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Foot and Ankle Clinics

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https://www.readbyqxmd.com/read/27871424/orthobiologic-in-foot-ankle
#1
EDITORIAL
Sheldon S Lin
No abstract text is available yet for this article.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871423/the-science-behind-surgical-innovations-of-the-forefoot
#2
REVIEW
Judith F Baumhauer, Michele Marcolongo
One of the areas of foot and ankle surgery that has had particular attention over the last 5 years has been forefoot surgery. Common procedures include correction of the lessor metatarsophalangeal joints and hammertoe deformities, specifically metatarsal shortening osteotomies and proximal interphalangeal joint fusions. The goals of these surgeries are to improve patient function and allow patients to fit into shoes more comfortably in metatarsal shortening and hammertoe.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871422/the-science-behind-wear-testing-for-great-toe-implants-for-hallux-rigidus
#3
REVIEW
Judith F Baumhauer, Michele Marcolongo
Various methods of repairing damaged articular cartilage surfaces have been proposed and a variety of implant materials have been tried in an attempt to decrease pain and improve function after cartilage repair. The hydrogel made of polyvinyl alcohol and saline is a unique material used as an implant in the great toe for advanced stage arthritis.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871421/mesenchymal-stem-cell-bearing-sutures-for-tendon-repair-and-healing-in-the-foot-and-ankle
#4
REVIEW
Eric W Tan, Lew C Schon
Improving the quality and strength of soft tissue repairs remains an important area of orthopedic research and innovation. The need for immobilization and early motion is an important balance essential for the successful treatment of tendon repair and reconstruction. Mesenchymal stem cell (MSC)-bearing sutures represent an emerging biological augmentation to traditional suture repair. Two previous large studies using stem cell sutures in rat Achilles tendon models have demonstrated early increased biomechanical strength and significantly increased ultimate failure strength...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871420/platelet-rich-plasma-and-concentrated-bone-marrow-aspirate-in-surgical-treatment-for-osteochondral-lesions-of-the-talus
#5
REVIEW
Youichi Yasui, Andrew W Ross, John G Kennedy
Platelet-rich plasma (PRP) and concentrated bone marrow aspirate (CBMA) have the potential to improve the quality of cartilage repair in osteochondral lesions of the talus (OLT). In this review, we describe the basic science and clinical evidence that has been published on the topic of PRP and CBMA on 2 commonly used surgical techniques for the treatment of OLT: bone marrow stimulation and osteochondral autograft transfer.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871419/the-use-of-allostem-in-subtalar-fusions
#6
REVIEW
J Chris Coetzee, Mark S Myerson, John G Anderson
Subtalar arthrodesis is the mainstay for treatment of a variety of hindfoot problems associated with arthritis, however with an unpredictable if not high rate of nonunion. This article covers the use of adipose-derived stem cells as an adjunct or alternative to autologous or other bone grafting materials. Promising development and encouraging data exist with respect to the use of adipose-derived mesenchymal stem cells for bone arthrodesis, which is discussed in more detail in the article.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871418/efficacy-of-a-cellular-allogeneic-bone-graft-in-foot-and-ankle-arthrodesis-procedures
#7
REVIEW
Travis J Dekker, Peter White, Samuel B Adams
A cellular allogeneic bone graft can be used in patients at high risk for nonunion after arthrodesis surgery. This study explores the utility and efficacy of MAP3 in foot and ankle arthrodesis procedures. Map3 is a cellular allogeneic bone graft that contains osteogenic, osteoconductive, osteoinductive, and angiogenic properties. A total of 23 mostly high-risk patients were included in this study. The overall fusion rate was 83%. Univariate analysis demonstrated diabetic patients remain at risk of recurrent nonunion (P<...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871417/large-bm-intra-articular-allograft
#8
REVIEW
Joan R Williams, Michael E Brage
Posttraumatic tibiotalar arthritis is a challenging problem in young, active patients. Many of these patients do not want to pursue ankle arthrodesis after they fail conservative treatment measures, as they wish to preserve joint motion. Osteochondral shell allograft arthroplasty has been described as a reasonable alternative for treating these patients. The procedure itself is technically demanding; however, with improvements in surgical technique and adequate preoperative patient counseling, it provides improvement in ankle function and has good outcomes for most patients at long-term follow-up...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871416/bone-marrow-aspirate-concentrate-for-bone-healing-in-foot-and-ankle-surgery
#9
REVIEW
Joshua S Harford, Travis J Dekker, Samuel B Adams
Autologous bone marrow aspirate concentrate (BMAC) has become a popular orthobiologic to augment bone healing. The potential benefit comes from osteoprogenitor cells and growth factors that can lead to new bone formation in the setting of foot and ankle arthrodesis procedures. BMAC has an excellent safety record and has demonstrated efficacy in animal models of bone healing. Although scant, the literature on the use of BMAC in foot and ankle surgery does demonstrate promise for this orthobiologic adjuvant.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871415/autologous-bone-graft-in-foot-and-ankle-surgery
#10
REVIEW
Christopher P Miller, Christopher P Chiodo
Bone graft is a common adjunct procedure in orthopedic surgery used for fusions, fracture repair, and the reconstruction of skeletal defects in the foot and ankle. Autologous graft, or autograft, involves the transport of bone from a donor site to another location in the same patient. It is considered by many to be the gold standard of bone grafting, as it is provides all biologic factors required for functional graft. Further, autograft is 100% histocompatible with no risk of disease transmission.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871414/orthobiologics-in-the-foot-and-ankle
#11
REVIEW
H Thomas Temple, Theodore I Malinin
