The relationship between postoperative coronal angle fluctuations and joint stability in patients with lateral ankle instability and osteochondral lesion of the talus

ZHANG Wan-xi; SONG Chen; HAN Biao; Xing Jie

doi:10.3969/j.issn.2095-252X.2026.02.006

Abstract：Objective To explore the relationship between postoperative fluctuations in coronal angles and joint stability in patients with lateral ankle instability accompanied by osteochondral lesion of the talus(OLT).Methods A total of 126 patients with lateral ankle instability and OLT,treated at our hospital from June 2022 to June 2024,were enrolled for this study.At the final follow-up,the functional status of the affected ankle joints was assessed using Mazur's scoring system.Patients were categorized into four groups:excellent,good,fair,and poor(excellent>92 points,good 87-92 points,fair 65-86 points,and poor<65 points).The Generalized Estimation Equation(GEE)model was employed to analyze differences in coronal and sagittal ankle angles among patients with varying prognoses.The Locally Weighted Scatterplot Smoothing(LOWESS)method was utilized to examine the two-dimensional curve relationships of continuous variables.Additionally,logistic regression analysis was conducted to assess the independent correlation between changes in coronal and sagittal angles of ankle acupoints one months after surgery and the risk of ankle joint dysfunction.Restricted cubic spline method was used to explore the correlation between the changes of coronal and sagittal angles of ankle points and the risk of ankle joint dysfunction.Results There were statistically significant differences(P<0.05)among the four groups of patients regarding age,Hepple stage,early functional exercise,and complications.The relative peak moment of the ankle joint(RPT),active position perception,and lower limb Y-balance(YBT-LQ)gradually decreased in the excellent,good,fair,and poor groups;Dynamic control rate(DCR),passive position perception,ankle coronal angle,and sagittal angle gradually increased(P<0.05).As the degree of poor prognosis increased,the coronal and sagittal angles of the ankle acupoints significantly increased(P<0.05).The coronal and sagittal angles of the ankle acupoints exhibited a certain nonlinear relationship with joint stability indicators.There was an independent correlation between the coronal angle(OR=1.623,95%CI=1.452-1.754,P<0.05)and the sagittal angle(OR=1.513,95%CI=1.387-1.629,P<0.05)within one month after surgery and the risk of ankle joint dysfunction.The trend test of the coronal and sagittal angles from low to high in the 5th percentile array revealed statistically significant differences(Ptrend<0.001).The coronal and sagittal angles of ankle points are non-linearly correlated with the risk of ankle dysfunction in OLT patients with lateral ankle instability(Pnon-linearity=0.026,0.041).Conclusions The changes of coronal and sagittal angles of ankle points have a nonlinear relationship with the joint stability index,and are independently related to the risk of ankle dysfunction.