Total Ankle Replacement Provides Symmetrical Postoperative Kinematics: A Biplane Fluoroscopy Imaging Study.
Total Ankle Replacement Provides Symmetrical Postoperative Kinematics: A Biplane Fluoroscopy Imaging Study.
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DOI：
10.1177/10711007221078001
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发表时间：
2022-06
影响因子：
2.7
通讯作者：
Anderson, Andrew E.
中科院分区：
文献类型：
--
作者：
Lenz, Amy L.;Lisonbee, Rich J.;Peterson, Andrew C.;Roach, Koren E.;Foreman, K. Bo;Barg, Alexej;Anderson, Andrew E.
TAR后的胫距和距下关节运动的体内测量是不可用的。使用双平面透视检查，我们验证了假体胫距关节和邻近的距下关节与未治疗的对侧肢体和对照组相比表现出运动学和运动范围差异的假设。41名确定的候选患者中，6名患者均接受了单侧Zimmer TAR（5.4±1.9年前），6名对照患者在地上行走和双跟上升活动时接受了双翼透视成像。计算机断层扫描；对图像进行分割和处理，作为基于模型的双翼透视数据跟踪的输入。测量包括TAR、未治疗的对侧和对照肢体的胫距和距下运动学。统计参数映射量化了在地上行走和双跟上升活动中的运动学差异。该TAR患者行走和跟起活动对称，两肢之间的胫距和距下关节没有明显的运动学差异。与对照组相比，患者表现出背屈/跖屈的运动范围减少，这与背屈峰值减少相对应，但仅在站立行走的后期阶段。TAR组胫骨背/跖屈活动范围的减少在双跟上升活动中变得更加明显。Zimmer TAR患者在行走活动和双跟上升时具有对称的运动学，但与对照组相比，他们在胫距运动学方面确实表现出轻微的代偿。距下关节缺乏明显的运动补偿可以解释为什么继发性距下骨关节炎在一些TAR设计的患者中相对不常见。
In vivo measurements of tibiotalar and subtalar joint motion following TAR are unavailable. Using biplane fluoroscopy, we tested the hypothesis that the prosthetic tibiotalar joint and adjacent subtalar joint would demonstrate kinematic and range of motion differences compared to the contralateral untreated limb, and control participants. Six patients of 41 identified candidates that all underwent unilateral Zimmer TAR (5.4 ± 1.9 years prior) and 6 control participants were imaged with biplane fluoroscopy during overground walking and a double heel-rise activity. Computed tomography scans were acquired; images were segmented and processed to serve as input for model-based tracking of the biplane fluoroscopy data. Measurements included tibiotalar and subtalar kinematics for the TAR, untreated contralateral, and control limbs. Statistical parametric mapping quantified differences in kinematics throughout overground walking and the double heel-rise activity. Patients with this TAR performed walking and heel-rise activities symmetrically with no significant kinematic differences at the tibiotalar and subtalar joints between limbs. Compared to control participants, patients exhibited reduced dorsi/plantarflexion range of motion that corresponded to decreased peak dorsiflexion, but only in the late stance phase of walking. This reduction in tibiotalar dorsi/plantarflexion range of motion in the TAR group became more apparent with double heel-rise activity. Patients with a Zimmer TAR had symmetric kinematics during activities of walking and double heel-rise, but they did exhibit minor compensations in tibiotalar kinematics as compared to controls. The lack of significant kinematic compensation at the subtalar joint may explain why secondary subtalar osteoarthritis is reported as being relatively uncommon in patients with some TAR designs.
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影响因子：
6.3
作者：
Mian, OS;Thom, JM;Minetti, AE
通讯作者：
Minetti, AE
DOI：
10.1080/10255842.2010.527837
发表时间：
2012-01-01
影响因子：
1.6
作者：
Pataky, Todd C.
通讯作者：
Pataky, Todd C.
影响因子：
5.3
作者：
Barg, Alexej;Bettin, Clayton C.;Gililland, Jeremy
通讯作者：
Gililland, Jeremy
影响因子：
2.6
作者：
Bey, Michael J;Kline, Stephanie K;Zauel, Roger
通讯作者：
Zauel, Roger
影响因子：
2.7
作者：
Kormi, Sami;Kohonen, Ia;Tiusanen, Hannu
通讯作者：
Tiusanen, Hannu