J. Leonard Goldner Award 2006: Total Ankle Replacement in Ankle Osteoarthritis: An Analysis of Muscle Rehabilitation

Abstract

TAR surgery improved muscle function (torque, EMG intensity) in osteoarthritic ankles. However, after 1 year, patients did not reach the level of the contralateral healthy leg, and the EMG frequency remained unchanged.

Center of pressure profiles in unilateral compared to bilateral end‐stage ankle osteoarthritis patients

“…Hubbard et al reported smaller sagittal plane ankle joint moments and frontal plane range of motion in the affected ankle (with OA) compared to the unaffected ankle in individuals preparing for total ankle arthroplasty and healthy controls. In addition, extrinsic ankle muscle activation was lower on the affected compared to unaffected limb and healthy controls . These findings suggest that patients with unilateral ankle OA place greater mechanical demand on the healthy limb, which may lead to an increased risk of future injury in the unaffected limb.…”

“…Therefore, patients with ankle OA, especially from a post‐traumatic etiology, may be at risk for disproportionately greater declines in proprioceptive feedback than those reported with healthy aging, which could result in exacerbated postural stability deficits, particularly in the AP direction. Additionally, unilateral ankle OA has been shown to alter ankle biomechanics including joint loading, range of motion, muscle activation joint torques . Hubbard et al reported smaller sagittal plane ankle joint moments and frontal plane range of motion in the affected ankle (with OA) compared to the unaffected ankle in individuals preparing for total ankle arthroplasty and healthy controls.…”

The effects of total ankle replacement on gait disability: Analysis of energetic and mechanical variables

“…This allows improved total ankle replacement and leads to normal kinematics. The clinical efficacy of TAR in reducing ankle pain, increasing ankle range of motion, and increasing the score of AOFAS has been demonstrated [31,32]. However, the effects of TAR on gait function have only been partially investigated as described in the introduction [5,16,25].…”

Muscular atrophy of the lower leg in unilateral post traumatic osteoarthritis of the ankle joint

“…However, it is still unclear whether the encountered muscle atrophy is reversible after TAR implantation. At one-year follow up after TAR surgery, Valderrabano et al demonstrated a significant improvement in muscle function (torque, EMG intensity), while the calf circumference decreased insignificantly [33]. Whether the cross-sectional muscle area is a prognostic factor for the outcome after TAR is not yet known and will be assessed by an upcoming follow-up study.…”