Abstract
Background
Little information is available about gait changes in ankle osteoarthritis and total
ankle replacement, and also about total ankle replacement patients’ rehabilitation
in the first year after surgery.
Methods
Thirty subjects were included in this study: 15 unilateral post-traumatic ankle osteoarthritis
patients and 15 age-/gender-matched control subjects. Patients were followed prospectively:
preoperatively, at 3, 6, 9, and 12 months after total ankle replacement. The clinical-functional
level was assessed by the American Orthopaedic Foot and Ankle Society ankle and the
Short-Form-36 health survey score. 3D ankle-hindfoot kinematic–kinetic analysis was
performed using a motion analysis and a two-plate force–platform system. Statistics
included repeated measures analysis of variances, independent sample and paired Student’s
t-tests (significance α = 0.05).
Findings
Compared to normal subjects, ankle osteoarthritis caused significant reduction of
the American Orthopaedic Foot and Ankle Society and Short-Form-36 score. In gait analysis,
ankle osteoarthritis showed a significant deficiency in six of seven spatiotemporal
variables, a decrease of the tri-planar ankle movement, a decrease of the second active
maximal vertical and the maximal medial ground reaction force, a reduction of the
sagittal and transverse ankle joint moments, a reduction of the ankle joint power.
Three months after total ankle replacement surgery patients experienced a worsening
of gait. At 12 months follow-up, all spatiotemporal variables were not different from
the normal subjects (full rehabilitation); in six of 11 kinematic and kinetic variables
there was a partial rehabilitation.
Interpretation
This study provides data for the clinical-biomechanical understanding of the normal,
arthritic, and total ankle replacement treated ankle during walking and the first
year of rehabilitation.
Keywords
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Article info
Publication history
Published online: July 09, 2007
Accepted:
May 9,
2007
Received:
December 19,
2005
Identification
Copyright
© 2007 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
