Changes in Relative Work of the Lower Extremity and Distal Foot Joints After Total Ankle Replacement: An Exploratory Study.

Ankle osteoarthritis does not only led to lower ankle power generation, but also results in compensatory gait mechanics at the hip and Chopart joints. Much of previous work explored the relative work distribution after total ankle replacement (TAR) either across the lower extremity joints where the foot was modelled as a single rigid unit or across the intrinsic foot joints without considering the more proximal lower limb joints. Therefore, this study aims, for the first time, to combine 3D kinetic lower limb and foot models together to assess changes in the relative joint work distribution across the foot and lower limb joints during level walking before and after patients undergo TAR.

Subtalar Arthrodesis in Patients With Prior Tibiotalar Arthrodesis for Posttraumatic Osteoarthritis.

Background: The tibiotalar arthrodesis for end-stage ankle osteoarthritis is a surgical procedure that leads to a modification of the kinematics of the adjacent joints and may result in the development of secondary osteoarthritic degeneration of the subtalar joint. It has previously been observed that subtalar arthrodesis in this context shows a lower fusion rate than isolated subtalar arthrodesis. This retrospective study reports the results of subtalar joint arthrodesis with previous ipsilateral tibiotalar arthrodesis and suggests some factors that may compromise the fusion of the joint.

Concomitant Triceps Surae Lengthening in Total Ankle Arthroplasty Affects the Mechanical Work at the Ankle Joint.

Background: Previous studies have examined the effect of concomitant triceps surae lengthening on ankle dorsiflexion motion at the time of total ankle arthroplasty (TAA). As plantarflexor muscle-tendon structures are important for producing positive ankle work during the propulsive phase of gait, caution should be exercised when lengthening triceps surae, as it may decrease plantarflexion strength. In order to develop an understanding of the work of the anatomical structures crossing the ankle during propulsion, joint work must be measured.

Early-Term Results of the Cadence Total Ankle Prosthesis: An European Noninventor Study.

Background: Although considerable literature can be found on the outcome of total ankle replacement (TAR), only a few studies have reported the results of the fixed-bearing Cadence prosthesis. This noninventor study reports a consecutive series of 60 Cadence TAR systems with a mean of 2.9 years' follow-up, focusing on clinical and radiographic outcomes and early complications.

The evidence base for interprofessional education within health professions education: A protocol for an update review.

Interprofessional education (IPE) interventions aiming to promote collaborative competence and improve the delivery of health and social care processes and outcomes continue to evolve. This paper reports on a protocol for an update review that we will conduct to identify and describe how the IPE evidence base has evolved in the last 7 years. We will identify literature through a systematic search of the following electronic databases: Medline, Embase, CINAHL, Education Source, ERIC, and BEI.

Decreased Mechanical Work Demand in the Chopart Joint After Total Ankle Replacement.

Background: The success of total ankle replacement (TAR) must be based on restoring reasonable mechanical balance with anatomical structures that can produce mechanical joint work through elastic (eg, tendons, fascia) or viscoelastic (eg, heel pad) mechanisms, or by active muscle contractions. Yet, quantifying the work distribution across the affected joint and the neighboring foot joints after TAR is lacking. Therefore, the objective of this study was to investigate if there is a change in the joint work distribution across the Ankle, Chopart, Lisfranc and Metatarsophalangeal joints during level walking before and after patients undergo TAR.

Post-sprain versus post-fracture post-traumatic ankle osteoarthritis: Impact on foot and ankle kinematics and kinetics.

Background: Common etiologies for post-traumatic ankle osteoarthritis are ankle fractures and chronic ankle instability. As the nature of trauma is different for these two etiologies, it might be expected that the two subtypes of post-traumatic ankle osteoarthritis would display different foot mechanics during gait.

Research Question: The objective of this exploratory cross-sectional study was to compare the foot kinematics and kinetics of patients suffering from post-fracture ankle osteoarthritis with those of patients suffering from post-sprain ankle osteoarthritis.

The accuracy and validity of the Sheffield Features of Gait Tool.

Gait is now widely used in the UK as a contributor to identification, and increasing interest is being shown in its use in both Europe and the US. One of the long standing criticisms of the use of gait as evidence has been the lack of a validated standard methodology. With the publication of the 'Code of practice for forensic gait analysis', and the adoption of the code as part of the 'Codes of Practice and Conduct for forensic science providers and practitioners in the Criminal Justice System' by the Forensic Science Regulator, forensic gait analysts are now required to provide evidence of the testing of the methods used.

Intrinsic foot joints adapt a stabilized-resistive configuration during the stance phase.

Background: This study evaluated the 3D angle between the joint moment and the joint angular velocity vectors at the intrinsic foot joints, and investigated if these joints are predominantly driven or stabilized during gait.

Methods: The participants were 20 asymptomatic subjects. A four-segment kinetic foot model was used to calculate and estimate intrinsic foot joint moments, powers and angular velocities during gait.

Change in gait biomechanics after total ankle replacement and ankle arthrodesis: a systematic review and meta-analysis.

