Mobile-Bearing Total Ankle Replacement In Vivo Kinematic Assessment: A Prospective Study Protocol

Caravelli, Silvio; Bragonzoni, Laura; Vocale, Emanuele; Zinno, Raffaele; Paolo, Stefano Di; Barone, Giuseppe; Blasiis, Paolo De; Benedetti, Maria Grazia; Zaffagnini, Stefano; Mosca, Massimiliano

doi:10.3390/jcm11185328

Cited by 4 publications

(6 citation statements)

References 38 publications

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“…As shown in our review for OA disease, the presence of proprioceptive mechanoreceptors in the context of capsule-ligamentous joint structures has been amply demonstrated in recent decades, but their presence and characterization within the cartilaginous layer has not yet been clearly highlighted to the best of our current knowledge [49][50][51][52]. Improving our understanding of articular cartilage functions, as well as characterizing proprioceptive mechanoreceptors also within the cartilaginous or subchondral layers could be of crucial importance for developing specific treatments for proprioceptive deficits.…”

Section: Discussionmentioning

confidence: 91%

Proprioception and Mechanoreceptors in Osteoarthritis: A Systematic Literature Review

Salamanna,

Caravelli,

Marchese

et al. 2023

JCM

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Purpose: Osteoarthritis (OA) is one of the most common chronic diseases in the world. It is frequently accompanied by high levels of persistent pain, as well as substantial impairments in function and functional capacity. This review aims to systematically analyze the changes in proprioception and related mechanoreceptors in OA patients. Methods: Studies from September 2013 to September 2023 were identified by conducting searches on the PubMed, Web of Science, and Scopus electronic databases following the PRISMA statement. One reviewer independently assessed and screened the literature, extracted the data, and graded the studies. The body of evidence underwent an evaluation and grading process using the ROBINS-I tool, which was specifically designed to assess the risk of bias in non-randomized studies of interventions. Results were summarized using descriptive methods. Results: A search through 37 studies yielded 14 clinical studies that were ultimately included. The primary focus of the studies was on the knee joint, particularly the posterior cruciate ligament (PCL). The studies found that PCL in OA patients had impaired proprioceptive accuracy, possibly due to changes in mechanoreceptors (Ruffini, Pacini, and Golgi Mazzoni corpuscles). This suggests that dysfunctional articular mechanoreceptors, especially in severe cases of OA, may contribute to reduced proprioception. Dynamic stabilometry also identified significant proprioceptive deficits in patients with knee articular cartilage lesions, underscoring the impact of such lesions on knee proprioception. Conclusions: Literature data have shown that proprioceptive accuracy may play an important role in OA, particularly in the knee PCL and cartilage. However, the role of proprioception and related mechanoreceptors needs to be further clarified. Future studies focusing on the relationship between proprioception, OA disease, and symptoms, considering age and gender differences, and exploring OA joints other than the knee should be conducted to improve clinical and surgical outcomes in cases where proprioception and mechanoreceptors are impaired in OA patients.

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Section: Discussionmentioning

confidence: 91%

Proprioception and Mechanoreceptors in Osteoarthritis: A Systematic Literature Review

Salamanna,

Caravelli,

Marchese

et al. 2023

JCM

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“…As per TAR-RSA protocol [23], the motor tasks identified included "Total range of motion with open kinetic chain", "Total range of motion with closed kinetic chain", and "Climbing on the tiptoes" (Figure 3). maximum plantarflexion position and reached the maximum dorsiflexion position with the operated ankle.…”

Section: Motor Tasks' Descriptionsmentioning

confidence: 99%

In Vivo Total Ankle Arthroplasty Kinematic Evaluation: A Prospective Radiostereometric Analysis

