Predicting post-total ankle arthroplasty walking speed based on preoperative gait mechanics

Area of Science:

• Orthopedics
• Biomechanics
• Geriatrics

Background:

• Decreased walking speed is a common issue in older adults, impacting physical function.
• Patients undergoing total ankle arthroplasty (TAA) often exhibit slower walking speeds compared to age-matched controls, even one year post-surgery.

Purpose of the Study:

• To assess if patients one year after TAA can meet established walking speed benchmarks.
• To investigate the predictive capability of gait metrics for achieving these walking speed benchmarks post-TAA.

Main Methods:

• 191 TAA patients were evaluated before and one year after surgery.
• Kinetic and kinematic data were collected during barefoot walking trials at self-selected speeds.
• Receiver operator curves were used to identify threshold values of gait variables predictive of achieving specific walking speeds (0.8, 0.9, 1.1, and 1.3 m/s).

Main Results:

• Significant percentages of patients achieved benchmark speeds: >0.8 m/s (91%), ≥0.9 m/s (85.3%), ≥1.1 m/s (64.9%), and 1.3 m/s (24.1%).
• Pre-operative walking speed was the strongest predictor of achieving post-operative walking speed benchmarks.
• Specific pre-operative speeds (e.g., >0.71 m/s for 0.8 m/s post-op, >1.09 m/s for 1.3 m/s post-op) were identified as predictive.

Conclusions:

• While many TAA patients improve walking speed, a substantial portion do not reach benchmarks necessary for activities like safely crossing streets (1.3 m/s).
• Pre-operative walking speed is a key indicator for predicting post-operative functional recovery.
• Identifying predictive gait metrics can inform the development of targeted interventions for TAA patients to improve walking performance.