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

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 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. 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 2years post-TAR.

Duke Scholars

Author Samuel Bruce Adams Jr. Orthopaedic Surgery

Author James Keith DeOrio Orthopaedic Surgery

Author Mark Erik Easley Orthopaedic Surgery

Author James Albert Nunley II Orthopaedic Surgery