Foot and Ankle Biomechanics During Gait of Patients with an Osteochondral Lesion of the Talus

Category: Ankle; Basic Sciences/Biologics Introduction/Purpose: An osteochondral lesion of the talus (OLT) is a defect of talar cartilage and subchondral bone, primarily linked to a history of ankle trauma. Mechanical overload is considered one of the reasons for the development of osteochondral lesions of the talus. However, no gait analysis of this patient group exists to date. We hypothesize that altered gait patterns lead to increased load at the side of the lesion compared to healthy controls. The primary aim of the study was to compare the foot and ankle biomechanics during gait between individuals with OLT and healthy controls. The secondary aim was to compare these parameters between individuals with a medial and lateral OLT. Methods: Ten patients diagnosed with symptomatic OLT (5 medial and 5 lateral lesions) underwent gait analysis. 3D kinematics according to the Amsterdam Foot Model, ground reaction force, and plantar pressure data were collected to quantify the motions and forces within the foot. OLT data were compared to a reference dataset of healthy controls (n=13) using statistical parametric mapping and one-way ANOVA. Results: The ankle joint was significantly rotated towards valgus in both the OLT groups compared to the control group during most of the gait cycle. Moreover, the medial OLT group showed decreased plantarflexion in the Lisfranc joint, and lateral OLT group showed higher peak pressures in the midfoot zone compared to the control group. Conclusion: The valgus rotation reduces medial loading, but was present in both OLT groups. Decreased Lisfranc plantarflexion and increased midfoot pressures indicate a tendency towards flat feet. The observed alterations in the OLT group could be adaptations to, or causes of, osteochondral damage in the ankle joint.