PRP is progressively emerging at the forefront of sports and rehabilitation medicine, and its role in different soft injuries has become the focus of research in recent years.ĭespite the popularity of PRP research, little was known about its role in the management of LAS. Growth factors are released from the alpha granules of platelets which induce chemotaxis, cell migration, angiogenesis, proliferation, differentiation and matrix production ( 2, 3). Platelet-rich plasma (PRP) is an autologous derivative of whole blood that stimulates a supra-physiological release of growth factors to jump start healing in chronic injuries. Therefore, it becomes apparent that the healthcare burden that emerges from so called “simple” LAS is substantial.Ĭonservative management and early functional rehabilitation remain to be the standard of care for all grades of LAS. While the direct costs for treatment of an isolated LAS are relatively low, compounding these are indirect costs from follow up care, loss of productivity, time loss of activity and care of its long-term consequences. Apart from the pain and temporary period of reduced functioning and disability, it is also associated with increased risk of recurrent ankle sprain, the development of chronic ankle stability (CAI) and post-traumatic ankle osteoarthritis (PTOA). Note: these tests should only be performed by a properly trained health care practitioner.Lateral ankle sprain (LAS) is the most common musculoskeletal injury in the physically active population it is also a common condition in the general population ( 1). Because there is a subjective grading scale (0-3) for laxity, it is important for the novice clinician to critically assess the motion and patient's response during the test. Based off the anatomical orientation, placing the ankle into 10-15 degrees of plantar flexion puts a stress on the ligament, which is enhanced when a posterior to anterior translation is applied. The function of the ATFL is to resist anterior translation of the ankle and prevent internal rotation of the talus on the tibia. The ATFL courses from the anterior aspect of the lateral malleolus to the anterior medial aspect of the neck of the talus. Importance of Test: The anterior drawer test is a beneficial test to perform in a patient following an inversion ankle sprain (injury to the lateral collateral ligaments). The 3 main components of the Lateral Collateral Ligaments of the ankle include the anterior talofibular ligament (ATFL), calcaneofibular ligament, and posterior talofibular ligament. Positive test results are often graded on a "0 to 3 scale", with 0 indicating no laxity & 3 indicating gross laxity.ĭiagnostic Accuracy: Sensitivity. A positive test results if the talus translates forward. The examiner then places the patient's foot into 10-15 degrees of plantar flexion and translates the rear foot anteriorly. Performing the Test: The examiner stabilizes the anterior distal leg with one hand & grasps the patient's calcaneus and rear foot with their second hand. This test primarily assesses the strength of the Anterior Talofibular Ligament.
Purpose: To test for ligamentous laxity or instability in the ankle.
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