title: Mid- to Long-term Clinical Outcome and Gait Biomechanics After Realignment Surgery in Asymmetric Ankle Osteoarthritis.
abstract: BACKGROUND
  Joint-preserving, realignment surgical procedures have gained increasing popularity as treatment of asymmetric early- and mid-stage ankle osteoarthritis. The aim of the present study was to quantify bilateral gait biomechanics in patients who underwent ankle realignment surgery by supramalleolar osteotomies.
  
  
  METHODS
  Eight patients, a minimum of 7 years after realignment surgery, and 8 healthy controls were included in this study. Three-dimensional instrumented gait analysis was used to assess spatiotemporal parameters, bilateral joint angles, and moments. Furthermore, a clinical evaluation on pain, ankle function, and quality of life was performed.
  
  
  RESULTS
  Compared with the healthy controls, the patients walked more slowly, had a smaller sagittal hindfoot range of motion on their affected leg, and had a lower peak ankle dorsiflexion moment (P < .05). There were no significant differences compared with controls for the ranges of motion in the foot segments of the nonaffected foot and for the knee and hip joint ranges of motion and peak moments of both legs. Additionally, patients and controls did not differ in the quality of life score. However, in the pain subscore, the patients reported significantly more pain than the healthy persons.
  
  
  CONCLUSIONS
  Despite different gait biomechanics of the affected foot after ankle realignment surgery, the quality of life for patients was comparable to that of healthy controls. Therefore, supramalleolar osteotomies should be considered as a promising treatment option in patients with asymmetric non-end-stage ankle osteoarthritis.
  
  
  METHODS
  Level III, comparative study.
authors: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland.
authors: Corina
authors: C
authors: Nüesch
authors: Laboratory for Biomechanics and Biomaterials, Department of Orthopaedics, Hannover Medical School, Hannover, Germany Center of Biomechanics and Calorimetry, University of Basel, Basel, Switzerland.
authors: Cora
authors: C
authors: Huber
authors: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland.
authors: Jochen
authors: J
authors: Paul
authors: Department of Orthopaedics, Harold K. Dunn Orthopaedic Research Laboratory, University of Utah, Salt Lake City, UT, USA.
authors: Heath B
authors: HB
authors: Henninger
authors: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland.
authors: Geert
authors: G
authors: Pagenstert
authors: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland.
authors: Victor
authors: V
authors: Valderrabano
authors: Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA corina.nueesch@usb.ch alexej.barg@hsc.utah.edu.
authors: Alexej
authors: A
authors: Barg
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000503:physiopathology; D000843:Ankle Joint / Q000503:physiopathology* / Q000601:surgery*; D001696:Biomechanical Phenomena / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D010003:Osteoarthritis / Q000503:physiopathology* / Q000601:surgery*; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology; D064232:Visual Analog Scale
keywords: biomechanics; gait analysis; realignment surgery; supramalleolar osteotomy