Document Type
Article
Language
eng
Format of Original
6 p.
Publication Date
10-2011
Publisher
Elsevier
Source Publication
Journal of Experimental and Clinical Medicine
Source ISSN
1878-3317
Original Item ID
doi: 10.1016/j.jecm.2011.09.003
Abstract
Introduction
Rheumatoid arthritis (RA) is a systemic autoimmune disease that can cause weakening and destruction of various joints of the foot and may result in pain and deformity. This clinical presentation can cause eventual loss of function, shoe-wear difficulties, and altered gait patterns.
Purpose
The goal of this prospective study was to quantify changes in temporal-spatial parameters and multisegmental foot and ankle kinematics in a group of patients with RA of the forefoot following surgery.
Methods
Three-dimensional (3-D) motion analysis was conducted preoperatively and postoperatively using a 15-camera Vicon Motion Analysis System (Vicon Motion Systems, Inc.; Lake Forest, CA) on 14 feet in 13 patients with forefoot RA. The Milwaukee foot model was used to characterize segmental kinematics and temporal-spatial parameters. Preoperative and postoperative data were compared using paired nonparametric methods; comparisons with normative data were performed using unpaired nonparametric methods.
Results
Preoperatively, the hallux was in a valgus position, the forefoot was abducted and in valgus, and range of motion was limited in various phases in all segments. Walking speed and stride length were decreased and stance prolonged when compared with normal controls. Postoperatively, the hallux alignment was restored to normal but a limited range of motion remained. Kinematics also demonstrated forefoot valgus and tibial internal rotation compared with the control population. Comparisons to healthy ambulators also showed decreased stride lengths and prolonged stance phase durations.
Conclusion
Surgery effectively restored alignment and weight-bearing capacity of the rheumatoid feet. Temporal-spatial parameters and kinematics, however, were not restored to control values, but rather were consistent with first metatarsophalangeal joint fusion effects. The altered mechanics after surgery demonstrate the importance of quantitative assessment in understanding the geometric and kinematic effects of surgical realignment with implications for postoperative rehabilitation and gait training.
Recommended Citation
Canseco, Karl; Albert, Carolyne; Long, Jason T.; Khazzam, Michael; Marks, Richard; and Harris, Gerald F., "Postoperative Foot and Ankle Kinematics in Rheumatoid Arthritis" (2011). Biomedical Engineering Faculty Research and Publications. 23.
https://epublications.marquette.edu/bioengin_fac/23
ADA Accessible Version
Comments
Accepted version. Journal of Experimental and Clinical Medicine, Volume 3, No. 5, pp 233-238 (October 2011), DOI: 10.1016/j.jecm.2011.09.003. © 2011 Elsevier. Used with permission.