Abnormalities of gait caused by ankle arthritis are improved by ankle arthrodesis.
OBJECTIVE
The surgical management of ankle arthritis with tibiotalar arthrodesis is known to alter gait, as compared with normal ankles. The purpose of this study was to assess post-operative gait function with gait before arthrodesis.


METHODS
We prospectively studied 20 patients who underwent three-dimensional gait analysis before and after tibiotalar arthrodesis. Cadence, step length, walking velocity and total support time were assessed. Kinetic parameters, including the moment and power of the ankle in the sagittal plane and hip power were also recorded.


RESULTS
Significant improvement was recorded across numerous parameters compared with pre-operative measurements. Temporal-spatial data demonstrated a significant increase in step length (p = 0.003) and velocity (p = < 0.001). Total support time decreased for the unaffected limb (p = 0.01). Kinematic results demonstrated that in the affected limb, total sagittal range of movement did not change significantly (p = 0.1259). However, the arc of movement had a near congruent shift with mean maximal dorsiflexion increasing from 5° (-17° to 16°) to 12° (5° to 18°) (p < 0.001) and mean maximal plantarflexion decreasing from 6.8° (6° to 21°) to 0.9° (-9° to 8°) (p = 0.003). Mean hip joint range of movement increased by 6° (-7° to 24°; p = 0.003). Kinetic results demonstrated no statistically significant change in ankle power (p = 0.1292). However, there was an increase in ankle moment (p = 0.04) and hip power (p = 0.01) in the surgically treated extremity. Sagittal plane range of movement was not reduced after tibiotalar fusion.


CONCLUSIONS
Although following tibiotalar arthrodesis the gait demonstrated never matched the gait shown in unaffected ankles, compared with the pre-operative analysis there was improvement in numerous temporal-spatial, kinematic, and kinetic measures. Cite this article: Bone Joint J 2016;98-B:1369-75.
Baylor University Medical Center, 3500 Gaston Ave, Dallas, Texas, 75246, USA.
J W
JW
Brodsky
Baylor University Medical Center, 3500 Gaston Ave, Dallas, Texas, 75246, USA.
J M
JM
Kane
Baylor Motion and Sports Performance Center, 411 N Washington Ave, Suite 2100, Dallas, TX, 75246, USA.
S
S
Coleman
Emory University School of Medicine, 59 Executive Park South, Suite 2000, Atlanta GA, 30329, USA.
J
J
Bariteau
Chaim Sheba Medical Center at Tel Hashomer affiliated to the Sackler Faculty of Medicine Tel Aviv University, Ramat Gan, 5265601, Israel.
S
S
Tenenbaum
D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001168:Arthritis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D001696:Biomechanical Phenomena; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*
Arthritis; Biomechanics; Gait studies; Outcome studies