Gait Analysis and Functional Outcomes Following Ankle Arthrodesis for Isolated Ankle Arthritis

Abstract

In the intermediate term following an arthrodesis for the treatment of end-stage ankle arthritis, pain is reliably relieved and there is good patient satisfaction. However, there are substantial differences between patients and the normal population with regard to hindfoot function and gait. On the basis of these results, patients should be counseled that an ankle fusion will help to relieve pain and to improve overall function; however, it is a salvage procedure that will cause persistent alterations in gait with a potential for deterioration due to the development of ipsilateral hindfoot arthritis.

Outcome of ankle arthrodesis and total ankle replacement for ankle arthrosis in terms of gait variability

“…In our study, the AOFAS and FAAM score results, representing the functional status of the patients, showed consistent results with previous studies [13,15,23,24] . A moderate to strong correlation was reported between both the clinical scores and the gait parameters in comparison to their variability.…”

“…Arthrosis of hip and knee joints is mostly due to idiopathic degeneration and tends to appear at an older age in comparison to ankle arthrosis, 70% of cases have a post-traumatic origin and most patients develop the disease at a relatively young age [23] . Elderly patients along with the existing insufficient neuromuscular control due to hip or knee degeneration may be the reason behind the high incidence of fall during the early postoperative phase [7] .…”

Is Total Ankle Arthroplasty A Cost-effective Alternative to Ankle Fusion?

“…Volume 469, Number 6, June 2011 A Markov Cost-effectiveness Analysis 1725 improvements in pain but lose ankle motion, have progressive hindfoot and midfoot arthritis develop [5], and lose normal gait patterns [19,27]. TAA has the benefits of maintaining ankle motion but the risks of implant failures, wound infections, and need for complicated revision surgery [13,17,20,25].…”

“…Arthritis of the lower extremity was assigned a utility near 0.7 from SF-36 surveys, similar to values of other lower extremity impairments [10,26]. TAA was given a utility of 0.9 [24], which is higher than that of ankle fusion (0.8), as studies suggest improved functional outcomes after TAA, including gait and ROM [6,19,20,27]. A recent study reported equivalent utilities of 0.73 one year postoperatively for patients who had TAA and ankle fusion [23].…”

“…Patients for whom nonoperative management fails may be offered surgery. Ankle fusion reduces pain at the cost of loss of ankle motion, altered gait kinematics [19,27], and accelerated arthritis in surrounding joints [5]. Patients also have a 3% to 10% risk of nonunion [13,20].…”