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Patient-Reported Outcomes, Function, and Gait Mechanics After Fixed and Mobile-Bearing Total Ankle Replacement.

Publication ,  Journal Article
Queen, RM; Sparling, TL; Butler, RJ; Adams, SB; DeOrio, JK; Easley, ME; Nunley, JA
Published in: J Bone Joint Surg Am
June 18, 2014

BACKGROUND: The popularity of total ankle replacement as a treatment for end-stage arthritis continues to grow. The purpose of this study was to assess changes in ankle kinetics and kinematics from a preoperative time point through two years postoperatively in patients who had received either a fixed-bearing or a mobile-bearing implant. METHODS: Ninety patients who received a primary total ankle replacement (forty-nine mobile-bearing and forty-one fixed-bearing) were examined. Three-dimensional joint mechanics and ground reaction forces were measured during level walking preoperatively and one and two years postoperatively. Patient-reported and functional outcomes were also collected. Data were analyzed with use of a 3 × 2 repeated-measures analysis of variance (ANOVA) to determine significant differences between implant types and across time (α = 0.05). RESULTS: No significant difference was observed in the ankle motion or step time between implant types or across time. However, there was a greater increase in the peak plantar flexion moment and the Short Form-36 (SF-36) total score across time in the fixed-bearing group than in the mobile-bearing group. Conversely, visual analog scale (VAS) pain scores exhibited greater improvement in the mobile-bearing group than in the fixed-bearing group. Independent of implant type, a significant improvement was observed in walking speed, results of the functional tests, spatiotemporal variables, patient-reported outcomes, and vertical ground reaction forces. Independent of time, the fixed-bearing group demonstrated a significant increase in both the weight-acceptance and the propulsion ground reaction forces compared with the mobile-bearing group. The mobile-bearing group completed the Sit-to-Stand test significantly faster. CONCLUSIONS: All of the observed changes suggest improved or maintenance of function following total ankle replacement. In general, the group with a fixed-bearing implant demonstrated improvements in ankle moment and ground reaction forces, while the mobile-bearing-implant group demonstrated improvements in patient-reported pain outcome. There were few significant changes between the two implant types. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

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Published In

J Bone Joint Surg Am

DOI

EISSN

1535-1386

Publication Date

June 18, 2014

Volume

96

Issue

12

Start / End Page

987 / 993

Location

United States

Related Subject Headings

  • Recovery of Function
  • Range of Motion, Articular
  • Patient Reported Outcome Measures
  • Pain Measurement
  • Osteoarthritis
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Gait
 

Citation

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Queen, R. M., Sparling, T. L., Butler, R. J., Adams, S. B., DeOrio, J. K., Easley, M. E., & Nunley, J. A. (2014). Patient-Reported Outcomes, Function, and Gait Mechanics After Fixed and Mobile-Bearing Total Ankle Replacement. J Bone Joint Surg Am, 96(12), 987–993. https://doi.org/10.2106/JBJS.M.00971
Queen, Robin M., Tawnee L. Sparling, Robert J. Butler, Samuel B. Adams, James K. DeOrio, Mark E. Easley, and James A. Nunley. “Patient-Reported Outcomes, Function, and Gait Mechanics After Fixed and Mobile-Bearing Total Ankle Replacement.J Bone Joint Surg Am 96, no. 12 (June 18, 2014): 987–93. https://doi.org/10.2106/JBJS.M.00971.
Queen RM, Sparling TL, Butler RJ, Adams SB, DeOrio JK, Easley ME, et al. Patient-Reported Outcomes, Function, and Gait Mechanics After Fixed and Mobile-Bearing Total Ankle Replacement. J Bone Joint Surg Am. 2014 Jun 18;96(12):987–93.
Queen, Robin M., et al. “Patient-Reported Outcomes, Function, and Gait Mechanics After Fixed and Mobile-Bearing Total Ankle Replacement.J Bone Joint Surg Am, vol. 96, no. 12, June 2014, pp. 987–93. Pubmed, doi:10.2106/JBJS.M.00971.
Queen RM, Sparling TL, Butler RJ, Adams SB, DeOrio JK, Easley ME, Nunley JA. Patient-Reported Outcomes, Function, and Gait Mechanics After Fixed and Mobile-Bearing Total Ankle Replacement. J Bone Joint Surg Am. 2014 Jun 18;96(12):987–993.

Published In

J Bone Joint Surg Am

DOI

EISSN

1535-1386

Publication Date

June 18, 2014

Volume

96

Issue

12

Start / End Page

987 / 993

Location

United States

Related Subject Headings

  • Recovery of Function
  • Range of Motion, Articular
  • Patient Reported Outcome Measures
  • Pain Measurement
  • Osteoarthritis
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Gait