Many allogeneic biologic materials, by themselves or in combination with cells or cell products, may be transformative in healing or regeneration of musculoskeletal bone and soft tissues. By reconfiguring the size, shape, and methods of tissue preparation to improve deliverability and storage, unique iterations of traditional tissue scaffolds have emerged. These new iterations, combined with new cell technologies, have shaped an exciting platform of regenerative products that are effective and provide a bridge to newer and better methods of providing care for orthopedic foot and ankle patients...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871413/b2a-polypeptide-in-foot-and-ankle-fusion
#12
REVIEW
Mark Glazebrook, Diana S Young
Foot and ankle fusion procedures often incorporate autogenous bone graft to help achieve bony union. Pain and morbidity associated with graft harvest have resulted in decreased autograft use as alternative bone graft substitutes have become available. Recently B2A peptide-coated ceramic granules have been developed and investigated. B2A, a bioactive synthetic multi-domain peptide acting on bone morphogenetic protein receptors of osteoblast precursor cells, amplifies the cell response to bone morphogenetic proteins...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871412/role-of-recombinant-human-bone-morphogenetic-protein-2-on-hindfoot-arthrodesis
#13
REVIEW
Jeremy Hreha, Ethan S Krell, Christopher Bibbo
Despite advances in understanding bone healing physiology and surgical techniques, delayed union and nonunion still occur after the treatment of hindfoot arthrodesis. There is increasing appeal of bone morphogenetic proteins (BMPs) owing to the innate osteoinductive abilities of BMPs. Effective treatment with BMPs has been shown in animal studies. Human clinical studies have also shown success. The only study investigating the use of recombinant human BMP (rhBMP)-2 in hindfoot arthrodesis found a significant increase in fusion rate...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871411/injectable-recombinant-human-platelet-derived-growth-factor-in-collagen-carrier-for-hindfoot-fusion
#14
REVIEW
Andrew Dodd, Timothy R Daniels
Arthrodesis of the hindfoot is a common procedure for degenerative joint disease and/or severe deformity. Nonunion is a common complication from this procedure, causing an increased burden to the patient and health care system, often resulting in the need for revision surgery. Recombinant human platelet-derived growth factor (rhPDGF) has been shown to be a safe and effective tool to enhance arthrodesis rates in hindfoot surgery while avoiding the potential morbidity of bone grafting. This article provides a review of the role of rhPDGF in hindfoot fusions, and the surgical technique for performing an rhPDGF enhanced double-arthrodesis through a medial approach...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871410/vancouver-experience-of-recombinant-human-platelet-derived-growth-factor
#15
REVIEW
Alistair Younger, Murray Penner, Harvey E Montijo
Joint arthrodesis utilizing autogenous bone graft remains the gold standard of treatment in fusion procedures of the foot and ankle. Graft harvest, however, has been associated with increased morbidity to patients as well as increased costs. With this in mind, multiple clinical studies have evaluated the efficacy of recombinant human platelet-derived growth factor (rh-PDGF-BB) with beta-tricalcium phosphate (B-TCP) to augment in foot and ankle arthrodesis with favorable results. These factors have led to the increased use of rh-PDGF-BB with B-TCP in Vancouver with good clinical results...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871409/the-efficacy-of-platelet-derived-growth-factor-as-a-bone-stimulating-agent
#16
REVIEW
Ethan S Krell, Christopher W DiGiovanni
Nonunion remains the most impactful complication following ankle and hindfoot arthrodesis. Historically, surgeons have relied on autologous bone graft (ABG) to combat nonunion risk. Although effective, ABG remains limited in quantity, varies in quality, and can be associated with harvest site pain and morbidity. Use of alternative bone-stimulating agents, however, avoids harvesting an autograft, and provides a more predictable dose-response efficacy. This article highlights findings from basic science, animal, and human clinical research that led to the approval of Augment Bone Graft...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871408/the-biology-of-bone-and-ligament-healing
#17
REVIEW
Jessica A Cottrell, Jessica Cardenas Turner, Treena Livingston Arinzeh, J Patrick O'Connor
This review describes the normal healing process for bone, ligaments, and tendons, including primary and secondary healing as well as bone-to-bone fusion. It depicts the important mediators and cell types involved in the inflammatory, reparative, and remodeling stages of each healing process. It also describes the main challenges for clinicians when trying to repair bone, ligaments, and tendons with a specific emphasis on Charcot neuropathy, fifth metatarsal fractures, arthrodesis, and tendon sheath and adhesions...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871407/the-role-of-orthobiologics-in-fracture-healing-and-arthrodesis
#18
REVIEW
Sheldon S Lin, Michael G Yeranosian
Nonunion after tibial shaft fracture and hindfoot arthrodesis remains a major problem. Known risk factors include advanced age, immunosuppression, smoking, and diabetes. Several factors must be considered in the fracture healing process. This review evaluates the efficacy of orthobiologics in improving union rates after fracture or arthrodesis. Use of compounds have shown increased cellular proliferation experimentally. Percutaneous autologous bone marrow has shown increased cellular proliferation. Matrix supplementation has shown significant improvements in bone healing...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27524713/advances-in-minimally-invasive-surgery-of-the-foot-and-ankle-percutaneous-arthroscopic-and-endoscopic-operative-techniques
#19
EDITORIAL
Anthony Perera
No abstract text is available yet for this article.
September 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27524712/arthroscopic-subtalar-double-and-triple-fusion
#20
REVIEW
Richard Walter, Stephen Parsons, Ian Winson
Arthroscopic approaches to subtalar, double, and triple arthrodesis allow relative preservation of the soft tissue envelope compared with traditional open approaches. The surgical technique involving the use of a 4.5-mm 30° arthroscope via sinus tarsi portals is described. All 3 joints of the triple joint can be prepared for fusion with motorized burrs. Rigid fixation is achieved with cannulated screws. High union rates and low complication rates have been reported.
September 2016: Foot and Ankle Clinics
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