Total ankle arthroplasty improves discrete and continuous stance phase gait symmetry.
Kelly Kugach, Nicole E-P Stark, Hassan-Galaydh Farah and 3 others
PMID 38970929WHAT IT FOUND
Patients with end-stage ankle arthritis who underwent total ankle arthroplasty showed improved gait symmetry at one and two years post-surgery.
Weight acceptance, propulsion, and ankle moments became more symmetrical, though hip angle asymmetry persisted throughout the stance phase.
Key findings
01Gait speed increased significantly by 31.5% at one year and 36% at two years compared to pre-operative levels.
02Symmetry for weight acceptance, propulsion, hip extension moment, and ankle plantarflexion moment improved from pre-op to one year and was retained at two years.
03Time-series analysis showed that symmetry improvements occurred across most of the stance phase, not just at discrete peak points.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
No age-matched control group was included, so it is unclear how much of the symmetry change is due to normal aging versus surgery. There was no standardized post-operative rehabilitation protocol; most patients did not attend formal physical therapy, making it difficult to attribute outcomes to specific interventions. The study normalized time-series data to the stance phase, which prevents assessment of the impact of temporal differences on symmetry. Multiple comparisons increase the risk of type 2 error, though statistical parameter mapping was used to mitigate this.
Declared interests
None of the authors declare any competing interests.
The easy way to misread this
Do not assume that improved gait symmetry equates to a return to normal biomechanics. Gait speed remained below healthy control averages, and hip angle asymmetry persisted throughout the stance phase. Additionally, because most patients did not receive formal physical therapy, these results reflect the natural history of recovery with minimal intervention, not necessarily the optimal outcome achievable with structured rehab.