Adjacent Joint Kinematics After Ankle Arthrodesis During Cadaveric Gait Simulation. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Arthrodesis is an effective and reliable treatment for end-stage ankle arthritis; however, many patients develop ipsilateral adjacent joint arthritis following surgery. The mechanism that drives adjacent joint arthritis remains uncertain. Cadaveric simulation permits direct investigation of the effects of both arthrodesis and movement strategy on adjacent joints during simulated walking. The objective of this study was to identify the isolated effect of ankle arthrodesis on adjacent joint kinematics during simulated walking. METHODS: Effects of ankle arthrodesis on adjacent joint kinematics were assessed in 8 cadaveric foot and ankle specimens using a robotic gait simulator. Gait parameters acquired from healthy adults and patients with ankle arthrodesis were used as inputs for simulations. Three-dimensional subtalar and talonavicular joint kinematics were directly measured before and after ankle arthrodesis, and healthy- and arthrodesis-gait parameters were applied to identify the isolated effect of the ankle arthrodesis on adjacent joint kinematics. RESULTS: Ankle arthrodesis increased subtalar and talonavicular joint motion during early and midstance independent of which gait parameters were used as inputs to the gait simulator. However, adjacent joint motions did not differ between the control and arthrodesis condition during late stance, when the healthy gait parameters were used as inputs. Conversely, adjacent joint motion decreased during late stance following arthrodesis when simulating gait using parameters typical in arthrodesis patients. CONCLUSIONS: Regardless of the gait parameter inputs, subtalar and talonavicular joint motions increased from normal kinematics, which likely increase the biomechanical burden placed on these adjacent joints and may lead to joint degeneration. CLINICAL RELEVANCE: Increased motion of the adjacent joints caused by ankle arthrodesis may explain the articular degeneration observed clinically.

publication date

  • August 24, 2017

Research

keywords

  • Ankle Joint
  • Arthrodesis
  • Gait
  • Range of Motion, Articular
  • Simulation Training

Identity

Scopus Document Identifier

  • 85033445802

Digital Object Identifier (DOI)

  • 10.1177/1071100717726806

PubMed ID

  • 28836449

Additional Document Info

volume

  • 38

issue

  • 11