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Clinics in Podiatric Medicine and Surgery

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https://www.readbyqxmd.com/read/28867061/the-evolution-of-arthritis-treatment-in-the-foot-and-ankle-a-change-in-the-gold-standard
#1
EDITORIAL
Alan Ng
No abstract text is available yet for this article.
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867060/surgical-complications-of-ankle-joint-arthrodesis-and-ankle-arthroplasty-procedures
#2
REVIEW
Benjamin D Overley, Matthew R Rementer
Total ankle arthroplasty (TAA) and ankle arthrodesis (AA) are complicated surgeries that carry a learning curve with them. Complications are an aspect of all surgeries that must be considered. Surgeons must be prepared to handle these complications. The most important things are early identification and treatment of these complications. Treating complications is a combination of medicines, conservative measures, and most importantly surgical intervention. Recent studies have shown a decrease in complications of TAA and AA over the past 10 years...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867059/revision-total-ankle-arthroplasty
#3
REVIEW
Jerome K Steck, John M Schuberth, Jeffrey C Christensen, Cynthia A Luu
With total ankle arthroplasty, documented complications can be categorized chronologically into intraoperative, postoperative, and late complications. Factors such as patient selection, surgeon experience, implant features, and prosthetic device selection can influence functional outcomes as well as incidence of complications. Even with impeccable surgical technique and optimal patient selection, complications that require revision may still arise and the most common complications with revision solutions are discussed in this article...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867058/complex-total-ankle-arthroplasty
#4
REVIEW
Stephen A Brigido, Scott C Carrington, Nicole M Protzman
Total ankle arthroplasty is a viable surgical technique for the treatment of end-stage degenerative joint disease. With continued advancement in prosthetic design, refined surgical techniques, and improved outcomes, the indications for total ankle replacement have expanded to include cases of increasing complexity. With meticulous preoperative planning and exacting execution, many frontal plane deformities and cases of avascular necrosis can now be successfully addressed at the time of prosthesis implantation or in a staged procedure...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867057/current-concepts-regarding-total-ankle-replacement-as-a-viable-treatment-option-for-advanced-ankle-arthritis-what-you-need-to-know
#5
REVIEW
Christopher L Reeves, Amber M Shane, Ryan Vazales
Much of the current literature suggests that total ankle replacement (TAR) is no longer an inferior or fringe treatment for advanced ankle arthritis compared with ankle fusion, but rather a viable option for recalcitrant arthritic ankle pathology in the correct patient population. In this article, current concepts associated with successful outcomes for TAR are discussed with an emphasis on ankle joint anatomy and biomechanics, preoperative planning and patient selection, understanding pathomechanics and soft tissue balancing, as well as the surgeon's learning curve...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867056/arthroscopic-ankle-arthrodesis-an-update
#6
REVIEW
Jason A Piraino, Michael S Lee
Arthroscopic ankle arthrodesis provides an alternative to open techniques. Advancements in arthroscopic techniques and instrumentation have made the procedure easier to perform. Arthroscopic ankle arthrodesis has demonstrated faster rates of union, fewer complications, reduced postoperative pain, and shorter hospital stays. Sound surgical techniques, particularly with regard to joint preparation, are critical for success. Comorbidities such as increased body mass index, history of smoking, malalignment, and posttraumatic arthritis should be considered when contemplating arthroscopic ankle arthrodesis...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867055/open-ankle-arthrodesis
#7
REVIEW
Samuel S Mendicino, Alexis L Kreplick, Jeremy L Walters
First described in 1879, ankle arthrodesis is a procedure that has undergone significant advancements not only in technique but also in technology and fixation. Surgeon preference has often dictated those changes with regard to incisional approaches, fixation methods, and use of bone graft and biologics but one constant has always remained: open ankle arthrodesis is a predictable, time-tested procedure with consistent results when performed in appropriate patients. This article highlights the changes that have occurred since the introduction of this procedure and provides a brief overview of the preferred technique...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867054/advances-in-ankle-cartilage-repair
