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I think Frank Burke in Melbourne pioneered this technique for 'frozen shoulder' or more specifically adhesive capsulitis of the shoulder; whereby a mixture of saline, cortisone etc is pumped in to the shoulder joint capsule. The main therapeutic effect is said to be the stretching force from within (distended internally).

Apropo to this technique, does anyone know of this procedure for the talo-crural joint?

Ron

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Ron,

When is this indicated ?? Arthrofibrosis of the talocrural although reported is uncommon in my experience. Most LROM of the ankle is due to muscle contracture and DJD. If any part of the capsule is clinically tight it would be the posterior part. This area is thickened with a fibrocartilage-like surface that acts like a meniscus when taught. I doubt that a syringe could produce enough pressure to stretch this.

Nick

Non-osseous recalcitrant (to conservative intervention) sagittal-plane ROM limitation.

The negatives are apparently negligible in relation to shoulder hydrodilatation, so I wondered if it has been tried to distend the TC joint capsule.

I am not certain that it would work either but...I might give it a go and see if I can get to the holy grail of 10 degrees.

Witnessed one today. Patient of mine has endured non-osseous anterior ankle impingement since a forklift ran over him years ago. Recent surgery to clear the anterior joint yielded no significant improvement to ankle dorsi-flexion lunge.

Will post photos if they are clear enough.

Will report on patient progress (subjective and objective) over the coming weeks.



I apologise to the church of evidence-based-practice (aka scientology) for my sample size of 1, the resultant error of 1, and the lack of placebo contol group.


Ron
Physiotherapist (Masters) & Podiatrist
Amen