Post-sprain versus post-fracture post-traumatic ankle osteoarthritis: Impact on foot and ankle kinematics and kinetics

Leemrijse, Thibaut; Chèze, Laurence; Naaïm, Alexandre; Dumas, Raphaël; Bevernage, Bernhard Devos; Birch, Ivan; Besse, Jean-Luc

doi:10.1016/j.gaitpost.2021.03.029

Cited by 14 publications

(12 citation statements)

References 29 publications

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“…(1) The nursing staff actively communicated with the patients to understand their psychological state and helped them relieve negative emotions to improve their treatment cooperation [ 8 , 9 ]. (2) The patients were given health education, including the causes of diabetes mellitus, blood glucose control, and care for calcaneal fractures.…”

Section: Methodsmentioning

confidence: 99%

The Efficacy of Targeted Perioperative Management for Diabetic Patients with Traumatic Calcaneal Fractures

Hao

Liu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To assess the efficacy of targeted perioperative management for diabetic patients with traumatic calcaneal fractures. Methods. Between April 2020 and December 2020, 100 diabetic patients with traumatic calcaneal fractures treated in our institution satisfying the inclusion criteria were enrolled and assigned to receive either conventional treatment with surgery or plaster fixation (observation group) or targeted treatment with surgery or plaster fixation (experimental group) via the random number table method, with 50 patients in each group. All eligible patients were followed up for 1 year postoperatively. Outcome measures included length of hospital stay, recovery time, fracture healing, duration of postoperative wound drainage, complication rate, blood glucose, and treatment satisfaction. The Maryland score was used for the assessment of foot function. Results. The duration of postoperative wound drainage, length of hospital stay, and recovery time in the experimental group (3.63 ± 1.04 d, 12.13 ± 3.77 d, and 111.22 ± 16.24 d) were significantly shorter than those in the observation group (5.71 ± 2.34 d, 15.28 ± 4.42 d, 123.10 ± 22.82 d) ( P < 0.01 ). The experimental group obtained a markedly higher complete healing rate versus the observation group ( P < 0.001 ). A significantly lower complication rate was observed in the experimental group than in the observation group ( P < 0.05 ). The Maryland scores results were dichotomized into good (≥75 points) and poor (<75 points). The experimental group showed significantly higher Maryland scores good rate and treatment satisfaction versus the observation group ( P < 0.01 ). The experimental group patients were associated with better postoperative fasting glucose and 2 h postprandial glucose versus those in the observation group ( P < 0.05 ). Conclusion. Targeted treatment in the perioperative management of diabetic patients with traumatic calcaneal fractures significantly promotes the recovery of patients, reduces the incidence of complications, increases treatment satisfaction, and ameliorates the doctor-patient relationship.

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Section: Methodsmentioning

confidence: 99%

The Efficacy of Targeted Perioperative Management for Diabetic Patients with Traumatic Calcaneal Fractures

Hao

Liu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…The dynamic evaluation of clinical foot and ankle disorders is regularly performed with three-dimensional gait analyses including a marker-based multi-segment foot model (MFM). These analyses have been applied in multiple patient populations such as cerebral palsy [ 1 ], clubfeet [ 2 ], rheumatoid arthritis [ 3 ], osteoarthritis [ 4 ], diabetes [ 5 ], posterior tibial tendon dysfunction [ 6 ] and several hallux deformities [ 7 , 8 ]. In clinical practice these analyses are mainly used to inform and evaluate treatment decisions.…”

Section: Introductionmentioning

confidence: 99%

The Amsterdam Foot Model: a clinically informed multi‐segment foot model developed to minimize measurement errors in foot kinematics

