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Gait Analysis Following Total Ankle Replacement and Subtalar Fusion

Completed
Conditions
Ankle Osteoarthritis
Interventions
Procedure: TAR through lateral approach and subtalar fusion
Procedure: TAR through anterior approach and subtalar fusion
Registration Number
NCT03356951
Lead Sponsor
I.R.C.C.S Ospedale Galeazzi-Sant'Ambrogio
Brief Summary

Subtalar fusion is commonly performed in post-traumatic subtalar osteoarthritis, rheumatoid arthritis, posterior tibial tendon dysfunction, tarsal coalition and primary subtalar osteoarthritis. Patients with osteoarthritis or severe dysfunction involving both the ankle and the subtalar joint may benefit from an tibiotalocalcaneal fusion (TTC) or an ankle replacement and subtalar fusion. With the development of new prosthetic designs and of surgical techniques, total ankle replacements (TAR) became a reasonable alternative to fusion with functional and quality of life improvements. A gait analysis of patients that underwent TAR and simultaneous subtalar fusion allows to study with precision and reliability the ankle range of motion (ROM). On the contrary, in healthy subjects or in patients that underwent isolated TAR this is not possible because the ankle ROM is influenced by the ROM of the subtalar joint in such a way that it is not possible to analyze the two joints separately. Also, excluding the role of the subtalar joint, it is possible to accurately analyze and compare the consequences on ankle kinematics of two different prosthetic designs.

Detailed Description

Patients who previously have underwent TAR and simultaneous subtalar fusion are retrospectively reviewed. Minimum follow-up after the surgery is 12 months.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
23
Inclusion Criteria
  • Patients who underwent ankle prosthesis (Hintegra ankle system, Zimmer Trabecular Metal Total Ankle) and simultaneous fusion of the subtalar joint with at least 12 months of follow-up willing and capable of adhering to postoperative clinical protocols and functional evaluations and who have signed a specific informed consent form approved by the Ethics Committee
  • Males or females aged between 20 and 80 years old.
  • Patients with diagnosis of primary not-inflammatory degenerative articular disease
Exclusion Criteria
  • Patients with Body Mass Index (BMI)> 35.
  • Patients with active or suspected latent periprosthetic infection
  • Patients who underwent revision surgery.
  • Prosthesis of the hip, knee or ankle, homolateral or contralateral.
  • Fusion failure of subtalar joint.
  • Patients with chronic heart failure (NYHA stage> 2)
  • Presence of neurological disorders, neuromuscular disorders or other major musculoskeletal pathologies
  • Cognitive deficits.
  • Impossibility to match questionnaires due to cognitive disorders or language dysfunctional disorders

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Lateral approach groupTAR through lateral approach and subtalar fusionTAR through lateral approach and subtalar fusion
Anterior approach groupTAR through anterior approach and subtalar fusionTAR through anterior approach and subtalar fusion
Primary Outcome Measures
NameTimeMethod
Gait analysis1 day

Differences in functional scores obtained by Mini-lab stereophotogrammetry-based Gait Analysis for Lower Limbs

Secondary Outcome Measures
NameTimeMethod
AOFAS1 day

Differences in Functional Scores on the American Orthopaedic Foot and Ankle Society Score

Short Form Health Survey (SF-12)1 day

Differences in Health Scores on the 12-Item Short Form Health Survey

VAS (Visual Analog Scale)1 day

Differences in Pain Scores on the Visual Analog Scale

Trial Locations

Locations (1)

IRCCS Galeazzi Orthopedic Hospital

🇮🇹

Milan, Italy

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