Biomechanics of the ankle joint and clinical outcomes of total ankle replacement

Michael, Junitha M.; Golshani, Ashkahn; Gargac, Shawn; Goswami, Tarun

doi:10.1016/j.jmbbm.2008.01.005

Cited by 74 publications

(60 citation statements)

References 58 publications

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“…This slight improvement in ankle RoM after TAR also appears associated with increased knee flexion in stance compared to AAD. Similar to an earlier study, sign of knee hyperextension at terminal stance was also seen in the AAD group in this study [20]. Compensatory motion at the subtalar and midtarsal joints contribute to the amount of ankle dorsiflexion obtained by goniometric measurements and gait analysis [21] and RoM even seems to increase with time after arthrodesis [22].…”

Section: Discussionsupporting

confidence: 90%

“…Excluding those patients, the Hintegra® implant showed a mean postoperative RoM of 27°which correlated significantly with symptoms, sports and pain. The motion of the normal ankle joint in the sagittal plane averages 70°of motion, but during the stance phase of the gait cycle RoM is said to be limited to 25° [20]. In our patient series mean ankle RoM as assessed with gait analysis was 17°after TAR and 12°for AAD patients.…”

Section: Discussionmentioning

confidence: 68%

“…Impact of ankle fusion on gait is hyperextension of the knee and increased stress on the adjacent hindfoot joints that might enhance osteoarthritic changes of those joints [20], which is one major argument for implantation of TAR. A clearly increased degeneration of the adjacent joints with time was seen in our patients after AAD but also after TAR in the medium-term without significant differences between the two groups.…”

Section: Discussionmentioning

confidence: 99%

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Are our expectations bigger than the results we achieve? A comparative study analysing potential advantages of ankle arthroplasty over arthrodesis

Braito

Dammerer

Kaufmann

et al. 2014

International Orthopaedics (SICOT)

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Purpose Prior studies have reported improved gait performance and kinematics after total ankle arthroplasty (TAR) compared to ankle arthrodesis (AAD). Given these findings, AAD has been primarily considered as a salvage procedure that may lead to adjacent joint degeneration. Methods A total of 101 TAR and 40 screw arthrodeses were enrolled in a retrospective study with a prospectively designed follow-up examination that included gait analysis and outcome assessment with the AOFAS hindfoot score and FAOS questionnaire. Results Significant asymmetry in gait and reduced range of motion compared to normal remained after both procedures. Subjective outcome improved after both procedures, and pain was significantly better after TAR. Limited functional gains after TAR and joint degeneration to the same degree after both procedures was seen in the mid-term. Hindfoot fusion seemed to have a greater impact on postoperative function than ankle arthrodesis. Conclusion Considering only minor functional gains of TAR compared to AAD the implantation of current TAR designs in large patient series may be questioned.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Are our expectations bigger than the results we achieve? A comparative study analysing potential advantages of ankle arthroplasty over arthrodesis

Braito

Dammerer

Kaufmann

et al. 2014

International Orthopaedics (SICOT)

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“…2). Descriptions of the design rationale and of the prosthesis have been published [38] and discussed in recent reviews [12,13,22,39,49].…”

Section: Methodsmentioning

confidence: 99%

Total Ankle Replacement Compatible with Ligament Function Produces Mobility, Good Clinical Scores, and Low Complication Rates: An Early Clinical Assessment

Giannini

Romagnoli

O’Connor

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background A three-part ankle replacement was developed to achieve compatibility with the natural ligaments by allowing fibers on the medial and lateral sides to remain isometric during passive motion. Unlike all current prostheses, the new design uses nonanatomically shaped components on the tibia and talus and a fully conforming interposed meniscal bearing.Questions/purposes Does this new design restore ankle mobility, improve clinical score, and result in low complication and early revision rates? Patients and Methods We reviewed 51 patients in whom 51 prostheses were implanted in a seven-center trial from July 2003 to July 2006. The mean age of the patients at surgery was 61.5 years (range, 35.1-82.5 years). We used the AOFAS score to assess clinical outcome. We used lateral radiographs to assess function. The minimum followup was 24 months (mean, 30 months; range, 24-48 months). Results The mean preoperative AOFAS score of 38.5 increased to 76.9, 79.1, 76.4, and 79.0 at 12, 24, 36, and 48 months, respectively. We observed a correlation between meniscal bearing movement on the tibial component (mean, 3.4 mm; range, 2-12 mm) and range of flexion at the replaced ankle (mean, 27.48; range, 168-538). We revised one arthroplasty in the second postoperative year for lateral impingement, providing a 3-year cumulative survival rate of 97% and performed one other secondary operation for hindfoot pain. Conclusions These data suggest the new prosthesis can provide short-term restoration of ankle mobility, a good clinical score, and low complication and failure rates. Longer followup with larger numbers is required.

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“…Determination of contact area between these ankle joint components as a function of loading, ankle position, and stability, is crucial for understanding the pathogenesis of ankle disorders, such as degenerative arthrosis amongst other ankle abnormalities (Hideji et al, 1998). In order to measure contact pressures, most studies used pressure-sensitive film, or pressure transducers mounted at or below the joint surface (Beaudoin et al, 1991;Anderson et al, 2007;Michael et al, 2008). In some studies, finite element method was used and validated by comparing the computed pressure distribution with those derived by various experimental methods (Anderson et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Assessment of stress distribution in ankle joint: simultaneous application of experimental and finite element methods

Chitsazan¹,

Rouhi²,

Abbasi³

et al. 2015

IJECB

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Abstract:The goal of this study was to determine stress distribution in ankle joint by correlating with the strain distribution and its trend around tibia adjacent to the joint. Using an in-house device, an ankle from a cadaver was kept stable and loaded in various positions: neutral, dorsiflexion, plantar flexion, inversion and eversion. A total of six strain gauges were mounted around the shaft of the tibia, near the tibiotalar joint. This arrangement allowed us to measure deformations in the shaft of tibia. Patient-specific ankle joint geometry was generated from computed tomography data. The finite element model (FEM) of the ankle was validated using the experimental data logged by the strain gauges, and used for obtaining stress on the joint surface. A strong correlation was observed between the FEM and experimentally measured strains in magnitude (R = 0.94, P = 0.008), consequently stress distribution over the joint surface was obtained. 46A. Chitsazan et al.

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Biomechanics of the ankle joint and clinical outcomes of total ankle replacement

Cited by 74 publications

References 58 publications

Are our expectations bigger than the results we achieve? A comparative study analysing potential advantages of ankle arthroplasty over arthrodesis

Are our expectations bigger than the results we achieve? A comparative study analysing potential advantages of ankle arthroplasty over arthrodesis

Total Ankle Replacement Compatible with Ligament Function Produces Mobility, Good Clinical Scores, and Low Complication Rates: An Early Clinical Assessment

Assessment of stress distribution in ankle joint: simultaneous application of experimental and finite element methods

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