Shoes Matter in Ankle Surgery Gait Analysis

Most gait studies post-ankle surgery are performed with participants walking barefoot, which is not a realistic scenario. A notable study evaluated walking patterns of 126 patients who underwent total ankle replacement, ankle arthrodesis, and tibiotalocalcaneal arthrodesis, as well as 35 healthy control participants. The assessments were conducted both barefoot and while wearing two types of footwear: standard running shoes and rocker bottom shoes. 

Key study findings

• Footwear improvements enhanced function by increasing walking speed by 0.06  meters/second and forefoot force, while decreasing midfoot load by less than 0.1%.

• Rocker bottoms offered no significant advantage over regular runners.

• Total ankle replacement and ankle arthrodesis were similar but underperformed compared to healthy controls.

• Tibiotalocalcaneal arthrodesis had the poorest outcomes.

• Rocker shoes narrowed midfoot index differences without affecting force or speed.

Shoes, particularly running shoes, improve gait outcomes post-surgery. Future studies should focus on gait with footwear, rather than just barefoot.