The effect of tibio-talar arthrodesis on foot kinematics and ground reaction force progression during walking.
Degenerative osteoarthritis in the subtalar and mid-tarsal joints occurring after tibio-talar arthrodesis is thought to be a consequence of abnormal foot dynamics. We hypothesized that the forward tilt of the tibia during stance induces early heel-off and alteration of the progression of ground reaction force (GRF) after ankle arthrodesis. Three-dimensional gait analysis was performed on nine patients who had an ankle arthrodesis fused in a neutral position and on ten control subjects. Patients walking barefoot were compared to controls. The GRF progression was shifted forward during mid-stance, heel-off occurred earlier and was associated with less anterior tilt of the tibia and a more posterior position of the GRF with reference to the metatarsal heads. The GRF progression, heel-off and tibial tilt were not significantly different between patients and controls when walking in shoes but the GRF was still more posterior at heel-off. Increasing the walking speed worsened the anomalies of foot dynamics. These alterations of foot dynamics are thought to be associated with pathogenic stresses applied to the mid-foot.
Beyaert
C
C
Laboratoire d' Analyse de la Posture et du Mouvement, Centre d' Appareillage, Institut Régional de Réadaptation de Nancy, Gondreville, France. c.beyaert@chu-nancy.fr
Sirveaux
F
F
Paysant
J
J
Molé
D
D
André
J-M
JM
D000704:Analysis of Variance; D000843:Ankle Joint / Q000601:surgery*; D001174:Arthrodesis; D001696:Biomechanical Phenomena; D005528:Foot / Q000502:physiology*; D005684:Gait / Q000502:physiology; D006801:Humans; D010003:Osteoarthritis / Q000601:surgery*; D012775:Shoes; D013628:Talus / Q000601:surgery; D013977:Tibia / Q000601:surgery; D016138:Walking / Q000502:physiology*