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Bilateral differences in gait mechanics following total ankle replacement: A two year longitudinal study

2014; Elsevier BV; Volume: 29; Issue: 4 Linguagem: Inglês

10.1016/j.clinbiomech.2014.01.010

1879-1271

Robin M. Queen, Robert J. Butler, Samuel B. Adams, James K. DeOrio, Mark E. Easley, James A. Nunley,

Bone fractures and treatments

Following total ankle replacement (TAR) patients demonstrate improvements in gait. The purpose of this study was to assess the changes in gait symmetry from a pre-operative assessment through two years following TAR.Seventy-eight patients who received a primary TAR and had no contralateral pain were examined. Three-dimensional joint mechanics and ground reaction forces were collected during seven walking trials pre-operatively, and 1 and 2-years post-operatively. Data was analyzed using a 2×3 repeated measures ANOVA to determine significant differences between limbs and across time points (α=0.05).Walking speed improved from pre-operative to each post-operative time point (P<.001; ES=1.5). Peak dorsiflexion was not changed across time or between sides, however, the dorsiflexion angle at heel strike was increased on the nonsurgical side (P=0.049; ES=0.32). Peak plantar flexion moment (P<.001; ES=.80), stance (P<.001; ES=.29) and step time (P<.001; ES=.41) were improved from pre-op to 1year post-surgery on the surgical side. Step (P<.001; ES=1.2) and stride length (P<.001; ES=1.2) demonstrated improvements across all time points, while the weight acceptance (P<.001; ES=.27) and propulsion ground reaction forces (P<.001; ES=.22) showed improvements between pre-op and 1year post-op.The results of the study indicate that the patients are able to walk faster and demonstrate an improvement in gait symmetry; however, this improvement does not return the patient to a symmetric walking pattern by 2years post-TAR.