Kyung Min Gyu, Kim Jahyung, Kim Joonhee, Lee Kyoung Min, Lee Dong Yeon
Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
J Orthop Res. 2025 Aug;43(8):1463-1471. doi: 10.1002/jor.26106. Epub 2025 May 31.
In instances of ankle osteoarthritis (OA), a significant proportion of patients exhibit varus ankle OA, while valgus ankle OA is less commonly seen. Both types employ distinct compensatory mechanisms to sustain a plantigrade gait. This study explored the variations in intersegmental foot and ankle motions between patients with varus and valgus ankle OA using multisegment foot gait analysis. The study included 55 patients with varus and 13 with valgus end-stage ankle OA. The DuPont foot model was utilized to evaluate intersegmental foot and ankle kinematics, and temporospatial gait parameters were also analyzed. Both groups displayed comparable temporospatial parameters. Notably, the varus ankle OA group showed significantly reduced sagittal range of motion (ROM) in both the forefoot and hindfoot but increased coronal ROM in the forefoot compared to their counterparts. The valgus ankle OA group demonstrated a significantly greater hindfoot coronal ROM compared to the varus ankle OA group. The varus ankle OA group exhibited significant hallux dorsiflexion during the terminal stance phase. In addition, the varus ankle OA group demonstrated significant forefoot plantar flexion and adduction during the stance phase and forefoot eversion throughout the gait cycle. In contrast, the valgus ankle OA group showed significant hindfoot eversion throughout the gait cycle and hindfoot dorsiflexion during the terminal stance phase. Although both groups displayed similar absolute talar tilt angles, distinct differences in the ROM and intersegmental positions highlighted unique compensatory mechanisms, emphasizing the value of kinematic analysis in assessing functional adaptations related to coronal alignment.
在踝关节骨关节炎（OA）病例中，相当一部分患者表现为内翻型踝关节OA，而外翻型踝关节OA则较少见。两种类型都采用不同的代偿机制来维持足底行走步态。本研究使用多节段足部步态分析，探讨内翻型和外翻型踝关节OA患者之间节段间足踝运动的差异。该研究纳入了55例内翻型和13例外翻型终末期踝关节OA患者。采用杜邦足部模型评估节段间足踝运动学，并分析时空步态参数。两组的时空参数相当。值得注意的是，与外翻型踝关节OA组相比，内翻型踝关节OA组前足和后足的矢状面活动范围（ROM）显著减小，但前足的冠状面ROM增加。外翻型踝关节OA组的后足冠状面ROM明显大于内翻型踝关节OA组。内翻型踝关节OA组在终末站立期表现出明显的拇背伸。此外，内翻型踝关节OA组在站立期表现出明显的前足跖屈和内收，以及在整个步态周期中的前足外翻。相比之下，外翻型踝关节OA组在整个步态周期中表现出明显的后足外翻，在终末站立期表现出后足背伸。尽管两组的距骨绝对倾斜角度相似，但ROM和节段间位置的明显差异突出了独特的代偿机制，强调了运动学分析在评估与冠状面排列相关的功能适应性方面的价值。
