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

Abstract

Background: Higher variability in gait parameters has been reported in patients’ with arthrosis of hip and knee joints, leading to dynamic instability and increased risk of falling. Higher variability and gait instability has also been noted to persist months after surgery. Ankle arthrosis is likely similar, but information regarding this is lacking. The purpose of the study was to evaluate gait variability following ankle arthrosis and its surgical treatments, ankle arthrodesis and total ankle replacement. Methods: Seventy participants, divided into controls, ankle arthrosis, ankle arthrodesis and total ankle replacement, performed gait assessment wearing 3-D inertial sensors through which gait parameters and the variability were compared among groups. Correlations between American Orthopedic Foot and Ankle score and Foot and Ankle Ability Measure score with the gait parameters and their variability were calculated. Results: All three case groups reported gait variability similar to that of the controls. On the contrary, significant differences (P < .01) were reported in several gait parameters when compared to the controls in all case groups. Furthermore, both clinical scores showed little to no correlation with gait variability and a good correlation was reported with gait parameters (P < .0001). Conclusions: The study did not find gait variability to be as reliable compared with gait parameters when assessing the outcome of ankle surgeries. Furthermore, among the gait parameters, walking speed showed a strong correlation with the patients’ functional status and is confirmed as an important parameter for ankle arthrosis.