Functional performance of a total ankle replacement: thorough assessment by combining gait and fluoroscopic analyses

Cenni, Francesco; Leardini, Alberto; Pieri, Maddalena; Berti, Lisa; Belvedere, Claudio; Romagnoli, Matteo; Giannini, Sandro

doi:10.1016/j.clinbiomech.2012.10.008

Cited by 25 publications

(13 citation statements)

References 39 publications

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“…Compared to the contralateral non-operated ankle at one year follow-up, several differences were still noted, but nearly physiological motion and loading were observed in the replaced ankle though limited to the stair climbing task [74]. However deterioration of the spatial-temporal parameters and abnormal muscular activation have also been noted at longer follow-up [75].…”

Section: Biomechanics Of Gait At the Human Ankle Complexmentioning

confidence: 99%

Biomechanics of the natural, arthritic, and replaced human ankle joint

Leardini

O’Connor

Giannini

2014

Journal of Foot and Ankle Research

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The human ankle joint complex plays a fundamental role in gait and other activities of daily living. At the same time, it is a very complicated anatomical system but the large literature of experimental and modelling studies has not fully described the coupled joint motion, position and orientation of the joint axis of rotation, stress and strain in the ligaments and their role in guiding and stabilizing joint motion, conformity and congruence of the articular surfaces, patterns of contact at the articular surfaces, patterns of rolling and sliding at the joint surfaces, and muscle lever arm lengths.The present review article addresses these issues as described in the literature, reporting the most recent relevant findings.

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Section: Biomechanics Of Gait At the Human Ankle Complexmentioning

confidence: 99%

Biomechanics of the natural, arthritic, and replaced human ankle joint

Leardini

O’Connor

Giannini

2014

Journal of Foot and Ankle Research

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“…Single plane fluoroscopy is a model-based tracking (MBT) approach but lacks a second calibrated fluoroscopy view to accurately define 3D kinematics. Single plane fluoroscopy studies implemented videoradiography to continuously evaluate TAR dynamic range of motion and activities of daily living from a lateral view (Cenni et al, 2012(Cenni et al, , 2013List et al, 2012). Furthermore, tracking is solely based on implant alignment and not dependent on the visible tibial or talar landmarks that could further assist in evaluating kinematic alignment on imaging methods.…”

Section: Introductionmentioning

confidence: 99%

Methodology for Measurement of in vivo Tibiotalar Kinematics After Total Ankle Replacement Using Dual Fluoroscopy

Blair

Barg

Foreman

et al. 2020

Front. Bioeng. Biotechnol.

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Biomechanical data could improve our clinical understanding of failures in total ankle replacement (TAR) patients, leading to better surgical approaches and implant designs. Kinematics of the prosthetic tibiotalar joint in TAR patients have yet to be measured using dual fluoroscopy. With dual fluoroscopy, computed tomography (CT) images are acquired to track bone motion. One challenge with this approach is dealing with metal artifact in the CT images that distorts implant visualization and the surrounding bone to implant interfaces. The aim of this study was to develop a methodology to measure in vivo TAR kinematics using inputs of computer-aided design (CAD) models, dual fluoroscopy and CT imaging with metal artifact reduction. To develop this methodology, we created a hybrid three-dimensional (3D) model that contained both: (1) the segmented bone; and (2) the CAD models of the TAR components. We evaluated a patient following total ankle replacement to demonstrate feasibility. The patient performed a self-selected overground walk during which dual fluoroscopy images were collected at 200 Hz. In vivo tracking verifications were performed during overground walking using a distance calculation between the implant articular surfaces to evaluate the model-based tracking 3D solution. Tracking verification indicated realistic alignment of the hybrid models with an evenly distributed distance map pattern during the trial. Articular surface distance calculations were reported as an average of 1.3 mm gap during the entirety of overground walking. The successful implementation of our new tracking methodology with a hybrid model presents a new approach to evaluate in vivo TAR kinematics. Measurements of in vivo kinematics could improve our clinical understanding of failures in TAR patients, leading to better long-term surgical outcomes.

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“…This allows for the reconstruction of the absolute and relative position and orientation of the prosthesis components in 3D by using 2D-to-3D spatial matching [35]. This has been widely adopted for assessing the surface-to-surface interaction of prosthesis components in total joint replacement [35][36][37][38] and to a limited extent in THA [39][40][41][42]. However, single-plane VA has been demonstrated to be a good compromise between patient safety and measurement accuracy [42].…”

Section: Introductionmentioning

confidence: 99%

“…However, single-plane VA has been demonstrated to be a good compromise between patient safety and measurement accuracy [42]. Rarely, 3D GA and VA have been used in combination, and only in total knee and ankle replacements [36,43,44].…”

Section: Introductionmentioning

confidence: 99%

Cup-To-Neck Contact and Range of Motion after Total Hip Arthroplasty with Large Head Diameters: An Original Three-Dimensional Combined Gait and Videofluoroscopy Analysis

et al. 2020

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After a total hip arthroplasty, a limited range of motion and lower-limb disability continue to be observed, with these being mainly associated with the implant design and the head-to-neck ratio. Larger diameters of the head bearings were assumed to provide better stability, a larger range of motion, and smaller risks of dislocation and stem-to-liner impingement. However, these claims have never been demonstrated in real patients. The specific aim of this study was to assess, via multi-instrumental analysis, whether the range of motion of a replaced hip is limited by the stem-to-liner contact in patients with large femoral head diameters. Twenty-three patients with a total hip arthroplasty were evaluated at their one-year follow-ups using clinical and instrumental examinations. A combined three-dimensional gait analysis of the full body and videofluoroscopy analysis of the replaced hip were performed during the execution of standard, i.e., daily living, and more demanding motor tasks. The latter were meant to reach the extreme range of motion at the replaced hip site, thus revealing possible stem-to-liner contact. An original technique based on imaging and computer-aided design (CAD) models of the prosthesis components was developed to calculate the stem-to-liner distance. Excellent clinical scores were observed in the study. The gait analysis showed that the range of motion of the replaced hip in the sagittal plane, averaged over all patients, ranged from 28° to 78° in standard activities. In more demanding tasks, single peaks were as high as 110°, 39°, and 60° in the sagittal, frontal, and transverse anatomical planes, respectively. In all motor tasks, the stem-to-liner distances ranged from 8.7 to 13.0 mm on average, with one outlier minimum distance being 2.2 mm. This study shows that, even in demanding motor tasks and with an extreme range of motion, the hip joint replaced with large femoral head diameters did not experience impingement between the prosthesis components.

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Functional performance of a total ankle replacement: thorough assessment by combining gait and fluoroscopic analyses

Cited by 25 publications

References 39 publications

Biomechanics of the natural, arthritic, and replaced human ankle joint

Biomechanics of the natural, arthritic, and replaced human ankle joint

Methodology for Measurement of in vivo Tibiotalar Kinematics After Total Ankle Replacement Using Dual Fluoroscopy

Cup-To-Neck Contact and Range of Motion after Total Hip Arthroplasty with Large Head Diameters: An Original Three-Dimensional Combined Gait and Videofluoroscopy Analysis

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