Multi-segment foot kinematics after total ankle replacement and ankle arthrodesis during relatively long-distance gait.

This study aimed to investigate the influence of ankle osteoarthritis (AOA) treatments, i.e., ankle arthrodesis (AA) and total ankle replacement (TAR), on the kinematics of multi-segment foot and ankle complex during relatively long-distance gait. Forty-five subjects in four groups (AOA, AA, TAR, and control) were equipped with a wearable system consisting of inertial sensors installed on the tibia, calcaneus, and medial metatarsals. The subjects walked 50-m twice while the system measured the kinematic parameters of their multi-segment foot: the range of motion of joints between tibia, calcaneus, and medial metatarsals in three anatomical planes, and the peaks of angular velocity of these segments in the sagittal plane. These parameters were then compared among the four groups. It was observed that the range of motion and peak of angular velocities generally improved after TAR and were similar to the control subjects. However, unlike AOA and TAR, AA imposed impairments in the range of motion in the coronal plane for both the tibia-calcaneus and tibia-metatarsals joints. In general, the kinematic parameters showed significant correlation with established clinical scales (FFI and AOFAS), which shows their convergent validity. Based on the kinematic parameters of multi-segment foot during 50-m gait, this study showed significant improvements in foot mobility after TAR, but several significant impairments remained after AA.

[1]  Kim Parker,et al.  Gait analysis and functional outcomes following ankle arthrodesis for isolated ankle arthritis. , 2006, The Journal of bone and joint surgery. American volume.

[2]  R. Burdett,et al.  Evidence of Validity for the Foot and Ankle Ability Measure (FAAM) , 2005, Foot & ankle international.

[3]  J. Nilsson,et al.  10-year survival of total ankle arthroplasties , 2011, Acta orthopaedica.

[4]  B M Jolles,et al.  Evaluation of a mixed approach combining stationary and wearable systems to monitor gait over long distance. , 2010, Journal of biomechanics.

[5]  F. Su,et al.  Gait analysis after ankle arthrodesis. , 2000, Gait & posture.

[6]  K. Roach,et al.  The Foot Function Index: a measure of foot pain and disability. , 1991, Journal of clinical epidemiology.

[7]  M. Huguier,et al.  Biostatistiques au quotidien , 2000 .

[8]  S. Pinney,et al.  A Meta-analysis of Outcome Rating Scales in Foot and Ankle Surgery: Is There a Valid, Reliable, and Responsive System? , 2004, Foot & ankle international.

[9]  Vinzenz von Tscharner,et al.  Gait analysis in ankle osteoarthritis and total ankle replacement. , 2007, Clinical biomechanics.

[10]  C. Saltzman.  Perspective on total ankle replacement. , 2000, Foot and ankle clinics.

[11]  K. Aminian,et al.  Quaternion-based fusion of gyroscopes and accelerometers to improve 3D angle measurement , 2006 .

[12]  A Leardini,et al.  Position and orientation in space of bones during movement: anatomical frame definition and determination. , 1995, Clinical biomechanics.

[13]  K. Aminian,et al.  Ambulatory measurement of 3D knee joint angle. , 2008, Journal of biomechanics.

[14]  K. Fahrbach,et al.  Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis. A systematic review of the literature. , 2007, The Journal of bone and joint surgery. American volume.

[15]  J. Paysant,et al.  The effect of tibio-talar arthrodesis on foot kinematics and ground reaction force progression during walking. , 2004, Gait & posture.

[16]  C. Saltzman,et al.  Foot and Ankle International. , 2013, Foot & ankle international.

[17]  Piriou Philippe,et al.  Ankle Replacement versus Arthrodesis: A Comparative Gait Analysis Study , 2008 .

[18]  Benno M Nigg,et al.  Kinematic Changes After Fusion and Total Replacement of the Ankle Part 1: Range of Motion , 2003, Foot & ankle international.

[19]  A Leardini,et al.  GAIT analysis in patients operated with a novel total ankle prosthesis. , 2009, Gait & posture.

[20]  K Aminian,et al.  Outcome evaluation of ankle osteoarthritis treatments: plantar pressure analysis during relatively long-distance walking. , 2011, Clinical biomechanics.

[21]  K. Aminian,et al.  Segmentation of foot and ankle complex based on kinematic criteria , 2011, Computer methods in biomechanics and biomedical engineering.

[22]  Henk J. Stam,et al.  Ambulatory monitoring of mobility-related activities: the initial phase of the development of an activity monitor , 1995 .

[23]  E. Berg.  Range of Motion , 2020, Definitions.

[24]  Julien Favre,et al.  Measurement of multi-segment foot joint angles during gait using a wearable system. , 2012, Journal of biomechanical engineering.

[25]  J. Nunley,et al.  Clinical Rating Systems for the Ankle-Hindfoot, Midfoot, Hallux, and Lesser Toes , 1994, Foot & ankle international.

[26]  H. K. Ramakrishnan,et al.  Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait , 1989, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[27]  Benno M Nigg,et al.  Kinematic Changes After Fusion and Total Replacement of the Ankle Part 2: Movement Transfer , 2003, Foot & ankle international.

[28]  C L Saltzman,et al.  Long-Term Results Following Ankle Arthrodesis for Post-Traumatic Arthritis , 2001, The Journal of bone and joint surgery. American volume.