Hind- and Midfoot Motion After Ankle Arthrodesis

Area of Science:

• Orthopedic surgery
• Biomechanics
• Radiology

Background:

• Ankle arthrodesis (AA) may increase adjacent joint osteoarthritis due to compensatory motion.
• Patient-reported outcomes and reliable radiographic analysis post-AA are understudied.

Purpose of the Study:

• To evaluate patient-reported outcomes after AA.
• To assess radiographic measures of AA position and adjacent joint osteoarthritis.
• To compare hindfoot and midfoot range of motion post-AA to the contralateral side.

Main Methods:

• Radiographic measurement of hindfoot and midfoot sagittal range of motion in 17 patients with unilateral AA.
• Radiographic evaluation of AA position and adjacent joint osteoarthritis.
• Comparison of measurements to the contralateral limb.
• Assessment of patient-reported outcomes using validated questionnaires and comparison to a control group (n=18).

Main Results:

• No significant difference in hindfoot/midfoot sagittal range of motion or tibiotalar angle compared to the contralateral side at 3.5 years.
• Posterior talar translation was observed post-AA.
• Low reliability was found for evaluating hindfoot coronal position and adjacent joint osteoarthritis.
• Patients reported lower SF-36 physical health scores and other outcome measures compared to controls, despite high satisfaction.

Conclusions:

• AA does not increase hindfoot/midfoot sagittal motion at 3.5 years.
• The hindfoot alignment view is unsuitable for analyzing hindfoot position post-AA.
• Radiographic evaluation of adjacent joint osteoarthritis using the Kellgren and Lawrence scale showed low reliability.
• Patients report poorer outcomes but are satisfied with AA results.