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Category: Ankle Arthritis Introduction/Purpose: Step count and activity monitoring are objective tools to measure improvement in functional ability in patients undergoing Total ankle replacement (TAR); this area is underexplored in literature. Activity monitoring sensors provide additional information on physical activity and energy expenditure in addition to step counts. These carried out in a real-life environment helps us to understand the impact of intervention in improving physical activity. The aim of this study was to study physical activity patterns in the community in patients who underwent TAR surgery. Methods: 10 patients who underwent a TAR between 2017 and 2019 were recruited. Exclusion criteria included previous reconstructive surgery, h/o infection, PVD, neurological disease and other joint replacements. Written consent was obtained. Patients were provided with ActivPAL TM activity monitor to wear over a 7-day period along with a self-reported diary to record activity patterns. This was carried out pre-operatively and 2 years. Data from sensors were downloaded and activity patterns were analysed with SPSS IBM 28 statistical package. Results: 10 patients (7 males, 3 females) were recruited. Mean age of patients were 65.16 years (52.4 to 78.1yrs).there was a trend for improvement in Sitting / Lying (hours) from 121.36 to 132.56 (p=0.367) and Standing (hours) 25.53 to 33.23 (p=0.411), although this did not achieve statistical significance. Step count (in hours) improved from 8.8 hrs to 10.8 hrs (p=0.05); Step count increased from 38544 to 47074 (p=041) from pre-op to 2 years. Energy expenditure (metabolic equivalents) improved from 192.3 to 219.5 (p=0.033). Conclusion: At 2 years post-operatively, TAR patients showed considerable improvement in step count and energy expenditure compared to pre-operative levels. The results of this novel study helps us to understand the functional improvements in terms of physical activity and energy expenditure gained from TAR surgery

Category: Basic Sciences/Biologics; Ankle Introduction/ Purpose: The aim of this study was to investigate plantar pressures changes with gait in patients presenting with ankle arthritis pre and post TAR. Methods: Patients who were listed for a primary TAR with a 3 component mobile bearing prosthesis were included. Exclusion criteria included refusal of consent, previous surgery to foot, h/o infection, peripheral vascular disease, neurological disease and other LL joint replacements. Gait analysis was carried out using TekscanTM plantar preasure (PP) analysis system and PP) were recorded pre- operatively and 1 year post-operatively. Gait asymmetries were recorded in Percentage for ST parameters. 11 patients were recruited to this study. Mean age were 70.5 years. Results: Improvement centre of pressure pattern restoration and Force percentage curve (FP) patterns from pre-op to 1 Year. Improvement in foot progression angle was seen in 6 out of 11 patients (54.5%). Plantar pressure analysis showed deviation from reference ranges for 1) differences in centre of pressure (COP) 2) changes to hindfoot vs. forefoot loading ratio 3) change in loading pattern at heel in KPa (p < 0.05) 4) differences in gait parameters (reduction in cadence, walking velocity, increase in active propulsion time; p< 0.05) 5) changes to foot progression angles. These findings correlate with MOX-FQ scores (p>0.565) for pain, difficulty with walking/standing and difficulty with social activities. Gait asymmetries improved at 1 year for step velocity (76.1 to 93.4%) and mid stance time (76.04 to 93.5% in 8/11patients)(p < 0.05). Conclusion: This study shown that TAR surgery helps in restoring centre of pressure, force percentage curve patterns and reduces asymmetries in step velocity and mid stance times during gait at 1 year post surgery. Plantar pressure analysis is a useful tool to study improvement in function in this patient group.