Wang Henry, Brown Scott R
Biomechanics Laboratory, School of Kinesiology, Ball State University, Muncie, IN 47306, USA.
Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland 1020, New Zealand.
J Sport Health Sci. 2017 Sep;6(3):340-345. doi: 10.1016/j.jshs.2016.01.012. Epub 2016 Jan 11.
End-stage ankle arthritis impairs joint function and patients' mobility. Total ankle replacement is a surgical procedure to treat severe ankle arthritis. Salto Talaris Anatomic Ankle (STAA) was designed to mimic the normal ankle anatomy and flexion/extension of the ankle movement. The purpose of this study was to examine the effect of an STAA ankle replacement on ankle joint function and mechanics during gait.
Five patients with end-stage unilateral ankle arthritis were recruited. Patients performed level walking in a laboratory setting on 2 occasions, prior to and 3 months after the STAA ankle surgeries. American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score was obtained. A 12-camera motion capture system was used to perform walking analysis. Gait temporo-spatial parameters and ankle joint mechanics were evaluated. Paired Student's tests and non-parametric Wilcoxon matched tests were performed to examine the differences in biomechanical variables between the pre- and post-surgery walking conditions.
Compared to the pre-surgical condition, at 3 months of post-STAA surgery, patients experienced greater improvement in AOFAS hindfoot score ( = 0.0001); the STAA ankle demonstrated a 31% increase in ankle joint excursion ( = 0.045), a 22% increase in ankle plantarflexor moment ( = 0.075), a 60% increase in ankle power absorption ( = 0.023), and a 68% increase in ankle power production ( = 0.039). Patients also demonstrated a 26% increase in walking speed ( = 0.005), a 20% increase in stride length ( = 0.013), a 15% decrease in double support time ( = 0.043), and a 5% decrease in total stance time ( = 0.055).
Three months after surgeries, the STAA patients experienced improvements in ankle function and gait parameters. The STAA ankle demonstrated improved ankle mechanics during daily activities such as walking.
终末期踝关节关节炎会损害关节功能和患者的活动能力。全踝关节置换术是治疗重度踝关节关节炎的一种外科手术。Salto Talaris解剖型踝关节（STAA）旨在模拟正常的踝关节解剖结构以及踝关节的屈伸运动。本研究的目的是探讨STAA踝关节置换术对步态期间踝关节功能和力学的影响。
招募了5例终末期单侧踝关节关节炎患者。患者在实验室环境中于STAA踝关节手术前和术后3个月各进行2次平地行走。获取美国矫形足踝协会（AOFAS）后足评分。使用12台摄像机的运动捕捉系统进行步行分析。评估步态时空参数和踝关节力学。采用配对学生t检验和非参数Wilcoxon配对检验来检查手术前和手术后步行条件下生物力学变量的差异。
与手术前相比，STAA手术后3个月时，患者的AOFAS后足评分有更大改善（P = 0.0001）；STAA踝关节的关节活动度增加了31%（P = 0.045），踝关节跖屈力矩增加了22%（P = 0.075），踝关节能量吸收增加了60%（P = 0.023），踝关节能量产生增加了68%（P = 0.039）。患者的步行速度也提高了26%（P = 0.005），步幅增加了20%（P = 0.013），双支撑时间减少了15%（P = 0.043），总站立时间减少了5%（P = 0.055）。
手术后3个月，接受STAA手术的患者在踝关节功能和步态参数方面有改善。STAA踝关节在日常活动如行走期间表现出改善的踝关节力学。
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