Arthrodesis of ankle, hindfoot increased ambulatory function
Patients with severe ankle and hindfoot arthritis who underwent arthrodesis experienced increases in gait velocity, ankle moment and hip motion and power, according to study results.
Researchers prospectively studied 21 patients with severe ankle and hindfoot arthritis who underwent unilateral tibiotalocalcaneal arthrodesis with an intramedullary nail with 3-D gait analysis at a minimum of 1 year postoperatively. Temporospatial measurements included cadence, step length, walking velocity and total support time, and kinematic parameters included sagittal plane motion of the ankle, knee and hip. The kinetic parameters measured by the researchers included sagittal plane ankle power and moment and hip power. The researchers also analyzed gait symmetry by comparing the step lengths on the affected and unaffected sides.
Compared with patients’ own preoperative function, results showed a significant improvement in multiple parameters of postoperative gait. Analysis of temporospatial data revealed significant increases in cadence and walking speed, as well as decreased total support time, according to the researchers.
In the operatively treated limb, sagittal plane ankle motion decreased from 13.2° preoperatively to 10.2° postoperatively, according to kinematic results. The researchers also found an increase in the contralateral limb from 22.2° to 24.1°. Results showed an increase in hip motion on the affected side, from 39° to 43°, and an increase in knee motion, from 56° to 60°.
Kinetic results demonstrated significant increases in ankle moment of the operatively treated limb, ankle power of the contralateral limb and hip power on the affected side postoperatively, as well as a significant improvement in gait symmetry, according to the researchers.
Disclosure: Brodsky received consulting fees and is on the speakers’ bureau for Small Bone Innovations and Integra Life Sciences; received an educational grant from Synthes, OMeGA Medical Grants and OREF; and received a research grant from Small Bone Innovations.