Schuh Reinhard, Hofstaetter Jochen Gerhard, Hofstaetter Stefan Gerhard, Adams Samual B, Kristen Karl-Heinz, Trnka Hans-Joerg
Department of Orthopaedic Surgery, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria.
Clin Biomech (Bristol). 2011 Jul;26(6):620-5. doi: 10.1016/j.clinbiomech.2011.02.001. Epub 2011 Mar 10.
Arthrodesis is a well-established treatment option for end-stage osteoarthritis of the ankle. Osteoarthritis of the ankle can alter plantar pressure distribution. However, surprisingly little is known about the effect of ankle arthrodesis to alter plantar pressure distribution. The purpose of this study was to determine plantar pressure distribution in a selected group of patients with unilateral arthrodesis of the ankle joint.
20 patients with an average age of 60 years who underwent isolated unilateral ankle arthrodesis using a 3-crossed screw technique by a single surgeon were included. After a mean of 25 months (range 12-75 months) post surgery plantar pressure distribution was determined in five regions of the foot. The outcome was evaluated clinically, using the American Orthopaedic Foot and Ankle Society hindfoot score, as well as radiographically. The contralateral normal foot was used as a control.
Comparing the foot that underwent tibiotalar arthrodesis to the contralateral normal foot, differences were found in the peak pressure and maximum force in the toe region and the lateral midfoot region. In addition, a decrease in the contact time in the forefoot region and a decrease of the contact area in the toe region of the operated foot were identified. The other regions did not show a significant difference. The mean American Orthopaedic Foot and Ankle Society score of the operated leg was 79 (range 46-92) at the last follow up, and the mean fixation angle of the arthrodesis on lateral weight bearing radiographs was 90° (range 86°-100°).
Our results indicate that arthrodesis of the ankle joint can provide high levels of function with minimal changes in the plantar pressure distribution.
关节融合术是治疗晚期踝关节骨关节炎的一种成熟治疗选择。踝关节骨关节炎会改变足底压力分布。然而，令人惊讶的是，关于踝关节融合术对改变足底压力分布的影响却知之甚少。本研究的目的是确定一组选定的单侧踝关节融合术患者的足底压力分布情况。
纳入20例平均年龄60岁的患者，这些患者由同一位外科医生采用三交叉螺钉技术进行了孤立性单侧踝关节融合术。术后平均25个月（范围12 - 75个月），在足部的五个区域测定足底压力分布。采用美国矫形足踝协会后足评分进行临床评估，并进行影像学评估。对侧正常足作为对照。
将接受胫距关节融合术的足部与对侧正常足进行比较，发现趾区和足外侧中足区的峰值压力和最大力存在差异。此外，还发现患足前足区的接触时间减少，趾区的接触面积减小。其他区域未显示出显著差异。末次随访时，患侧美国矫形足踝协会评分的平均值为79分（范围46 - 92分），外侧负重位X线片上关节融合术的平均固定角度为90°（范围86° - 100°）。
我们的结果表明，踝关节融合术可在足底压力分布变化最小的情况下提供高水平的功能。
