Ankle cartilage health and physical activity in adults with a history of lateral ankle sprain.

Lateral ankle sprain (LAS) is a common injury with long-term consequences, including joint degeneration and behavioral adaptations. This study compares talar cartilage measures, physical activity, and injury-related fear between young and middle-aged adults with and without a history of LAS. Forty adults were categorized into four groups: young ankle sprain (YAS), young control (YC), middle-aged ankle sprain (MAS), and middle-aged control (MC). Talar cartilage cross-sectional area (CSA), echointensity (EI), and echogenicity (EG) were measured using ultrasound. Physical activity was assessed via accelerometry and the Godin Questionnaire. The Tampa Scale of Kinesiophobia-11 (TSK-11), the Fear-Avoidance Beliefs Questionnaire (FABQ), and the Foot and Ankle Disability Index (FADI) were used to evaluate injury-related fear and ankle function. Significant age × LAS interactions for lateral EI (p = .016, d = -0.88) and medial EI (p = .007, d = -0.91) indicated compositional decline in MAS vs. YAS. Medial EI was higher in YAS than MAS (p = .007, d = 0.91), reflecting better cartilage composition in younger LAS participants. LAS history was associated with increased lateral CSA (p = .008, d = 0.62) and medial CSA (p = .017, d = 1.50). LAS participants also had reduced lateral EG (p = .009, d = 0.78), FADI-ADL (p = .001, d = 1.21), FADI-S (p = .019, d = 0.79), and very vigorous physical activity (p = .023, d = 0.74) compared to controls. No significant differences were observed for TSK-11 (p = .054) or FABQ (p = .102). Adults with prior LAS exhibited early signs of talar cartilage morphology, evidenced by thickening and a more hypoechoic appearance on ultrasound. These changes occurred with selfreported functional deficits, but without significant increases in fear of movement or exercise avoidance.