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


Journal Article

Background 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. Methods 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). Findings 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 1 year 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 1 year post-op. Interpretation 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 2 years post-TAR. © 2014 Elsevier Ltd.

Full Text

Duke Authors

Cited Authors

  • Queen, RM; Butler, RJ; Adams, SB; Deorio, JK; Easley, ME; Nunley, JA

Published Date

  • January 1, 2014

Published In

Volume / Issue

  • 29 / 4

Start / End Page

  • 418 - 422

Electronic International Standard Serial Number (EISSN)

  • 1879-1271

International Standard Serial Number (ISSN)

  • 0268-0033

Digital Object Identifier (DOI)

  • 10.1016/j.clinbiomech.2014.01.010

Citation Source

  • Scopus