Background

Ankle and hindfoot malalignment is a common finding in patients suffering from post-traumatic ankle osteoarthritis. However, no studies have addressed the effect of concomitant foot deformities on intrinsic foot kinematics and kinetics. Therefore, the objective of this study was to investigate the effect of ankle and hindfoot malalignment on the kinematics and kinetics of multiple joints in the foot and ankle complex in patients suffering from post-traumatic ankle osteoarthritis.

Methods

Twenty-nine subjects with post-traumatic ankle osteoarthritis participated in this study. Standardized weight-bearing radiographs were obtained preoperatively to categorize patients as having cavus, planus or neutral ankle and hindfoot alignment, based on 4 X-ray measurements. All patients underwent standard gait assessment. A 4-segment foot model was used to estimate intrinsic foot joint kinematics and kinetics during gait. Statistical parametric mapping was used to compare foot kinematics and kinetics between groups.

Findings

There were 3 key findings regarding overall foot function in the 3 groups of post-traumatic ankle osteoarthritis: (i) altered frontal and transverse plane inter-segmental angles and moments of the Shank-Calcaneus and Calcaneus-Midfoot joints in the cavus compared to the planus group; (ii) in cavus OA group, Midfoot-Metatarsus joint abduction sought to compensate the varus inclination of the ankle joint; (iii) there were no significant differences in inter-segmental angles and moments between the planus and neutral OA groups.

Interpretation

Future studies should integrate assessment of concomitant foot and ankle deformities in post-traumatic ankle osteoarthritis, to provide additional insight into associated mechanical deficits and compensation mechanisms during gait.

中文翻译：

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踝关节和后足畸形对创伤后踝关节骨关节炎患者足部力学的影响

背景

踝关节和后足畸形是创伤后踝关节骨关节炎患者的常见发现。但是，尚无研究探讨伴随脚部畸形对固有脚部运动学和动力学的影响。因此，本研究的目的是研究踝关节和后足错位对创伤后踝关节骨关节炎患者足踝复合体多关节运动学和动力学的影响。

方法

29名创伤后踝关节骨关节炎患者参加了这项研究。术前获取标准化的负重X光片，根据4个X射线测量结果，将患者分类为具有龋，扁平或中性踝和后足对齐。所有患者均接受标准步态评估。使用4段脚模型估计步态中固有的脚关节运动学和动力学。统计参数映射用于比较各组之间的足部运动学和动力学。

发现

在3组创伤后脚踝骨关节炎中，有3个关于整体脚功能的关键发现：扁平组 （ii）在恒骨OA组中，中足-eta骨关节外展试图补偿踝关节的内翻倾斜度；（iii）扁平骨和中性骨关节炎组之间的节段间角度和力矩没有显着差异。

解释

未来的研究应综合评估创伤后脚踝骨关节炎中同时发生的脚和脚踝畸形，以进一步了解步态中相关的机械缺陷和补偿机制。