Faculty Collaboration Database

Multi-segment foot kinematics during gait following ankle arthroplasty. J Orthop Res 2022 Mar;40(3):685-694

Date

04/30/2021

Pubmed ID

33913547

DOI

10.1002/jor.25062

Scopus ID

2-s2.0-85106000150 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

Ankle arthritis is a debilitating disease marked by pain and limited function. Total ankle arthroplasty improves pain while preserving motion and offers an alternative to the traditional treatment of ankle fusion. Gait analysis and functional outcomes tools can provide an objective balanced analysis of ankle replacement for the treatment of ankle arthritis. Twenty-nine patients with end-stage ankle arthritis were evaluated before and after ankle arthroplasty. Multi-segment foot and ankle kinematics were assessed annually following surgery (average 3.5 years, range 1-6 years) using the Milwaukee Foot Model and a Vicon video motion analysis system. Functional outcomes (American Orthopedic Foot and Ankle Society [AOFAS] ankle/hindfoot scale, short form 36 [SF-36] questionnaire) and temporal-spatial parameters were also assessed. Kinematic results were compared to findings from a previously collected group of healthy ambulators. AOFAS and SF-36 mean scores improved postoperatively. Walking speed and stride length increased after surgery. There were significant improvements in tibial sagittal range of motion in terminal stance and hindfoot sagittal range of motion in preswing. Decreased external rotation of the tibia and increased external rotation of the hindfoot were noted throughout the gait cycle. Pain and function improved after ankle replacement as supported by better outcomes scores, increased temporal-spatial parameters, and significant improvement in tibial sagittal range of motion during terminal stance and hindfoot sagittal range of motion during preswing. While multi-segment foot kinematics were improved, they were not restored to control values. Statement of clinical significance: Total ankle arthroplasty does not fully normalize mutli-segment gait kinematics despite improved patient-reported outcomes and gait mechanics.

Author List

Fritz JM, Canseco K, Konop KA, Kruger KM, Tarima S, Long JT, Law BC, Kraus JC, King DM, Harris GF

Authors

Karl Canseco MD Research Scientist II in the Orthopaedic Surgery department at Medical College of Wisconsin
Gerald Harris PhD Director in the Orthopaedic Research Engineering Center (OREC) department at Marquette University
David M. King MD Chair, Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
Jonathan C. Kraus MD Assistant Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
Karen Kruger PhD Research Assistant Professor in the MU-MCW Department of Biomedical Engineering department at Marquette University
Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Ankle
Ankle Joint
Arthritis
Arthroplasty, Replacement, Ankle
Biomechanical Phenomena
Gait
Humans
Pain
Range of Motion, Articular