Article

A thorough assessment of patients after total ankle replacement
during activity of daily living can provide complete evidence of restored
function in the overall lower limbs and replaced ankle. This study analyzes how
far a possible restoration of physiological mobility in the replaced ankle can
also improve the function of the whole locomotor apparatus. METHODS: Twenty
patients implanted with an original three-part ankle prosthesis were analyzed 12
months after surgery during stair climbing and descending. Standard gait analysis
and motion tracking of the components by three-dimensional fluoroscopic analysis
were performed on the same day using an established protocol and technique,
respectively. FINDINGS: Nearly physiological ankle kinematic, kinetic and
electromyography patterns were observed in the contralateral side in both motor
activities, whereas these patterns were observed only during stair climbing in
the operated side. Particularly, the mean ranges of flexion at the replaced ankle
were 13 degrees and 17 degrees during stair climbing and descending,
respectively. Corresponding 2.1 and 3.1mm antero/posterior meniscal-to-tibial
translations were correlated with flexion between the two metal components
(p<0.05). In addition, a larger tibiotalar flexion revealed by fluoroscopic
analysis resulted in a physiological hip and knee moment. INTERPRETATION: The
local and global functional performances of these patients were satisfactory,
especially during stair climbing. These might be associated to the recovery of
physiological kinematics at the replaced ankle, as also shown by the consistent
antero/posterior motion of the meniscal bearing, according to the original
concepts of this ankle replacement design.
CI - Copyright (c) 2012 Elsevier Ltd. All rights reserved.

Langue : ANGLAIS