Background: The aim of this systematic review with meta-analysis was to determine the change in gait biomechanics after total ankle replacement and ankle arthrodesis for end-stage osteoarthritis.

Methods: Electronic databases were searched up until May 2019. Peer-reviewed journal studies including adult participants suffering from end-stage ankle osteoarthritis and reporting pre- and post-operative kinematics, kinetics and spatio-temporal effects of total ankle replacement and ankle arthrodesis during walking were included with a minimum of 12 months follow-up.

The identification of individuals by observational gait analysis using closed circuit television footage: Comparing the ability and confidence of experienced and non-experienced analysts.

Gait is known to have been used as evidence since 1839, initially based on the apocryphal belief that a person can be identified by their gait. The potential uniqueness of gait has yet to be proven, and therefore gait is currently considered to be a contributor to identification rather than a method of identification. In 2013 Birch et al.

The repeatability and reproducibility of the Sheffield Features of Gait Tool.

Gait, the pattern or style in which locomotion is undertaken, has kinematic characteristics that may occur in varying proportions of a population and therefore have discriminatory potential. Forensic gait analysis is the analysis, comparison and evaluation of features of gait to assist the investigation of crime. While there have been recent developments in automated gait recognition systems, gait analysis presented in criminal court to assist in identification currently relies on observational analysis by expert witnesses.

A review of the historical use and criticisms of gait analysis evidence.

The use of gait analysis is a well-established facet of practice for many professions and a fundamental aspect of clinical practice. In recent times, gait analysis evidence has emerged as a new area of forensic practice. As its use has continued to spread and develop, the area of work has come under close scrutiny and subsequent criticism.

A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39.

Background: Interprofessional education (IPE) aims to bring together different professionals to learn with, from, and about one another in order to collaborate more effectively in the delivery of safe, high-quality care for patients/clients. Given its potential for improving collaboration and care delivery, there have been repeated calls for the wider-scale implementation of IPE across education and clinical settings. Increasingly, a range of IPE initiatives are being implemented and evaluated which are adding to the growth of evidence for this form of education.

Arthroscopic Debridement After Total Ankle Arthroplasty.

Background: Residual pain due to impingement after ankle arthroplasty can be addressed with arthroscopic debridement. Literature focusing on the effectiveness of arthroscopic debridement after total ankle arthroplasty (TAA) is scarce. The authors report a case series of 12 patients complaining of anterior or posterior impingement pain, 11 of which were in the absence of malalignment which were treated by arthroscopy.

Anatomical characteristics of the flexor digitorum accessorius longus muscle and their relevance to tarsal tunnel syndrome a systematic review.

Background: Clinical and cadaver studies have reported that supernumerary muscles could be the etiology of a variety of pathologic disorders, such as posterior impingement syndrome, tarsal tunnel syndrome (TTS), and flexor hallucis longus tenosynovitis. We describe a unique variant of the flexor digitorum accessorius longus (FDAL) muscle as an apparent cause of TTS, functioning as an independent flexor of the second toe, which has not been described in the literature. In addition to this case report, a systematic review was performed of TTS caused by the FDAL muscle.

Terminology and forensic gait analysis.

The use of appropriate terminology is a fundamental aspect of forensic gait analysis. The language used in forensic gait analysis is an amalgam of that used in clinical practice, podiatric biomechanics and the wider field of biomechanics. The result can often be a lack of consistency in the language used, the definitions used and the clarity of the message given.

Review of clinical approaches and diagnostic quantities used in pedobarographic measurements.

The non-invasive nature of pedobarographic measurements is particularly attractive to researchers for analyzing and characterizing the impact of specific pathological foot conditions. However, adequate clinical use of pedobarographic technology requires a profound technical and methodological knowledge. Several papers summarized the technical capacities of pedobarographic technology.

Dynamic in vivo subtalar joint kinematics measured using a skin marker-based protocol a face validity study.

Background: The subtalar joint allows complex motion of the foot relative to the leg, the analysis of which has presented a major challenge for researchers. The considerable interpatient variation in structure and function of the subtalar joint highlights the importance of developing a protocol to assess the kinematics in individuals rather than developing an overarching description of function. The use of skin-mounted markers is, therefore, preferable, allowing the noninvasive collection of data.

Dynamic in-vivo subtalar joint kinematics measured using a skin marker based protocol: a face validity study.

Abstract Background: The subtalar joint allows complex motion of the foot relative to the leg, the analysis of which has presented a major challenge for researchers. The considerable inter-subject variation in structure and function of the subtalar joint highlights the importance of developing a protocol to assess the kinematics in individuals rather than an overarching description of function. The use of skin mounted markers is therefore preferable, allowing the non-invasive collection of data.

The effect of frame rate on the ability of experienced gait analysts to identify characteristics of gait from closed circuit television footage.

Forensic gait analysis is increasingly being used as part of criminal investigations. A major issue is the quality of the closed circuit television (CCTV) footage used, particularly the frame rate which can vary from 25 frames per second to one frame every 4s. To date, no study has investigated the effect of frame rate on forensic gait analysis.