Schallig

Noort

Piening

et al. 2022

Journal of Foot and Ankle Research

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Background Foot and ankle joint kinematics are measured during clinical gait analyses with marker-based multi-segment foot models. To improve on existing models, measurement errors due to soft tissue artifacts (STAs) and marker misplacements should be reduced. Therefore, the aim of this study is to define a clinically informed, universally applicable multi-segment foot model, which is developed to minimize these measurement errors. Methods The Amsterdam foot model (AFM) is a follow-up of existing multi-segment foot models. It was developed by consulting a clinical expert panel and optimizing marker locations and segment definitions to minimize measurement errors. Evaluation of the model was performed in three steps. First, kinematic errors due to STAs were evaluated and compared to two frequently used foot models, i.e. the Oxford and Rizzoli foot models (OFM, RFM). Previously collected computed tomography data was used of 15 asymptomatic feet with markers attached, to determine the joint angles with and without STAs taken into account. Second, the sensitivity to marker misplacements was determined for AFM and compared to OFM and RFM using static standing trials of 19 asymptomatic subjects in which each marker was virtually replaced in multiple directions. Third, a preliminary inter- and intra-tester repeatability analysis was performed by acquiring 3D gait analysis data of 15 healthy subjects, who were equipped by two testers for two sessions. Repeatability of all kinematic parameters was assessed through analysis of the standard deviation (σ) and standard error of measurement (SEM). Results The AFM was defined and all calculation methods were provided. Errors in joint angles due to STAs were in general similar or smaller in AFM (≤2.9°) compared to OFM (≤4.0°) and RFM (≤6.7°). AFM was also more robust to marker misplacement than OFM and RFM, as a large sensitivity of kinematic parameters to marker misplacement (i.e. > 1.0°/mm) was found only two times for AFM as opposed to six times for OFM and five times for RFM. The average intra-tester repeatability of AFM angles was σ:2.2[0.9°], SEM:3.3 ± 0.9° and the inter-tester repeatability was σ:3.1[2.1°], SEM:5.2 ± 2.3°. Conclusions Measurement errors of AFM are smaller compared to two widely-used multi-segment foot models. This qualifies AFM as a follow-up to existing foot models, which should be evaluated further in a range of clinical application areas.

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“…22 This multisegment foot model has revealed the kinematic and kinetic alterations occuring in the joints of the foot other than the affected ankle in patients with end-stage ankle osteoarthritis. 5,6,13,14 Patients were instructed to walk at a self-selected, comfortable speed barefoot across the walkway. A minimum of 5 representative trials were collected per patient, a trial being considered representative when the foot of interest made clear contact with the pressure plate without visual adjustments in walking behavior.…”

Section: Data Capture and Analysismentioning

confidence: 99%

“…This hypothesis is underpinned by the findings of previous studies that found compensatory strategies in the distal foot joints triggered to compensate for the altered ankle joint biomechanics in patients with ankle osteoarthritis compared to healthy reference data during walking. 5,20 (2) Following TAR surgery, does the joint work distribution across the intrinsic joints of the foot approach the values of the control group of asymptomatic subjects? We hypothesized that the mechanical contribution of the ankle joint after surgery would remain impaired compared with control subjects and that it would be partially compensated by the distal joints of the foot.…”

Section: Introductionmentioning

confidence: 99%

Decreased Mechanical Work Demand in the Chopart Joint After Total Ankle Replacement

et al. 2022

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Background: The success of total ankle replacement (TAR) must be based on restoring reasonable mechanical balance with anatomical structures that can produce mechanical joint work through elastic (eg, tendons, fascia) or viscoelastic (eg, heel pad) mechanisms, or by active muscle contractions. Yet, quantifying the work distribution across the affected joint and the neighboring foot joints after TAR is lacking. Therefore, the objective of this study was to investigate if there is a change in the joint work distribution across the Ankle, Chopart, Lisfranc and Metatarsophalangeal joints during level walking before and after patients undergo TAR. Methods: Fifteen patients with end-stage ankle osteoarthritis scheduled for primary TAR for pain relief were recruited and peer-matched with a sample of 15 control subjects. All patients underwent a 3D gait analysis before and after surgery, during which a kinetic multisegment foot model was used to quantify intersegmental joint work. Results: The contribution of the Ankle joint ( P = .007) to the total foot and ankle positive work increased significantly after TAR. In contrast, a significant decrease in the contribution to the total foot and ankle joint positive work ( P < .001) were found at the Chopart joint after TAR. The foot joints combined produced a significant increase in a net mechanical work from +0.01 J/kg before surgery to +0.05 J/kg after TAR ( P = .006). Conclusion: The findings of this study corroborate the theoretical rationale that TAR reduces significantly the compensatory strategy in the Chopart joint in patients with end-stage ankle osteoarthritis after TAR. However, the findings also showed that the contribution of the ankle joint of patients after TAR to the total foot and ankle joint positive work remained impaired compared to the control group.

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Post-sprain versus post-fracture post-traumatic ankle osteoarthritis: Impact on foot and ankle kinematics and kinetics

Cited by 14 publications

References 29 publications

The Efficacy of Targeted Perioperative Management for Diabetic Patients with Traumatic Calcaneal Fractures

The Efficacy of Targeted Perioperative Management for Diabetic Patients with Traumatic Calcaneal Fractures

The Amsterdam Foot Model: a clinically informed multi‐segment foot model developed to minimize measurement errors in foot kinematics

Decreased Mechanical Work Demand in the Chopart Joint After Total Ankle Replacement

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