#8
REVIEW
Alan Ng, Andrew Bernhard, Kaitlyn Bernhard
Repair of osteochondral lesions of the talus can be difficult. Smaller lesions respond well to simple arthroscopy and microfracture, whereas larger cystic lesions may require allograft talus replacement or ankle fusions. The lesions in between are more difficult to treat. Autologous chondrocyte implantation and matrix-associated autologous chondrocyte implantation have shown promising results. Future research may include new techniques, pharmacologic intervention, and cell-based therapies, and may be better served with prospective observational studies instead of costly randomized controlled studies...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867053/osteochondral-autograft-and-allograft-transplantation-in-the-talus
#9
REVIEW
Alan Ng, Kaitlyn Bernhard
Large, symptomatic, focal chondral, and osteochondral lesions of the ankle are treated with osteochondral autograft/allograft transplantation (OAT) procedure, a reconstructive bone grafting technique that uses one or more cylindrical osteochondral grafts from an area of low impact or allograft source and transplants them into the prepared defect site on the talus. This technique allows defects to be filled with mature, hyaline articular cartilage. Acute or chronic chondral or osteochondral lesions can be debilitating; provided here is a review of osteochondral autograft or allograft transplantation...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867052/supramalleolar-osteotomies
#10
REVIEW
Varun Chopra, Paul Stone, Alan Ng
Distal tibial malalignment can result from posttraumatic malunion, physeal disturbances, congenital or metabolic diseases, and degenerative arthritis. Malalignment leads to an altered load distribution across the joint leading to early ankle joint arthritis. If a substantial part of the joint is salvageable, ankle fusion or joint replacement is not always the best option. Realignment of the distal tibia with a joint-sparing supramalleolar osteotomy is a valuable procedure in correcting deformity at the distal tibia...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867051/arthroscopic-treatment-of-ankle-arthritis
#11
REVIEW
Eric A Barp, John G Erickson, Jennifer L Hall
Ankle arthritis can be broadly classified as primary arthritis (nontraumatic degeneration) or secondary arthritis (post-traumatic degeneration). A good understanding of the anatomic features and presentations associated with each will assist the surgeon in determining the best course of action for each patient. Many variations of both primary and secondary arthritis can be treated conservatively; however, there are many times when conservative therapy is not adequate. In these cases, ankle arthroscopy may be considered before a joint fusion or replacement...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867050/ankle-arthrodiastasis-with-circular-external-fixation-for-the-treatment-of-posttraumatic-ankle-arthritis
#12
REVIEW
Hani M Badahdah, Thomas Zgonis
Ankle arthrodiastasis provides an alternative surgical treatment of the mild to moderate posttraumatic ankle arthritis. Ankle arthrodesis or ankle implant arthroplasty is usually reserved for the end-stage ankle arthritis and after conservative treatment options have been implicated for a long period of time. Ankle joint destructive procedures are often considered for the older and less active population with strict selected surgical criteria and prolonged rehabilitation. In either ankle joint-sparing or ankle destructive procedures, lower extremity deformity correction will need to be addressed before or at the time of index surgery for the overall patient's successful outcome...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867049/nonsurgical-treatment-of-ankle-arthritis
#13
REVIEW
Michael A Gentile
Nonsurgical treatment of ankle arthritis can be a short-term fix or a long-term solution. An understanding of the biomechanics of the ankle is helpful in the successful use of orthotics and bracing. Pharmacologic and/or biologic treatments can be used exclusively or in concert with mechanical interventions to decrease pain, improve function, and potentially extend the life span of an arthritic ankle.
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28576199/foot-and-ankle-arthrodesis
#14
EDITORIAL
John J Stapleton
No abstract text is available yet for this article.
