A three-year prospective comparative gait study between patients with ankle arthrodesis and arthroplasty

Segal, Ava D.; Cyr, Krista M.; Stender, Christina J.; Whittaker, Eric C.; Hahn, Michael E.; Orendurff, Michael S.; Ledoux, William R.; Sangeorzan, Bruce J.

doi:10.1016/j.clinbiomech.2018.02.018

Cited by 23 publications

(52 citation statements)

References 44 publications

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“…8 studies reported moderate evidence of an increase in ankle dorsiflexion angle after the implantation of a TAR (SMD: 0.37, 95%CI 0.14 to 0.59) with a MD of 1.72° (95%CI 0.70-2.73). 7,9,11,18,26,37,44,46 Fixed-bearing TAR showed similar improvements in ankle dorsiflexion angle to the mobile-bearing TAR (Table 4). 11,37,44 Limited evidence indicated no change in ankle dorsiflexion angle after an AA.…”

Section: Maximum Ankle Dorsiflexion Anglementioning

confidence: 78%

“…11,37 Twelve studies were rated as "fair quality" scoring between 14 and 17. 5,7,8,21,23,26,32,38,40,41,44,45 The Kappa inter-rater agreement were case series studies, 1 was a prospective cohort study and 2 were retrospective studies (Table 2).…”

Section: Quality Assessmentmentioning

confidence: 99%

“…Moderate evidence indicated an increase in ankle plantarflexion angle after implantation of a TAR (SMD: 0.37, 95%CI 0.14 to 0.60) with a MD of 2.03° (95%CI 1.07-2.99). 7,9,11,18,26,39,44,46 Six studies 7,9,18,26,39,46 analysing mobile-bearing prostheses reported moderate evidence of an increase in ankle plantarflexion angle after implantation (SMD: 0.38, 95%CI 0.06 to 0.71) with a MD of 2.18° (95%CI 0.78-3.58). However, pooled data of studies analysing fixed-bearing prostheses showed moderate evidence of no increase or decrease in ankle plantarflexion RoM after surgery.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

“…However, pooled data of studies analysing fixed-bearing prostheses showed moderate evidence of no increase or decrease in ankle plantarflexion RoM after surgery. 11,37,44 Limited evidence of no change in ankle plantarflexion angle after an AA. 5,18,44…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

“…Based on the pooled SMD from 10 studies totalling 224 participants, there was moderate evidence of an increase in peak plantarflexion ankle moment (SMD: 0.39, 95%CI 0.15 to 0.64) after TAR (Table 3 & 4, Fig.2). 8,9,11,18,23,26,39,44,46,51 No MD could be given for studies analysing mobile-bearing prostheses as two of the studies 9,26 normalized the data by a length measurement as well as a weight measurement.…”

Section: Peak Plantarflexion Ankle Momentmentioning

confidence: 99%

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Change in gait biomechanics after total ankle replacement and ankle arthrodesis: a systematic review and meta-analysis

Besse

Naaïm

Leemrijse³

et al. 2020

Clinical Biomechanics

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Maximum Ankle Dorsiflexion Anglementioning

confidence: 78%

Section: Quality Assessmentmentioning

confidence: 99%

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Section: Peak Plantarflexion Ankle Momentmentioning

confidence: 99%

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Change in gait biomechanics after total ankle replacement and ankle arthrodesis: a systematic review and meta-analysis

Besse

Naaïm

Leemrijse³

et al. 2020

Clinical Biomechanics

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Ankle fusion and replacement gait similar post‐surgery, but still exhibit differences versus controls regardless of footwear

Stone

Shofer

Stender

et al. 2021

Journal Orthopaedic Research

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Persons with ankle osteoarthritis (AOA) often seek surgical intervention to alleviate pain and restore function; however, recent research has yielded no superior choice between the two primary options: fusion and replacement. One factor yet to be considered is the effect of footwear on biomechanical outcomes. Comparisons of AOA biomechanics to a normative population are also sparse. The objectives of this study were to (1) determine how footwear uniquely affected gait in persons with ankle fusion and replacement and (2) provide context for AOA biomechanics via comparisons to a healthy adult sample. Thirty-four persons with AOA performed overground walking trials barefoot and shod before surgical intervention and then received either an ankle fusion (n = 14) or replacement (n = 20). Two and/or three years post-surgery, patients returned for gait analysis. Nineteen controls performed the same gait procedures during a single study visit. Spatiotemporal variables and peak angles, internal moments, powers, and forces were calculated to quantify gait behavior. Overall, the two surgical groups performed similarly to each other but demonstrated marked differences from controls both pre-and post-surgery. No significant differences were detected when examining the effect of footwear. The motion of the midfoot with respect to the hindfoot and forefoot may be instrumental in gait biomechanics following an ankle fusion or replacement and should be considered in future investigations.

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Predicting post‐total ankle arthroplasty walking speed based on preoperative gait mechanics

Renner

Delaney

Hill

et al. 2022

Journal Orthopaedic Research

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Decreased walking speed is associated with impaired physical performance and function in older adults. Following total ankle arthroplasty (TAA), walking speed continues to be slower than age matched controls. The purpose of this study was to determine if patients 1 year post‐TAA can achieve walking speed benchmarks and investigate if gait metrics are predictive of achieved benchmarks. 191 TAA patients were recruited and assessed pre‐TAA and 1 year post‐TAA. Kinetic and kinematic data were collected during seven self‐selected speed barefoot walking trials along a 30‐m walkway. Receiver operator curves were generated for each variable to determine threshold values needed to achieve walking speeds of 0.8, 0.9, 1.1, and 1.3 m/s. Each variable's predictive ability was classified according to the area under the curve. Ninety one percent of participants achieved a walking speed > 0.8 m/s, 85.3% achieved ≥0.9 m/s, 64.9% walked at ≥1.1 m/s, and 24.1% achieved a walking speed of 1.3 m/s by 1 year post‐TAA. Walking speed pre‐TAA was the strongest predictor with ankle moment, power and GRF data showing mixed results. Clinical Significance: 75.9% of participants were unable to walk at 1.3 m/s—a speed indicative of safely crossing a street. Variables predictive of postoperative walking speed benchmarks could be useful in developing interventions for the TAA population. The strongest predictor across all walking speed benchmarks was preoperative walking speed. A walking speed > 0.71 m/s was predictive of achieving 0.8 m/s 1 year post‐TAA, while >1.09 m/s predicted 1.3 m/s 1 year post‐TAA.

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A three-year prospective comparative gait study between patients with ankle arthrodesis and arthroplasty

Cited by 23 publications

References 44 publications

Change in gait biomechanics after total ankle replacement and ankle arthrodesis: a systematic review and meta-analysis

Change in gait biomechanics after total ankle replacement and ankle arthrodesis: a systematic review and meta-analysis

Ankle fusion and replacement gait similar post‐surgery, but still exhibit differences versus controls regardless of footwear

Predicting post‐total ankle arthroplasty walking speed based on preoperative gait mechanics

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