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Blood‐induced cartilage damage alters the ankle joint load during walking
Author(s) -
Eerdekens Maarten,
Peerlinck Kathelijne,
Staes Filip,
Pialat JeanBaptiste,
Hermans Cedric,
Lobet Sébastien,
Scheys Lennart,
Deschamps Kevin
Publication year - 2020
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.24715
Subject(s) - ankle , medicine , cartilage , gait , physical medicine and rehabilitation , range of motion , surgery , anatomy
Abstract Ankle cartilage damage due to repeated joint bleeds often leads to altered gait in adult patients with hemophilia. It is therefore of clinical importance to develop an understanding of the biomechanical gait features in hemophilia patients with and without blood‐induced cartilage damage and age‐matched control subjects. We recruited a control group (n = 17), patients with hemophilia (PwH) without blood‐induced ankle cartilage damage (PwH_ NoCartDam , n = 5) and PwH with severe blood‐induced ankle cartilage damage (PwH_ CartDam , n = 19). We collected three‐dimensional gait analysis data with following outcome variables in the ankle, Chopart and the first metatarsophalangeal (MTP 1) joints: range of motion (ROM) during stance phase, peak joint moment and powers. Biomechanical loading (BW) was quantified as the joint reaction forces using inverse dynamic analysis. Loading rate (BW/s) and impulse (BW*s) were calculated between 50% and 70% of stance phase. All biomechanical variables of the ankle joint were significantly lowered in the PwH_ CartDam group compared with both the control subjects and the PwH_ NoCartDam group. No compensatory biomechanical function was observed in other foot joints. An ankle loading rate of 2.64 ± 0.83 BW/s was observed in the control group, which was significantly higher than 1.75 ± 0.43 BW/s ( P = .049) and 1.22 ± 0.59 BW/s ( P < .001) in respectively the PwH_ NoCartDam group and PwH_ CartDam group. Patients with severe blood‐induced cartilage damage demonstrated a (mal)adaptive gait strategy as they experience difficulties to properly unload the ankle cartilage during walking.