title: Functional limitations associated with end-stage ankle arthritis.
abstract: BACKGROUND
  Ankle arthritis, like hip and knee arthritis, has a substantial impact on patient function. Understanding the functional limitations of ankle arthritis may help to stratify treatment strategies.
  
  
  METHODS
  We measured the preoperative demographic characteristics, physical function, and self-assessed function of patients with end-stage ankle arthritis and identified correlations among these metrics. Participants wore a StepWatch 3 Activity Monitor for two weeks and completed the Musculoskeletal Function Assessment and Short Form-36 surveys. Gait kinematics and kinetics were also measured as participants walked at a self-selected pace.
  
  
  RESULTS
  Musculoskeletal Function Assessment and Short Form-36 scores revealed reduced perceived function for patients with end-stage ankle arthritis compared with healthy controls. These patients also took fewer total steps per day, took fewer high-intensity steps, and chose to walk at a slower walking speed. Gait analysis revealed reduced ankle motion, peak ankle plantar flexor moment, peak ankle power absorbed, and peak ankle power generated for the affected limb compared with the unaffected limb. High-intensity step count was also correlated with both survey scores, walking speed, step length, peak ankle plantar flexor moment, and peak ankle power generated. Walking speed, step length, and ankle motion were correlated with peak ankle plantar flexor moment and power generated.
  
  
  CONCLUSIONS
  Generally, patients with end-stage ankle arthritis have reduced physical and perceived function compared with healthy individuals. Additionally, high-intensity step count was a better indicator of physical and perceived function compared with total steps per day for this population.
authors.affiliation: Department of Veterans Affairs, RR&D Center, 1660 South Columbian Way, Mail Stop 151, VA Medical Center, Seattle, WA 98108, USA. avasegal@gmail.com
authors.forename: Ava D
authors.initials: AD
authors.lastname: Segal
authors.forename: Jane
authors.initials: J
authors.lastname: Shofer
authors.forename: Michael E
authors.initials: ME
authors.lastname: Hahn
authors.forename: Michael S
authors.initials: MS
authors.lastname: Orendurff
authors.forename: William R
authors.initials: WR
authors.lastname: Ledoux
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Sangeorzan
mesh_terms: D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology*; D001168:Arthritis / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009043:Motor Activity / Q000502:physiology*; D016059:Range of Motion, Articular; D012649:Self Concept