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Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_III | Pages 454 - 454
1 Sep 2009
Rouhani H Favre J Creviosier X Jolles B Aminian K
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Recently, many mathematical descriptors were proposed to quantify 3D motions of the foot and ankle complex. However, since the ranges of rotation in foot joints are rather small, the reliability of these kinematic assessments is questionable. Particularly, achievement of acceptable results for clinical decision makings demands to extract repeatable features. In this study, repeatability of kinematics assessment of multi-segment foot by means of different mathematical descriptors was investigated.

25 tiny markers were mounted on dominant anatomical landmarks of the foot and ankle complex. Six young healthy subjects were asked to walk over a forceplate surrounded by six infra-red cameras. Marker trajectories were captured during one stance phase and several trials per subject were recorded. Foot and ankle complex was considered as six rigid segments:

Shank,

Hindfoot,

Mid-foot,

Medial forefoot

Lateral forefoot

Toes.

3D angles between each pair of segments (i.e., 1~2, 2~3, 3~4, 3~5 and 4~6) were calculated based on three common mathematical descriptors:

helical angle,

joint coordinate system and

projection angles.

Then, the coefficient of multiple correlations (CMC) was used to estimate the degree of similarity among joint angle patterns for intra-subject and inter-subjects trials.

It was observed that the three angle calculation methods had comparable repeatability for both intra-subject and inter-subjects kinematics. No significant difference among their repeatability was noticed. Most of angles showed good pattern repeatability intra-subject and acceptable pattern repeatability inter-subjects. In conclusion, all three calculation methods for foot joint angles can be reliably applied. Further studies enrolling patients with foot and ankle pathology are necessary to investigate the relevance of these measurements for clinical evaluations.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_I | Pages 161 - 161
1 Mar 2009
Crevoisier X Aminian K Favre J Rouhani H Jolles B
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Introduction: Ankle arthropathy is associated with a decreased motion of the ankle-hindfoot during ambulation. Ankle arthrodesis was shown to result in degeneration of the neighbour joints of the foot. Inversely, total ankle arthroplasty conceptually preserves the adjacent joints because of the residual mobility of the ankle but this has not been demonstrated yet in vivo. It has also been reported that degenerative ankle diseases, and even arthrodesis, do not result in alteration of the knee and hip joints. We present the preliminary results of a new approach of this problem based on ambulatory gait analysis.

Patients and Methods: Motion analysis of the lower limbs was performed using a Physilog® (BioAGM, CH) system consisting of three-dimensional (3D) accelerometer and gyroscope, coupled to a magnetic system (Liberty©, Polhemus, USA). Both systems have been validated. Three groups of two patients were included into this pilot study and compared to healthy subjects (controls) during level walking: patients with ankle osteoarthritis (group 1), patients treated by ankle arthrodesis (group 2), patients treated by total ankle prosthesis (group 3).

Results: Motion patterns of all analyzed joints over more than 20 gait cycles in each subject were highly repeatable. Motion amplitude of the ankle-hindfoot in control patients was similar to recently reported results. Ankle arthrodesis limited the motion of the ankle-hindfoot in the sagittal and horizontal planes. The prosthetic ankle allowed a more physiologic movement in the sagittal plane only. Ankle arthritis and its treatments did not influence the range of motion of the knee and hip joint during stance phase, excepted for a slight decrease of the hip flexion in groups 1 and 2.

Conclusion: The reliability of the system was shown by the repeatability of the consecutive measurements. The results of this preliminary study were similar to those obtained through laboratory gait analysis. However, our system has the advantage to allow ambulatory analysis of 3D kinematics of the lower limbs outside of a gait laboratory and in real life conditions. To our knowledge this is a new concept in the analysis of ankle arthropathy and its treatments. Therefore, there is a potential to address specific questions like the difficult comparison of the benefits of ankle arthroplasty versus arthrodesis. The encouraging results of this pilot study offer the perspective to analyze the consequences of ankle arthropathy and its treatments on the biomechanics of the lower limbs ambulatory, in vivo and in daily life conditions.