July 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28576198/current-orthobiologics-for-elective-arthrodesis-and-nonunions-of-the-foot-and-ankle
#15
REVIEW
George F Wallace
A fusion rate of 100% would be ideal. Despite adhering to sound surgical principles, complete compliance, and no adverse comorbidities, that 100% fusion rate goal is elusive. Orthobiologics are a special class of materials developed to enhance the fusion rates in foot and ankle arthrodesis sites. Whether orthobiologics are used for the first fusion or reserved for a nonunion is debatable, especially when considering cost.
July 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28576197/soft-tissue-coverage-after-revisional-foot-and-ankle-surgery
#16
REVIEW
Geoffrey G Hallock
Unlike the traumatic "mangled" foot and ankle in which amputation could be an acceptable if not preferred option, revisional foot and ankle surgery starts with a viable foot that is then injured by the surgeon hopefully to benefit the patient. Any untoward sequela, such as inadequate wound healing, instead always requires consideration of limb salvage. Unfortunately, this may not be so simple. A proactive approach to solve this problem in a timely fashion is important. The goal must always be to get a healed wound so the final result improves the ability for independent ambulation by the patient...
July 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28576196/management-of-osteomyelitis-and-bone-loss-in-the-diabetic-charcot-foot-and-ankle
#17
REVIEW
Daniel J Short, Thomas Zgonis
Bone loss and destruction due to diabetic Charcot neuroarthropathy (CN) and osteomyelitis of the foot and ankle is a challenging clinical condition when lower extremity preservation is considered. Resection and excision of osteomyelitis and associated nonviable soft tissue can lead into large osseous and soft tissue defects that will most likely need the utilization of bone grafting and subsequent arthrodesis for stability and anatomic alignment. In the diabetic population with peripheral neuropathy, osseous instability can lead to subsequent lower extremity deformity, ulceration, infection and/or amputation...
July 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28576195/tibiotalocalcaneal-arthrodesis-for-foot-and-ankle-deformities
#18
REVIEW
Patrick R Burns, Augusta Dunse
Tibiotalocalcaneal arthrodesis is a safe and viable option to treat patients with arthridities affecting ankle and subtalar joints, neuromuscular disorders, avascular necrosis of the talus, failed ankle arthrodesis, instability, and Charcot neuroarthropathy. Choice of incision and fixation is based on deformity, pathology, prior surgery and hardware, and surgeon comfort and preference. Intramedullary nails offer high primary stability, reduce sustained soft tissue damage, and may allow for earlier return to activities than traditional plate or screw constructs...
July 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28576194/operative-fixation-options-for-elective-and-diabetic-ankle-arthrodesis
#19
REVIEW
Crystal L Ramanujam, John J Stapleton, Thomas Zgonis
Ankle arthrodesis remains one of the most definitive treatment options for end-stage arthritis, paralysis, posttraumatic and postinfectious conditions, failed total ankle arthroplasty, and severe deformities. The general aims of ankle arthrodesis are to decrease pain and instability, correct the accompanying deformity, and create a stable plantigrade foot. Several surgical approaches have been reported for ankle arthrodesis with internal fixation options. External fixation has also evolved for ankle arthrodesis in certain clinical scenarios...
July 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28576193/hindfoot-arthrodesis-for-the-elective-and-posttraumatic-foot-deformity
#20
REVIEW
John J Stapleton, Thomas Zgonis
Triple (talonavicular, subtalar, and calcaneocuboid) joint arthrodesis and most recently double (talonavicular and subtalar) joint arthrodesis have been well proposed in the literature for surgical repair of the elective, posttraumatic, and/or neuropathic hindfoot deformities. The articulation of the hindfoot with the ankle and midfoot is multiaxial, and arthrodesis of these joints can significantly alter the lower extremity biomechanical manifestations by providing anatomic correction and alignment. This article reviews the indications and preoperative planning for some of the most common procedures to address the hindfoot deformity...
July 2017: Clinics in Podiatric Medicine and Surgery
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