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Effects of Ankle Fusion on Gait

Trauma is the most common cause of ankle arthritis in active, young adults. Ankle fusion may be the only answer to end pain in the late stages of ankle arthritis. Surgeons and their patients are interested in knowing the long-term results of this operation. This study compares a group of 26 patients who had ankle fusion with a control group of 27 healthy, same age, same sex adults.

Measures used to compare the two groups included range of motion, gait analysis, and X-rays. Questions used to measure function were also included. As expected, the fusion group had much less motion, especially when walking. X-rays showed osteoarthritic changes developing in the other joints of the ankle and foot.

A six-camera, three-dimensional (3-D) system was used to monitor walking patterns. Range of motion, cadence (steps per minute), and stride length were assessed in both groups. The ankle fusion group had a slower pace and shorter stride length compared to the control (normal) group. The fusion group also had decreased motion at the hip, hindfoot, and forefoot.

The authors suggest that anyone thinking about an ankle fusion should be carefully counseled. They should be told that ankle fusion is a salvage procedure. It will give them pain relief and improve overall function. It will not restore a normal walking pattern. The restricted ankle motion puts them at risk for arthritis in the other ankle and foot joints.

References: Rhys Thomas, FRCS (ORTH), et al. Gait Analysis and Functional Outcomes Following Ankle Arthrodesis for Isolated Ankle Arthritis. In The Journal of Bone and Joint Surgery. March 2006. Vol. 88-A. No. 3. Pp. 526-535.

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