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Ankle arthrodesis. Long-term follow-up with gait analysis
The Journal of Bone and Joint Surgery. American Volume
|October 1, 1979
Summary
Ankle arthrodesis (surgical fusion) for post-traumatic arthritis allows good function in daily life, especially with proper footwear. Gait analysis shows compensation for lost ankle motion, but barefoot walking reveals slowed velocity and shortened stride.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Rehabilitation Medicine
Background:
- Post-traumatic arthritis frequently affects the ankle joint, leading to pain and functional limitations.
- Ankle arthrodesis is a surgical procedure to fuse the ankle joint, aiming to alleviate pain and improve stability.
- Understanding the long-term functional outcomes and gait adaptations after ankle fusion is crucial for patient management.
Purpose of the Study:
- To perform a functional assessment of patients who underwent ankle arthrodesis for post-traumatic arthritis.
- To evaluate the impact of ankle fusion on gait patterns using clinical evaluation and gait analysis.
- To identify compensatory mechanisms and potential adverse effects of ankle arthrodesis.
Main Methods:
- A cohort of twelve patients with post-traumatic arthritis underwent ankle arthrodesis.
- A comprehensive clinical evaluation and gait analysis were performed after an average follow-up of eight years.
- A weighted point system was used for clinical grading, and gait parameters were analyzed to assess walking patterns.
Main Results:
- Patients demonstrated good functional performance in daily living while wearing shoes.
- Gait analysis revealed excellent characteristics when patients wore shoes, with compensation for lost ankle motion through foot and contralateral limb adjustments.
- Barefoot walking showed significant adverse effects, including reduced gait velocity and stride length.
- Specific gait deviations, such as back-knee deformity and toe-walking, were observed in some patients without shoes.
Conclusions:
- Ankle arthrodesis can lead to satisfactory functional outcomes for post-traumatic arthritis, particularly when appropriate footwear is utilized.
- Compensatory mechanisms involving the foot and contralateral limb effectively mitigate the loss of ankle motion during shod walking.
- The absence of appropriate footwear can reveal limitations and adverse gait alterations following ankle fusion, highlighting the importance of footwear in rehabilitation.