Correlation between functional impairment and quantitative MRI assessment of ankle cartilage in chronic ankle instability

Background Chronic ankle instability (CAI) is characterized by persistent ankle pain, instability, and recurrent sprains. Previous studies have investigated functional impairments and cartilage degeneration separately, but the relationship between them in CAI remains unclear and unexplored. Objective This study aimed to compare the outcomes of functional impairments and cartilage composition between individuals with CAI and healthy controls to develop targeted interventions to improve joint health and prevent cartilage degeneration in patients with CAI. Methods This case–control study enrolled 20 individuals with CAI and 25 healthy controls. Dynamic balance measured using the Y-Balance Test (YBT) and static postural control was quantified by analyzing the trajectory of the center of pressure (CoP). T2 mapping of the talocrural joint was conducted using a 3-T magnetic resonance imaging scanner to assess ankle cartilage composition. Clinical questionnaire such as the Cumberland Ankle Instability Tool (CAIT) was used to evaluate the self-reported functional instability. Results The T2 values were significantly higher in medial center (MC), medial posterior (MP), and lateral posterior (LP) ( P < .05) subregions of the talar cartilage in the CAI group compared with the control group, indicating greater cartilage degeneration. Higher T2 values in the MC subregion were correlated with poorer CAIT scores ( r = −0.484, P= .031) and YBT reach distances on the injury side ( r ranged from −0.721 to −0.557, P < .05). The T2 elevations were also associated with reduced YBT reach distances on the healthy side and increased CoP excursions during eyes-closed postural control testing (eyes open: r = −0.585, P= .001; eyes closed: r = −0.469, P= .037). Conclusions This study provides evidence of functional impairments and cartilage degeneration in individuals with CAI. The observed biomechanical compensations and increased cartilage T2 values may contribute to the development of CAI and potentially increase the risk of long-term joint degeneration. These valuable insights into the pathophysiology of CAI may aid in developing targeted interventions to mitigate long-term joint degeneration.