with sinus tarsi pain is highly associated with interosseous talocalcaneal ligament (ITCL) tear which may be the cause for subtalar instability (STI). METHODS: The study is based on 104 LAI with sinus tarsi pain ankles who had performed lateral ankle ligament stabilization. i.e. Modified Brostrum procedure (MBP), lateral ankle reconstruction (LAR) or subtalar ligament reconstruction (STR) with subtalar arthroscopic (STA) examinations from 2007 to 2018. The STA has been mainly focused on the ITCL injury and debridement of the ITCL tears and synovitis were performed when present. VAS pain score, AOFAS, Karlsson-Peterson functional score were evaluated. RESULTS: According to the ST arthrosopic findings, ITCL tears were present in 94% (98/104) of the ankles. Lateral ankle instability (LAI), subtalar instability (STI), and LAI and STI combined were 32%, 30% and 38% respectively. MBP, LAR and STR were performed in 23%, 22% and 56% respectively. VAS pain score was improved from 5.3 to 1.9 (p<0.05). AOFAS score was improved from 67 to 89 (p<0.05), while K-P score improved from 50 to 83 (p<0.05). Sinus tarsi pain was relieved in 65% of the patients. CONCLUSION: We found the high incidence of the ITCL tears (98%) in LAI with sinus tarsi pain, and also diagnosed the STI in 68% of the ankles. We believe that in case of LAI with sinus tarsi pain, ST arthroscopic evaluation for ITCL tears is necessary and the possibility