19 peer-reviewed studies linked to ankle (limited motion) (diagnostic code 5271), from PubMed and the U.S. National Library of Medicine. Each citation links to its source.
Systematic review
Treatment of Chronic Ankle Instability in the Military Population: A Systematic ReviewFoot & Ankle Specialist · 2024
- Surgical and conservative care for chronic ankle instability in service members
- High prevalence of ankle instability and limited motion in military
- Return-to-duty rates and persistent functional deficits
Direct military-population SR supports nexus/severity for DC 5271
View on PubMed ↗Cross-sectional
Prevalence and risk factors of ankle osteoarthritis in a population-based study.Foot Ankle Surg · 2024
- Radiographic ankle osteoarthritis prevalence was 13.9%, with 1.2% reporting painful ankle OA.
- Female sex, aging, prior ankle fracture, and chronic ankle instability were independent risk factors for ankle OA.
Quantifies ankle OA prevalence and confirms prior ankle trauma/instability as causal risk factors, supporting the in-service-injury-to-arthritis nexus for DC 5271.
View on PubMed ↗Systematic review
Total ankle replacement versus ankle arthrodesis for patients aged 50-85 years with end-stage ankle osteoarthritis: the TARVA RCT.Health Technol Assess · 2023
- Both total ankle replacement and ankle fusion improved walking/standing quality of life at 1 year, with no statistically significant difference on the primary outcome.
- Wound-healing issues (13.4% vs 5.7%) and nerve injuries (4.2% vs <1%) were higher with total ankle replacement; ankle-fusion non-union was 12.1% (7.1% symptomatic).
- A post hoc analysis showed fixed-bearing total ankle replacement statistically outperformed fusion on the walking/standing score.
Highest-quality RCT for end-stage ankle OA surgery, documenting substantial residual disability and complication burden relevant to severe DC 5271 cases.
View on PubMed ↗Cohort study
How Common is Subsequent Posterior Tibial Tendon Dysfunction or Tarsal Tunnel Syndrome After Ankle Sprain Injury?The Journal of Knee Surgery · 2022
- Quantifies subsequent posterior tibial tendon and tarsal tunnel diagnoses after ankle sprain
- Secondary-condition pipeline for downstream VA claims
- Time-to-secondary-condition reported
Supports secondary service connection for ankle/foot conditions from in-service sprain
View on PubMed ↗Review
Ankle Osteoarthritis.Rev Bras Ortop (Sao Paulo) · 2021
- The main etiology of ankle OA is post-traumatic, and prevalence is higher among young and obese people.
- Overall risk of developing post-traumatic ankle OA after 20 years is almost 40%, especially in Weber type B and C bimalleolar fractures.
- In talus fractures the prevalence of post-traumatic OA approaches 100% depending on lesion severity and follow-up time.
Documents that most ankle arthritis is post-traumatic with high long-term incidence after injury, anchoring causation and natural-history arguments for DC 5271.
View on PubMed ↗Meta-analysis
Clinical Outcomes of Total Ankle Arthroplasty Versus Ankle Arthrodesis for the Treatment of End-Stage Ankle Arthritis in the Last Decade: a Systematic Review and Meta-analysis.J Foot Ankle Surg · 2020
- Total ankle arthroplasty produced significantly better AOFAS function and range-of-motion improvement than arthrodesis.
- No significant differences were found between arthroplasty and fusion in pain relief, gait analysis, or patient satisfaction.
- Total ankle arthroplasty had significantly higher complication and reoperation rates than arthrodesis.
Confirms that even with modern surgery end-stage ankle arthritis leaves persistent functional and motion deficits, supporting severity ratings under DC 5271.
View on PubMed ↗Review
Epidemiology of Ankle Sprains and Chronic Ankle InstabilityJournal of Athletic Training · 2019
- ~40% of ankle sprains progress to chronic ankle instability
- Highest incidence in physically active populations including military training
- Population-level incidence rates
In-service ankle sprain commonly causes lasting limitation of motion
View on PubMed ↗Review
Current Concepts in Osteoarthritis of the Ankle: Review.Surg Technol Int · 2019
- Review of ankle osteoarthritis: a leading cause of chronic disability, most commonly post-traumatic, occurring in younger patients and associated with obesity.
- Presents with stiffness, swelling, and pain; diagnosis uses four weight-bearing radiographic views.
- Surgical options for moderate-severe disease either carry high complication rates or restrict ankle range of motion.
Comprehensive overview of post-traumatic ankle arthritis, its disability burden, and how treatment affects range of motion, directly supporting a limited-ankle-motion claim.
View on PubMed ↗Clinical guideline
2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains.Br J Sports Med · 2016
- International Ankle Consortium consensus identifies lateral ankle sprain and resulting chronic ankle instability as a conduit to a significant global healthcare burden.
- Early management of lateral ankle sprain is recommended to reduce chronic ankle instability and its sequelae.
- Chronic ankle instability is linked to decreased physical activity and early-onset ankle joint post-traumatic osteoarthritis.
Authoritative consensus tying acute ankle sprains to chronic instability and early-onset arthritis, the precise progression underlying DC 5271 claims.
View on PubMed ↗Meta-analysis
Hyaluronic acid and other conservative treatment options for osteoarthritis of the ankle.Cochrane Database Syst Rev · 2015
- Hyaluronic acid reduced the Ankle Osteoarthritis Scale total score by only 12% at six months versus placebo, on low-quality evidence.
- Insufficient data exist to create an evidence synthesis as a base for ankle-OA treatment guidelines.
