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Bone Joint J. 2016 Oct;98-B(10):1369-1375.

Abnormalities of gait caused by ankle arthritis are improved by ankle arthrodesis.

Author information

1
Baylor University Medical Center, 3500 Gaston Ave, Dallas, Texas, 75246, USA.
2
Baylor Motion and Sports Performance Center, 411 N Washington Ave, Suite 2100, Dallas, TX, 75246, USA.
3
Emory University School of Medicine, 59 Executive Park South, Suite 2000, Atlanta GA, 30329, USA.
4
Chaim Sheba Medical Center at Tel Hashomer affiliated to the Sackler Faculty of Medicine Tel Aviv University, Ramat Gan, 5265601, Israel.

Abstract

AIMS:

The surgical management of ankle arthritis with tibiotalar arthrodesis is known to alter gait, as compared with normal ankles. The purpose of this study was to assess post-operative gait function with gait before arthrodesis.

PATIENTS AND METHODS:

We prospectively studied 20 patients who underwent three-dimensional gait analysis before and after tibiotalar arthrodesis. Cadence, step length, walking velocity and total support time were assessed. Kinetic parameters, including the moment and power of the ankle in the sagittal plane and hip power were also recorded.

RESULTS:

Significant improvement was recorded across numerous parameters compared with pre-operative measurements. Temporal-spatial data demonstrated a significant increase in step length (p = 0.003) and velocity (p = < 0.001). Total support time decreased for the unaffected limb (p = 0.01). Kinematic results demonstrated that in the affected limb, total sagittal range of movement did not change significantly (p = 0.1259). However, the arc of movement had a near congruent shift with mean maximal dorsiflexion increasing from 5° (-17° to 16°) to 12° (5° to 18°) (p < 0.001) and mean maximal plantarflexion decreasing from 6.8° (6° to 21°) to 0.9° (-9° to 8°) (p = 0.003). Mean hip joint range of movement increased by 6° (-7° to 24°; p = 0.003). Kinetic results demonstrated no statistically significant change in ankle power (p = 0.1292). However, there was an increase in ankle moment (p = 0.04) and hip power (p = 0.01) in the surgically treated extremity. Sagittal plane range of movement was not reduced after tibiotalar fusion.

CONCLUSION:

Although following tibiotalar arthrodesis the gait demonstrated never matched the gait shown in unaffected ankles, compared with the pre-operative analysis there was improvement in numerous temporal-spatial, kinematic, and kinetic measures. Cite this article: Bone Joint J 2016;98-B:1369-75.

KEYWORDS:

Arthritis; Biomechanics; Gait studies; Outcome studies

PMID:
27694591
DOI:
10.1302/0301-620X.98B10.37614
[Indexed for MEDLINE]

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