Recovery of Balance and Lower Extremity Joint Contributions in Total Ankle Arthroplasty Patients

Abstract

Ankle arthritis is a debilitating condition that causes severe pain and decreased function in the affected limb on the order of end-stage hip arthrosis, end-stage kidney disease, and congestive heart failure. Total ankle replacement is a viable surgical option for treating end-stage ankle arthritis, but few have studied its effects on balance over time. Therefore, the purpose of this study was to test the accuracy of a single-marker method of tracking center of mass, evaluate center of pressure measurements in total ankle replacement patients, and analyze lower extremity joint contributions over a two-year recovery period. Subjects stood on two force platforms for ten seconds in different conditions, and relevant variables were calculated from the force platform and 3D motion capture data. Results showed that increasing recovery time restored partial symmetry between the surgical and non-surgical limbs in ground reaction force, ankle range of motion, and ankle and hip moment contribution in static balance tasks. Furthermore, the ankle and hip may have different roles in postural stability. The results of the studies suggest that total ankle replacement is an effective treatment for end-stage ankle arthritis in terms of restoring postural stability. While patients may not have returned to the level of healthy control subjects, they are more functional and more stable after a two-year recovery period. While further work is needed, the results are encouraging for the outlook of ankle arthritis patients who may need total ankle replacement surgery.