Coronal plane ankle alignment, gait, and end-stage ankle osteoarthritis

Area of Science:

• Orthopedics
• Biomechanics
• Gait Analysis

Background:

• Unilateral ankle osteoarthritis (OA) causes significant pain and functional disability.
• Tibiotalar malalignment and gait dysfunction are common in end-stage ankle OA.
• Coronal plane alignment (varus, valgus, neutral) may influence gait and function.

Purpose of the Study:

• To investigate the relationship between coronal plane ankle alignment and gait mechanics in end-stage OA.
• To compare spatial-temporal gait parameters, clinically-assessed function, and self-reported function across different alignment groups.
• To identify if ankle alignment is a primary driver of functional deficits in OA.

Main Methods:

• 96 patients with end-stage unilateral ankle OA were radiographically classified by coronal alignment (varus, valgus, neutral).
• Subjects completed the Foot and Ankle Disability Index (FADI) for self-reported function.
• Spatial-temporal gait parameters were measured during self-selected speed walking.

Main Results:

• The varus alignment group demonstrated a significantly faster Timed Up and Go test performance (P=0.05).
• No significant differences in other assessed gait parameters or function were found between varus, valgus, and neutral groups.
• The Timed Up and Go test was the only variable significantly affected by coronal alignment.

Conclusions:

• Coronal plane ankle alignment has a limited impact on gait mechanics and function in end-stage OA.
• Other contributing factors beyond coronal alignment significantly influence functional limitations in ankle OA patients.
• Further research is needed to explore additional factors affecting function in ankle OA.