Foot and Ankle Motion after Tibiotalocalcaneal Arthrodesis: Comparison with Tibiotalar Arthrodesis Using a Multi-Segment Foot Model

被引:4
作者
Cao, Linying [1 ]
Kyung, Min Gyu [2 ]
Park, Gil Young [2 ]
Hwang, Il-Ung [2 ]
Kang, Ho Won [3 ]
Lee, Dong Yeon [1 ,2 ,4 ,5 ]
机构
[1] Seoul Natl Univ, Coll Med, Dept Orthoped Surg, Seoul, South Korea
[2] Seoul Natl Univ Hosp, Dept Orthoped Surg, Seoul, South Korea
[3] Ewha Womans Univ, Mokdong Hosp, Dept Orthoped Surg, Seoul, South Korea
[4] Seoul Natl Univ Hosp, Dept Orthoped Surg, 103 Daehak Ro, Seoul 03080, South Korea
[5] Seoul Natl Univ, Coll Med, 103 Daehak Ro, Seoul 03080, South Korea
关键词
Ankle; Arthritis; Arthrodesis; Gait analysis; GAIT; OUTCOMES;
D O I
10.4055/cios22034
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Tibiotalocalcaneal arthrodesis is an established surgical procedure for treating patients with end-stage ankle joint arthritis and subtalar joint arthritis. Although it greatly relives pain, a major drawback is loss of range of motion. Although it is known to restrict an additional subtalar joint compared to tibiotalar arthrodesis, there is a lack of gait analysis studies comparing the two methods. This study aimed to evaluate the differences in kinematics of the foot and ankle joints between tibiotalar and tibiotalocalcaneal arthrodesis. We also compared preoperative and postoperative statuses for each surgical method.Methods: The study included 12 and 9 patients who underwent tibiotalar and tibiotalocalcaneal arthrodesis, respectively, and 40 healthy participants were included in the control group. The DuPont foot model was used to analyze intersegmental foot and ankle kinematics during gait.Results: Compared to controls, both tibiotalar and tibiotalocalcaneal arthrodesis resulted in slow gait speed with reduced stride length, increased step width, and decreased range of sagittal plane motion. Both fusion methods showed similar range of mo-tion in all segments and planes following surgery. Coronal positions showed more supination of the forefoot and pronation of the hindfoot segment after each operation, particularly tibiotalocalcaneal arthrodesis. Gait after tibiotalocalcaneal arthrodesis did not significantly differ from that after tibiotalar arthrodesis, but there was a tendency of more pronation in the hindfoot segment.Conclusions: Both fusion methods limited foot and ankle motion in similar ways. Comparing tibiotalar and tibiotalocalcaneal ar-throdesis suggests that additionally fusing the subtalar joint does not cause greater movement restriction in patients. Objectively comparing tibiotalar and tibiotalocalcaneal arthrodesis will facilitate further understanding of the effect of tibiotalocalcaneal ar-throdesis on movement and the value of subtalar joint motion for improved preoperative counselling.
引用
收藏
页码:631 / 644
页数:14
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