- Guidelines used for hip and knee OA may not apply to ankle OA because its etiology (usually trauma) differs.
Shows conservative options for ankle OA are limited and weakly effective, reinforcing that the condition often remains symptomatic and disabling (DC 5271).
View on PubMed ↗Systematic review
Chronic complaints after ankle sprains: a systematic review on effectiveness of treatments.J Orthop Sports Phys Ther · 2014
- Although most people recover after a lateral ankle sprain, a considerable percentage have persistent complaints.
- A training program produced better pain and function outcomes and fewer recurrent sprains than a wait-and-see policy.
- Evidence was insufficient to determine the most effective surgical treatment for chronic post-sprain complaints.
Demonstrates that ankle symptoms frequently persist despite treatment, supporting chronicity and residual functional loss central to DC 5271.
View on PubMed ↗Cohort study
Incidence of ankle sprains among active-duty members of the United States Armed Services from 1998 through 2006.J Athl Train · 2010
- The ankle-sprain incidence rate was 34.95 per 1,000 person-years among US active-duty service members from 1998 through 2006.
- This incidence was 5 times greater than that previously reported in civilian population studies.
- Female service members were 21% more likely than males to sustain an ankle sprain (IRR 1.21).
Establishes that ankle injuries occur at five times the civilian rate in active-duty military, directly supporting service-connection for ankle limited-motion claims (DC 5271).
View on PubMed ↗Meta-analysis
Safety and efficacy of total ankle arthroplasty versus ankle arthrodesis for ankle osteoarthritis: A systematic review and meta-analysis.Foot (Edinb) · 2023
- Meta-analysis of 36 studies comparing total ankle arthroplasty vs ankle arthrodesis for ankle osteoarthritis.
- Arthroplasty showed lower risk of infection (RR 0.63), amputation (RR 0.40), and non-union (RR 0.11), plus significantly greater overall range of motion than fusion.
- Fusion inherently sacrifices ankle motion, unlike arthroplasty.
Demonstrates that surgical management of end-stage ankle arthritis directly trades off range of motion, relevant to severity and treatment outcomes in a limited-ankle-motion claim.
View on PubMed ↗Meta-analysis
One in Three Patients With Chronic Lateral Ankle Instability Has a Cartilage Lesion.Am J Sports Med · 2023
- The pooled incidence of (osteo)chondral lesions in ankles with chronic lateral instability was 32.2% (about one in three).
- Of all lesions, 57% were osteochondral and 85% were located on the talus (68% medial talar dome).
Links chronic ankle instability to intra-articular cartilage damage, the mechanism by which in-service ankle injuries progress to arthritis under DC 5271.
View on PubMed ↗Review
Examination of Ankle Trauma in United States Military Members: A Scoping Review.Cureus · 2022
- Military members' ankle injuries and return-to-duty expectations differ significantly from the general population.
- The review identified a lack of RCTs, underrepresentation of vulnerable military subgroups, and no single validated test for ankle mobility/strength to clear return to duty.
Characterizes the distinct burden and assessment gaps of military ankle trauma, supporting service-connection context for DC 5271.
View on PubMed ↗Meta-analysis
Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis.Br J Sports Med · 2017
- Overview of 46 systematic reviews on treatment of acute ankle sprain and chronic ankle instability.
- Strong evidence for NSAIDs and early mobilization for acute pain/swelling/function; bracing and neuromuscular training prevent recurrence.
- Conflicting evidence for surgery and acupuncture in acute sprains.
Summarizes the evidence base for managing the recurrent ankle sprains/instability that commonly precede limited ankle motion, supporting treatment-history and prognosis context in an ankle claim.
View on PubMed ↗Review
Understanding and treating lateral ankle sprains and their consequences: a constraints-based approach.Sports Med · 2013
- Lateral ankle sprains commonly progress along a continuum of disability: ~30% develop chronic ankle instability and up to 78% of those develop post-traumatic ankle osteoarthritis.
- Consequences include ligament laxity, restricted range of motion, and impaired gait and postural control.
- Frames ankle sprain as more than a local injury, with lasting structural and sensorimotor deficits.
Establishes the causal pathway from a service-typical ankle sprain to chronic instability and limited motion / arthritis, supporting service-connection and chronicity in an ankle-motion claim.
View on PubMed ↗Cohort study
Twenty-one-year follow-up of supination-external rotation type II-IV (OTA type B) ankle fractures: a retrospective cohort study.J Orthop Trauma · 2012
- At a median 21-year follow-up, excellent or good results were seen for functional score (92%) and osteoarthritis (97%).
- Whole-person functional impairment ranged from 0% to 16%.
- No outcome differences were found between operative and nonoperative treatment or between fracture subtypes.
Provides long-term natural-history data showing measurable residual ankle impairment decades after injury, informing prognosis for DC 5271 claims.
View on PubMed ↗Systematic review
Brain Neuroplasticity Related to Lateral Ankle Ligamentous Injuries: A Systematic Review.Sports Med · 2023
- Structural and functional brain adaptations were found in patients with chronic ankle instability versus healthy controls or copers.
- Alterations were mainly in the sensorimotor network (pre/postcentral gyrus, supplementary and middle frontal areas) and dorsal anterior cingulate cortex.
- White-matter microstructure changes in the cerebellum were related to lateral ankle sprains.
Suggests ankle injury produces central nervous-system changes that help explain persistent dysfunction and high recurrence, contextualizing chronicity in DC 5271.
View on PubMed ↗