Clinical outcome and gait analysis of ankle arthrodesis

The purpose of our study was to describe and analyze the functional outcomes of mid-term followup patients with ankle arthrodesis.

Twenty patients who had an isolated ankle arthrodesis were followed for a mean of 3 years after surgery. We performed physical and functional examination, radiographic examination and CT scan. Each completed standardized, self-reported outcome questionnaires SF-36, AOFAS and Mazur scores. All subjects were evaluated with a kinetic and kinematic gait analysis and a plantar pressure study.

Only one patient used a cane and seven patients required an insole to walk. We observed no relation between the scores obtained. Most of the patients showed good functional results and poor life quality scores. The joints that were significantly more degenerated were the Chopart and the subtalar joints, which were affected in 16 patients in the fused limb. The kinematic parameters showed compensatory motion in the neighboring joints and the kinetic parameters studied were similar in the arthrodesis limb and the control limb. There was no significant difference between the arthrodesis limb and the contralateral limb for plantar pressures.

Although ankle arthrodesis will help to relieve pain and to improve overall function, it is considered to be a salvage procedure that causes persistent alterations in gait, with the possible development of symptomatic osteoarthritis in the other joints of the foot. Patients and treating physicians should also expect overall pain and functional limitations to increase over time.