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Ankle strength, muscle size, and adipose content following unilateral tibiotalar arthrodesis
Author(s) -
Nichols Jennifer A.,
Foreman Kenneth Bo,
Barg Alexej,
Saltzman Charles L.,
Anderson Andrew E.
Publication year - 2019
Publication title -
journal of orthopaedic research®
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.24282
Subject(s) - arthrodesis , ankle , isometric exercise , medicine , range of motion , ankle dorsiflexion , physical medicine and rehabilitation , anatomy , physical therapy , alternative medicine , pathology
Tibiotalar arthrodesis is commonly used to treat end‐stage ankle osteoarthritis. Post‐operative impairments are often attributed to limited ankle motion. However, whether muscular deficits also exist, thereby potentially contributing to impairments, is unknown. This study aimed to identify post‐operative deficits in ankle musculature by examining range of motion, strength (maximum isometric ankle joint torque), and leg composition (cross‐sectional area of individual tissue types: bone, subcutaneous adipose, intramuscular adipose, muscle). Ten individuals with unilateral tibiotalar arthrodesis participated. Paired t ‐tests ( p < 0.05) identified differences between the fused and contralateral, control limb. The results indicate that individuals with tibiotalar arthrodesis have profound losses of range of motion and strength. Across participants, range of motion in the fused limb was 53.5 ± 11.7%, 66.8 ± 6.3%, 38.2 ± 18.7%, 37.8 ± 13.6% less than the control for dorsiflexion, plantarflexion, inversion, and eversion, respectively. The largest strength deficit was in dorsiflexion, with the fused limb producing 47.2 ± 9.4% less torque than the control. The quantity and quality of muscle tissue was also negatively affected in individuals following tibiotalar arthrodesis. The total cross‐sectional area of the fused limb was 11.4 ± 5.4% smaller than the control limb. This change was primarily due to the 16.1 ± 6.7% decrease in muscle cross‐sectional area. However, intramuscular adipose was significantly increased. Although the posterior compartment demonstrated a significant decrease in cross‐sectional area, when accounting for differences in total cross‐sectional area, the relative sizes of the four muscle compartments were consistent between limbs. This cross‐sectional study motivates longitudinal research examining muscular deficits and whether these deficits are reversible with exercise and rehabilitation. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res