Biomedical subjects

Johannes L Tol

Publications and source records attributed to Johannes L Tol.

5 recordsLinked to original sources

PubMed2006

Anterior ankle impingement.

The anterior ankle impingement syndrome is a clinical pain syndrome that is characterized by anterior ankle pain on (hyper) dorsiflexion. The plain radiographs often are negative in patients who have anteromedial impingement. An oblique view is recommended in these patients. Arthroscopic excision of soft tissue overgrowths and osteophytes is an effective way of treating anterior impingement of the ankle in patients who have no narrowing of the joint space. For grade II lesions (osteophytes secondary to arthritis with joint space narrowing) arthroscopic treatment is a good option, because no other therapeutic option is available with the exception of an arthrodesis or prothesis.

Ankle Injuries↗

PubMed2004

The anterior ankle impingement syndrome: diagnostic value of oblique radiographs.

BACKGROUND: The diagnostic value of an oblique radiograph, in addition to a lateral radiograph, for detecting osteophytes in the anterior ankle impingement syndrome was evaluated in a prospective study. The hypothesis was that the application of a lateral radiograph is insufficient to detect osteophytes that are located in the anteromedial aspect of the ankle joint. Oblique anteromedial impingement (AMI) radiographs were hypothesized to be a relevant adjunct, because of their utility to detect these anteromedially located osteophytes. METHODS: Presence or absence of tibial and talar osteophytes on both radiographs was compared with the combined findings of CT, MRI scan, and arthroscopic surgery. Estimates of test characteristics were obtained for 60 consecutive patients with an anterior ankle impingement syndrome. RESULTS: It was shown that the sensitivity of lateral radiographs for detecting anterior tibial and talar osteophytes was 40% and 32%, respectively (specificity, 70% and 82%). When the lateral radiograph was combined with an oblique AMI radiograph, these figures increased to 85% and 73%, respectively (specificity decreased to 45% and 68%). This increase was due to the high sensitivity of the oblique AMI radiographs for detecting anteromedial osteophytes (93% for tibial and 67% for talar osteophytes). CONCLUSION: A lateral radiograph is insufficient to detect all anteriorly located osteophytes. An oblique AMI radiograph is a useful adjunct to routine radiographs and is recommended to detect anteromedial tibial and talar osteophytes.

Adolescent↗

PubMed2004

Etiology of the anterior ankle impingement syndrome: a descriptive anatomical study.

BACKGROUND: In the anterior ankle impingement syndrome, recurrent traction to the anterior joint capsule is stated to be the cause of formation of talotibial osteophytes. This hypothesis involves the assumption that the osteophytes originate at the site where a capsular attachment is located. A soft tissue component that can get squeezed between the distal tibia and talus is thought to be responsible for impingement complaints during dorsiflexion movements. METHODS: In eight ankle specimens, the width of the nonweightbearing tibial cartilage rim and the distance of the tibial and talar cartilage to the capsular attachment were measured. The relationship of the soft tissue components to the anterior joint was studied. The average tibial cartilage rim width was 2.4 mm (1.5-3.0 mm). Tibial and talar cartilage-capsule distances were 4.3 mm (0.5-9.0 mm) and 2.4 mm (1.8-3.3 mm), respectively. In all specimens, the anterior joint space contained a triangular soft tissue component, overlying the joint capsule. The component consisted of a synovial membrane and subsynovial located fat and collagen tissue. It was observed that in 15 degrees dorsiflexion the soft tissue component was squeezed between the tibia and talus. CONCLUSIONS: The anterior ankle joint capsule attaches proximal to the site where the anterior talotibial spurs originate. The hypothesis of formation of talotibial spurs due to repetitive capsule traction therefore does not seem plausible. The anatomic findings do support the hypothesis that an anteriorly located soft tissue component is present that can give impingement symptoms.

Aged↗

PubMed2002

Oblique radiograph for the detection of bone spurs in anterior ankle impingement.

OBJECTIVE: The aim of this study was to develop a radiographic view to detect anteromedial talotibial osteophytes that remain undetected on standard radiographs. DESIGN AND PATIENTS: In 10 cadaver specimens the maximal size was measured of anteromedial tibial osteophytes that remain undetected on a standard lateral radiograph projection, due to the presence of the anteromedial tibial rim. The average projection of the most prominent anterolateral tibial rim over the anteromedial rim was found to be 7.3 mm. A 7 mm barium-clay osteophyte was attached to this anteromedial rim of the distal tibia. Anteromedial osteophytes become most prominent on an oblique view, in which the radiographic beam is tilted into a 45 degrees craniocaudal direction with the leg in 30 degrees external rotation. This oblique view was compared with the findings of arthroscopic surgery in 25 consecutive patients with anterior ankle impingement syndrome. RESULTS: Medially located tibial and talar osteophytes remained undetected on a standard lateral projection and became visible on the oblique anteromedial impingement (AMI) radiograph. Anterolateral tibial and talar osteophytes were well detected on a standard lateral radiograph projection but were invisible on the AMI view. There was a high correlation between the location of the osteophyte and the location of symptoms and the findings at arthroscopy. CONCLUSION: A combination of lateral and oblique radiographs can be used to differentiate between anteromedial and anterolateral bony ankle impingement.

Adult↗

PubMedDate not supplied

The relationship of the kicking action in soccer and anterior ankle impingement syndrome. A biomechanical analysis.

Two different hypotheses have been advanced to explain the formation of talotibial osteophytes in the anterior ankle impingement syndrome. We investigated how frequently hyperplantar flexion occurs during kicking and whether the site of impact of the ball coincides with the reported location of the osteophytes. We also measured the magnitude of the impact force. We studied 150 kicking actions performed by 15 elite soccer players by using mobile sensors and high-speed video. In 39% of the kicking actions, the plantar flexion angle exceeded the maximum static plantar flexion angle. Ball impact was predominantly made with the anteromedial aspect of the foot and ankle, with impact between the ball and the base of the first metatarsal bone in 89% of the kicking actions and between the ball and the anterior part of the medial malleolus in 76%. Postimpact ball velocity averaged 24.6 m/s, with a corresponding average contact force of 1025 N. Hyperplantar flexion was reached in only the minority of the kicking actions. The data on impact location and impact force support the hypothesis that spur formation in anterior ankle impingement syndrome is related to recurrent ball impact, which can be regarded as repetitive microtrauma to the anteromedial aspect of the ankle.

Adult↗