{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T04:00:46Z","timestamp":1782964846184,"version":"3.54.5"},"reference-count":31,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2012,1,11]],"date-time":"2012-01-11T00:00:00Z","timestamp":1326240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:p>Background: Hindfoot trauma including ankle and subtalar sprains may be followed by osteochondral lesions and persisting pain originating from posttraumatic arthritis.<\/jats:p>\n                  <jats:p>Hypothesis: \u201cAcute severe\u201d supination sprains and \u201cmild supination sprains with increasing ligamentous incompetence\u201d of the hindfoot lead to medial ankle and subtalar stress concentrations that may contribute to osteochondral lesions (OCLs) and subsequent arthritis.<\/jats:p>\n                  <jats:p>Study Design: Controlled laboratory study.<\/jats:p>\n                  <jats:p>Methods: \u201cAcute severe\u201d sprains and \u201cmild sprains with increasing ligamentous incompetence\u201d (consecutive anterior talofibular ligament [ATFL], calcaneofibular ligament [CFL], and lateral talocalcaneal ligament [LTCL] transections) were simulated in human lower leg specimens (7 different specimens for each condition). The effect on the migration of the center of force (COF) and on the tibiotalar and subtalar pressures at 700-N (acute severe) and 150-N (mild sprain with increasing ligamentous incompetence) axial static and dynamic loads, respectively, was recorded using pressure sensors.<\/jats:p>\n                  <jats:p>Results: In the \u201cacute severe\u201d sprain, the peak pressure increase reached the level of significance in the ankle ( P = .042) and in the subtalar medial facet ( P = .046). The ankle COF migrated significantly toward the medial ( P = .001) and posterior ( P = .023) directions. In the \u201cmild sprain with increasing ligamentous incompetence\u201d condition, the ankle ( P = .018) and subtalar (medial facet, P = .022) peak pressure increased significantly with intact ligaments and with all ligaments cut. The ankle COF migrated significantly toward the medial direction when the ATFL and CFL or when all 3 ligaments were severed. The anteroposterior ankle COF migration was anterior when all ligaments were intact or when only the ATFL was severed but posterior when the CFL or when the CFL and the LTCL were severed in addition.<\/jats:p>\n                  <jats:p>Conclusion: Next to chronic inhomogeneous load distribution in the unstable hindfoot and shear stress during sprains, intra-articular pressure elevation (impact) in the ankle and subtalar joint during hindfoot supination sprains with intact ligaments or incompetent ligaments likely contributes to OCLs of the medial talar dome and the medial subtalar facet.<\/jats:p>\n                  <jats:p>Clinical Relevance: Intra-articular hindfoot pressure elevation (impact) in \u201cacute severe\u201d and in \u201cmild hindfoot supination sprains with increasing ligamentous incompetence\u201d is substantial for the development of OCLs at the medial midtalar dome and the medial facet of the subtalar joint.<\/jats:p>","DOI":"10.1177\/0363546511432550","type":"journal-article","created":{"date-parts":[[2012,1,12]],"date-time":"2012-01-12T01:28:59Z","timestamp":1326331739000},"page":"902-908","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Hindfoot Joint Pressure in Supination Sprains"],"prefix":"10.1177","volume":"40","author":[{"given":"Fabian","family":"Krause","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Inselspital, University of Berne, Berne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Blatter","sequence":"additional","affiliation":[{"name":"University of Berne, Berne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Waehnert","sequence":"additional","affiliation":[{"name":"AO Research Institute, Davos-Platz, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Windolf","sequence":"additional","affiliation":[{"name":"AO Research Institute, Davos-Platz, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Inselspital, University of Berne, Berne, 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