Caravelli,

Bragonzoni,

Zinno

et al. 2024

Biomedicines

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Ankle osteoarthritis (OA) represents a significant social burden and is one of the main causes of chronic disability in a rapidly growing part of the world’s population. Total ankle arthroplasty (TAA) has become increasingly popular despite the poor results obtained with the first dedicated designs. The purpose of this paper was to evaluate the ankle kinematics, in vivo and under weight-bearing conditions, of a TAA through a dynamic model-based radiostereometric analysis (MB-RSA). The clinical evaluation was performed by administering the American Orthopaedic Foot and Ankle Society ankle–hindfoot score and Short Form-36 questionnaires. The kinematic evaluation was conducted through MB-RSA during the execution of an open kinetic chain and a closed kinetic chain motor task. Double radiographic images of the ankle joint were processed using dedicated software to obtain a 3D reconstruction of the ankle prosthetic components’ motion. Eighteen patients (five females) completed the clinical and instrumental preoperative and postoperative evaluations (age 59.1 ± 10.3). All clinical scores showed a marked improvement (p < 0.005). During the closed kinetic chain motor tasks, the ankle showed a total range of motion (ROM) in dorsi-plantarflexion of 19.84°. The parameters in varus–valgus were recorded. Physiological motion can be achieved in TAA, characterized by a wide range of motion and coupling of movements on the three planes. The results of the present work may help to understand the real movement of a widespread TAA model and possibly to improve future designs and instrumentation.

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“…This study examined patients who underwent ankle TAA surgery via the implant of the Exactech Vantage ® prosthetic model (Gainesville, FL, USA), with a mobile-bearing and anterior approach [11,19].…”

Section: Surgical Procedures and Post-operative Protocolmentioning

confidence: 99%

“…Unlike other lower limb joints, ankle OA is rarely primary; the most common etiology is a previous trauma, and this implies that the patients suffering from this degenerative arthropathy are younger than the ones affected by knee or hip OA [9]. To restore pain-free ankle mobility, Total Ankle Replacement (TAR) is among the most common elective surgical procedures performed nowadays if the conservative treatment does not improve the symptoms [10,11].…”

Section: Introductionmentioning

confidence: 99%

Proprioception and Balance Control in Ankle Osteoarthritis and after Total Ankle Replacement: A Prospective Assessment

Caravelli,

Bragonzoni,

Vocale

et al. 2024

Applied Sciences

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Total Ankle Replacement (TAR) could, in theory, partially restore joint sensation and motion, enhancing motor coordination, functional stability, and proprioception in a joint affected by osteoarthritis. The aim of this study is to evaluate ankle proprioception before and after a Total Ankle Replacement via an instrumental objective assessment. The evaluation of proprioceptive stability was carried out using the dedicated Delos Postural Proprioceptive System (DPPS). The clinical evaluation was performed by administering validated questionnaires, namely the American Orthopaedic Foot and Ankle Society (AOFAS) score and Short Form-36 (SF-36). Twenty patients were selected, undergoing a complete procedure with clinical and instrumental pre-operative and post-operative evaluation at the end of the follow-up. AOFAS ankle–hindfoot and SF-36 both showed a statistically significant improvement between the pre-operative and post-operative state. The postural tests performed using the DPPS showed that the affected limb showed results slightly lower than in pre-operative. In conclusion, according to the current data, the TAR does not show an improvement in proprioceptive joint stability, and although the registered mean values do not present a statistical significance, the stabilometry shows data lower than the healthy limb. In this perspective, further studies are recommended to highlight any rehabilitation scheme or protocols, using wider case series.

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Mobile-Bearing Total Ankle Replacement In Vivo Kinematic Assessment: A Prospective Study Protocol

Cited by 4 publications

References 38 publications

Proprioception and Mechanoreceptors in Osteoarthritis: A Systematic Literature Review

Proprioception and Mechanoreceptors in Osteoarthritis: A Systematic Literature Review

In Vivo Total Ankle Arthroplasty Kinematic Evaluation: A Prospective Radiostereometric Analysis

Proprioception and Balance Control in Ankle Osteoarthritis and after Total Ankle Replacement: A Prospective Assessment

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