Impact of foot modeling on the quantification of the effect of total ankle replacement: A pilot study |
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| Affiliation: | 1. Univ Lyon, Univ Gustave Eiffel, LBMC UMR_T9406, 43 Bd Du 11 Novembre 1918, F69622, Lyon, France;2. Foot & Ankle Institute, 5 Avenue Ariane, 1200 Brussels, Belgium;3. Hospices Civils De Lyon, Centre Hospitalier Lyon-Sud, Service De Chirurgie Orthopédique Et Traumatologique, 69495 Pierre-Bénite Cédex, France;4. Department of Orthopedics and Traumatology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland;5. CHIREC Delta Hospital, 201 Boulevard Du Triomphe, 1160, Brussels, Belgium;1. KU Leuven, Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, Belgium;2. KU Leuven, Laboratory for Clinical Motion Analysis, University Hospital Pellenberg, Belgium;3. Parnasse-ISEI, Department of Podiatry, Avenue E. Mounier, 84 - 1200 Bruxelles, Belgium;4. Artevelde University College Ghent, Department of Podiatry, Ghent, Belgium;5. KU Leuven, Department of Development & Regeneration, Belgium;6. KU Leuven, Department of Orthopaedics, Foot & Ankle Unit, University Hospitals Leuven, Belgium;1. Arizona State University, College of Health Solutions, United States;2. Phoenix VA Medical Center, Department of Veterans Affairs, United States;1. Researcher of Grupo de Investigação da Mecânica do Movimento (BIOMEC) in Laboratório de pesquisa do exercício (LAPEX) at Universidade Federal do Rio Grande do Sul - UFRGS, Brazil;2. Professor and researcher of Grupo de Investigação da Mecânica do Movimento (BIOMEC) in Laboratório de pesquisa do exercício (LAPEX) at Universidade Federal do Rio Grande do Sul - UFRGS, Brazil;1. Department of Mechanical Engineering, University of Delaware, Newark, DE, USA;2. Biomechanics and Movement Science Program, University of Delaware, Newark, DE, USA;3. Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA;4. School of Education, University of Delaware, Newark, DE, USA;5. Department of Biomedical Engineering, University of Delaware, Newark, DE, USA;1. Glenrose Rehabilitation Hospital, Alberta Health Services, 10230 111 Avenue NW, Edmonton, Alberta, T5G 0B7, Canada;2. Faculty of Medicine and Dentistry, University of Alberta, W.C. Mackenzie Health Sciences Centre, 8440 112 Street NW, Edmonton, Alberta, T6G 2R7, Canada;3. Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Clinical Sciences Building, 8440 112 Street NW, Edmonton, Alberta, T6G 2B7, Canada;4. Department of Mechanical Engineering, University of Alberta, Donadeo Innovation Centre for Engineering, 9211 116 Street NW, Edmonton, Alberta, T6G 1H9, Canada;5. Department of Biomedical Engineering, University of Alberta, 1098 Research Transition Facility, Edmonton, Alberta, T6G 2V2, Canada;1. Conquest Hospital, East Sussex TN37 7RD, United Kingdom;2. Frimley Park Hospital, Surrey GU16 7UJ, United Kingdom;3. Queen Elizabeth the Queen Mother Hospital, Margate CT9 4AN, United Kingdom |
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| Abstract: | BackgroundKinematic and kinetic foot models showed that computing ankle joint angles, moments and power with a one-segment foot modeling approach alters kinematics and tends to overestimate ankle joint power. Nevertheless, gait studies continue to implement one-segment foot models to assess the effect of total ankle replacement.Research questionThe objective of this pilot study was to investigate the effect of the foot modeling approach (one-segment versus multi-segment) on how total ankle replacement is estimated to benefit or degrade the patient’s biomechanical performance.MethodsTen subjects with post-traumatic ankle osteoarthritis scheduled for total ankle replacement and 10 asymptomatic subjects were recruited. A one-segment and a multi-segment foot model were used to calculate intrinsic foot joints kinematics and kinetics during gait. A linear mixed model was used to investigate the effect of the foot model on ankle joint kinematic and kinetic analysis and the effect of total ankle replacement.ResultsDifferences in range of motion due to the foot model effect were significant for all the gait subphases of interest except for midstance. Peak power generation was significantly overestimated when computed with the one-segment foot model. Ankle and shank-calcaneus joint dorsi-/plantarflexion range of motion did not increase post-operatively except during the loading response phase. A significant ‘group’ effect was found for stance and pre-swing phase range of motion, with total ankle replacement patients showing lower range of motion values than controls for dorsi/plantarflexion.SignificanceThe outcome of this study showed that the ‘foot model’ had a significant effect on estimates of range of motion and power generation. The findings in our study therefore emphasize the clinical interest of multi-segment foot modeling when assessing the outcome of a therapeutic intervention. |
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| Keywords: | Ankle Osteoarthritis Prosthesis Gait Range of motion Joint power |
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