Article

Degenerative osteoarthritis in subtalar and midtarsal joints occurring after
tibiotalar arthrodesis may be related to biomechanical factors. For patients with
tibiotalar arthrodesis walking with their everyday shoes, the ground reaction
force is posterior at heel-off and the maximal foot-tibia dorsiflexion is at its
upper limit. We hypothesized that increasing the instep of the shoes would
improve these abnormalities. Three-dimensional gait analysis was done in nine
patients with ankle arthrodesis fused in the neutral position and for 10 control
subjects. Four conditions of walking were tested: barefoot, wearing everyday
shoes, wearing everyday shoes with the instep increased by 1 cm, and wearing
everyday shoes with the instep increased by 2 cm. In the arthrodesis group, the
two modified delayed heel-off shoe conditions shifted the ground reaction force
closer to the metatarsal heads at heel-off to a normal range, and reduced the
maximal foot and tibia dorsiflexion angle. Based on these results, patients with
a tibiotalar arthrodesis in the neutral sagittal position may be advised to
choose shoes with an instep of approximately 25 mm.

Langue : ANGLAIS