Background:End-stage ankle arthritis impairs joint function and patients' mobility.Total ankle replacement is a surgical procedure to treat severe ankle arthritis.Salto Talaris Anatomic Ankle^(TM)(STAA) was design...Background:End-stage ankle arthritis impairs joint function and patients' mobility.Total ankle replacement is a surgical procedure to treat severe ankle arthritis.Salto Talaris Anatomic Ankle^(TM)(STAA) was designed to mimic the normal ankle anatomy and flexion/extension of the ankle movement.The purpose of this study was to examine the effect of an STAA ankle replacement on ankle joint function and mechanics during gait.Methods:Five patients with end-stage unilateral ankle arthritis were recruited.Patients performed level walking in a laboratory setting on 2occasions,prior to and 3 months after the STAA ankle surgeries.American Orthopedic Foot and Ankle Society(AOFAS) hindfoot score was obtained.A 12-camera motion capture system was used to perform walking analysis.Gait temporo-spatial parameters and ankle joint mechanics were evaluated.Paired Student's t tests and non-parametric Wilcoxon matched tests were performed to examine the differences in biomechanical variables between the pre-and post-surgery walking conditions.Results:Compared to the pre-surgical condition,at 3 months of post-STAA surgery,patients experienced greater improvement in AOFAS hindfoot score(p = 0.0001);the STAA ankle demonstrated a 31% increase in ankle joint excursion(p = 0.045),a 22% increase in ankle plantarflexor moment(p = 0.075),a 60% increase in ankle power absorption(p = 0.023),and a 68% increase in ankle power production(p = 0.039).Patients also demonstrated a 26% increase in walking speed(p = 0.005),a 20% increase in stride length(p = 0.013),a 15% decrease in double support time(p = 0.043),and a 5% decrease in total stance time(p = 0.055).Conclusion:Three months after surgeries,the STAA patients experienced improvements in ankle function and gait parameters.The STAA ankle demonstrated improved ankle mechanics during daily activities such as walking.展开更多
As one of the most important concepts in traditional Chinese medicine, cutaneous regions have a close relationship with skin in modern medicine. According to the doctrine of traditional Chinese medicine, the cutaneous...As one of the most important concepts in traditional Chinese medicine, cutaneous regions have a close relationship with skin in modern medicine. According to the doctrine of traditional Chinese medicine, the cutaneous regions are the corresponding projections of twelve meridians in the superficial layer of the body and play an important role in body surface-viscera correlation. The symptoms of visceral disorders will reflect on cutaneous regions and one of the major patterns of manifestation is referred visceral pain accompanied by tenderness and hyperalgesia on the body surface. On the contrary, cutaneous regions participate in the treatment of visceral disorders. As major clinical applications of the cutaneous regions hypothesis, superficial acupuncture, subcutaneous needling, massage(tuina), moxibustion, and wrist-ankle acupuncture have achieved favorable therapeutic outcomes in clinical practice. Modern researches have gained insights into the biological background of cutaneous regions, however, further studies are needed to clarify the mechanisms.展开更多
文摘Background:End-stage ankle arthritis impairs joint function and patients' mobility.Total ankle replacement is a surgical procedure to treat severe ankle arthritis.Salto Talaris Anatomic Ankle^(TM)(STAA) was designed to mimic the normal ankle anatomy and flexion/extension of the ankle movement.The purpose of this study was to examine the effect of an STAA ankle replacement on ankle joint function and mechanics during gait.Methods:Five patients with end-stage unilateral ankle arthritis were recruited.Patients performed level walking in a laboratory setting on 2occasions,prior to and 3 months after the STAA ankle surgeries.American Orthopedic Foot and Ankle Society(AOFAS) hindfoot score was obtained.A 12-camera motion capture system was used to perform walking analysis.Gait temporo-spatial parameters and ankle joint mechanics were evaluated.Paired Student's t tests and non-parametric Wilcoxon matched tests were performed to examine the differences in biomechanical variables between the pre-and post-surgery walking conditions.Results:Compared to the pre-surgical condition,at 3 months of post-STAA surgery,patients experienced greater improvement in AOFAS hindfoot score(p = 0.0001);the STAA ankle demonstrated a 31% increase in ankle joint excursion(p = 0.045),a 22% increase in ankle plantarflexor moment(p = 0.075),a 60% increase in ankle power absorption(p = 0.023),and a 68% increase in ankle power production(p = 0.039).Patients also demonstrated a 26% increase in walking speed(p = 0.005),a 20% increase in stride length(p = 0.013),a 15% decrease in double support time(p = 0.043),and a 5% decrease in total stance time(p = 0.055).Conclusion:Three months after surgeries,the STAA patients experienced improvements in ankle function and gait parameters.The STAA ankle demonstrated improved ankle mechanics during daily activities such as walking.
基金supported by National Natural Science Foundation of China(No.81001548,No.81173341,No.81173332 and No.81202753)Shanghai Rising-star Program(No.12QA1403000)+1 种基金Shanghai Key Research Program of Traditional Chinese Medicine Development(No.ZYSNXD-CC-ZDYJ039)The Scientific Research Funds for Young Scholar of the Health System in Shanghai(No.XYQ2013081)
文摘As one of the most important concepts in traditional Chinese medicine, cutaneous regions have a close relationship with skin in modern medicine. According to the doctrine of traditional Chinese medicine, the cutaneous regions are the corresponding projections of twelve meridians in the superficial layer of the body and play an important role in body surface-viscera correlation. The symptoms of visceral disorders will reflect on cutaneous regions and one of the major patterns of manifestation is referred visceral pain accompanied by tenderness and hyperalgesia on the body surface. On the contrary, cutaneous regions participate in the treatment of visceral disorders. As major clinical applications of the cutaneous regions hypothesis, superficial acupuncture, subcutaneous needling, massage(tuina), moxibustion, and wrist-ankle acupuncture have achieved favorable therapeutic outcomes in clinical practice. Modern researches have gained insights into the biological background of cutaneous regions, however, further studies are needed to clarify the mechanisms.
