Gait analysis in ankle osteoarthritis and total ankle replacement

Valderrábano, Víctor; Nigg, Benno M.; Tscharner, Vinzenz von; Stefanyshyn, Darren J.; Goepfert, Beat; Hintermann, Beat

doi:10.1016/j.clinbiomech.2007.05.003

Cited by 227 publications

(257 citation statements)

References 33 publications

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“…Although the design of modern TAR systems is meant to theoretically allow a normal RoM [7], no improvement of total postoperative RoM compared to pre-operative values was seen in our TAR-alone patients and also reported in other studies with mean values between 24 and 28 degrees, respectively [18,19]. Hindfoot fusion led to a significantly worse clinically assessed RoM after TAR in our patient series.…”

Section: Discussioncontrasting

confidence: 46%

“…Patients in both the arthrodesis and arthroplasty groups reportedly improve in various parameters of gait when compared with their own pre-operative function [7,8]. For joint replacement it was suggested that functional results may approximate those of healthy subjects [7], which seemed to be the most powerful arguments for the choice of an arthroplasty in comparison to an arthrodesis despite higher complication and reoperation rates [15,16].…”

Section: Discussionmentioning

confidence: 99%

“…For joint replacement it was suggested that functional results may approximate those of healthy subjects [7], which seemed to be the most powerful arguments for the choice of an arthroplasty in comparison to an arthrodesis despite higher complication and reoperation rates [15,16]. Nevertheless, comparative studies showed that neither group functioned as well as normal subjects [8,9,11,17].…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, significant improvements including subjective outcome, more normal ankle function, gait kinematics and gait kinetics were observed following total ankle replacement (TAR) [5,6]. In cadaveric studies it was suggested that modern prosthetic designs are even able to achieve close to normal kinematics [7]. Since kinematic models vary, direct comparison of functional results and their impact on clinical outcome is necessary to identify potential advantages of one method over another.…”

Section: Introductionmentioning

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: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…The vast majority of post-traumatic ankle OA research has been focused on patient-oriented evidence and the results consistently show, regardless of the scale used, that those with post-traumatic ankle OA have greater levels of self-reported disability relative to age matched controls. (Horisberger, Hintermann, & Valderrabano, 2009a;Hubbard, Hicks-Little, & Cordova, 2009b;Khazzam, Long, Marks, & Harris, 2006;Messenger, Anderson, & Wikstrom, 2011;Valderrabano et al, 2007;Valderrabano et al, 2006b) Clinical-oriented evidence shows similar impairments as those associated with acute LAS and CAI. Specifically, decreases in ankle muscle strength and increased mechanical stiffness have been observed relative to age matched controls.…”

Section: Post-traumatic Ankle Oamentioning

confidence: 97%

Consequences of Ankle Inversion Trauma: A Novel Recognition and Treatment Paradigm

Hubbard¹,

Wikstrom²

2012

An International Perspective on Topics in Sports Medicine and Sports Injury

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Finite element analysis of bone‐prosthesis interface micromotion for cementless talar component fixation through critical loading conditions

Moideen

Lim

Yeow

et al. 2020

Numer Methods Biomed Eng

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The total ankle replacement (TAR) survivability rate is still suboptimal, and this leads to many orthopaedic surgeons opting arthrodesis as a better option for the ankle arthritis patients. One of the fundamental reasons is due to the lack of primary stability of the prosthesis fixation at the bone‐prosthesis interface hence leading to long‐term aseptic loosening of the talar component. The commercially available Scandinavian Total Ankle Replacement (STAR) Ankle design and several additional design features (including trabecular metal, side fin, double fin, and polka‐dot designs) were studied using finite element analysis, and the bone‐prosthesis interface relative micromotion (BPIRM) and talar bone minimum principal stresses were examined and analysed. Three loading conditions at a gait cycle of heel strike, midstance, and toe off with different meniscal bearing displacement were also included as part of the study parameters. The results were correlated to in vitro cadaveric measurements and reported clinical studies. Simulated results showed that the de‐bonding relative distance between the bone and prosthesis upon loading (COPEN defined by the simulation software) was the main reason constituting to the high interface micromotion between the talar component and talus bone (which could lead to long‐term aseptic loosening). The polka‐dot design was shown to induce the lowest BPIRM among all the designs studied.

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Gait analysis in ankle osteoarthritis and total ankle replacement

Cited by 227 publications

References 33 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

Consequences of Ankle Inversion Trauma: A Novel Recognition and Treatment Paradigm

Finite element analysis of bone‐prosthesis interface micromotion for cementless talar component fixation through critical loading conditions

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