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Foot and Ankle Clinics

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https://www.readbyqxmd.com/read/28502360/preface
#1
EDITORIAL
J Chris Coetzee
No abstract text is available yet for this article.
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502359/pearls-and-pitfalls-for-a-surgeon-new-to-ankle-replacements
#2
REVIEW
Federico Giuseppe Usuelli, Camilla Maccario
The role of the surgeon learning curve in total ankle replacement (TAR) has produced contradictory results. It is important for a new surgeon to know what clinical and radiological parameters are considered reliable and ideal. It is clear that exposure to a high-volume center will increase the reliability of a new surgeon approaching TAR. Implant choice may be influenced by surgeon training, and the debate of mobile versus fix-bearing prosthesis is still open. Anterior versus lateral approach is still an open debate, with any hypothetical advantages given by the direct vision on the center of rotation to be proven...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502358/is-there-anything-to-learn-from-a-national-joint-registry
#3
REVIEW
Dawson Muir
National joint registries (NJRs) have been established in Northern Europe for over 20 years. Since then, many other countries have begun collecting and reporting national data for total ankle arthroplasty (TAA). With relatively small numbers implanted, a large variety of available designs, and with any long-term reports dominated by designer groups, TAA is ideally placed to benefit from large national or even pooled national registries. This article reviews the existing registry-based literature with respect to what is already known...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502357/experience-with-navigation-in-total-ankle-arthroplasty-is-it-worth-the-cost
#4
REVIEW
Christopher W Reb, Gregory C Berlet
Optimal placement of correctly sized total ankle replacement (TAR) implants is elemental to prolonging the working life. The negative mechanical effects of implant malalignment are well characterized. There is one FDA-approved navigated TAR system with limited but encouraging outcomes data. Therefore, its value can be estimated only based on benefits other than a proven clinical outcomes improvement over conventional systems. These include unique preoperative planning through 3-dimensional templating and virtual surgery and the patient-specific cut guides, which also reduce overall instrumentation needed for the case...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502356/dealing-with-the-stiff-ankle-preoperative-and-late-occurrence
#5
REVIEW
Beat Hintermann, Roxa Ruiz, Alexej Barg
In patients with a stiff ankle replacement, appropriate resection of scarred capsular structures, hypertrophic bone debridement, and careful release of tendons should be performed to achieve good outcomes. Appropriately sized and correctly implanted components are required to restore ankle function to as normal as possible. Although not proven, the better a total ankle replacement is balanced, the less likely scar and heterotopic bone formation will occur. In patients with a stiff and painful ankle replacement, a preoperative diagnostic workup is mandatory to understand the underlying pathologic process and plan appropriate treatment...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502355/how-to-diagnose-and-treat-infection-in-total-ankle-arthroplasty
#6
REVIEW
Yousef Alrashidi, Ahmed E Galhoum, Martin Wiewiorski, Mario Herrera-Pérez, Raymond Y Hsu, Alexej Barg, Victor Valderrabano
Periprosthetic infection after total ankle arthroplasty (TAA) is a serious complication, often requiring revision surgery, including revision arthroplasty, conversion to ankle arthrodesis, or even amputation. Risk factors for periprosthetic ankle infection include prior surgery at the site of infection, low functional preoperative score, diabetes, and wound healing problems. The clinical presentation of patients with periprosthetic ankle joint infection can be variable and dependent on infection manifestation: acute versus chronic...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502354/soft-tissue-reconstruction-after-total-ankle-arthroplasty
#7
REVIEW
Yash J Avashia, Ronnie L Shammas, Suhail K Mithani, Selene G Parekh
Wound complications following total ankle replacement are common. A team approach, including plastic surgeons, should be utilized to manage these wound issues. The handling of the wound, from the index procedure, to a variety of flaps, can be utilized to provide a successful outcome following an ankle replacement.
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502353/management-of-talar-component-subsidence
#8
REVIEW
Shu-Yuan Li, Mark S Myerson
Component subsidence has been found to be the top complication that leads to failure of the total ankle arthroplasty (TAA). The cause of subsidence formation is unclear, and is multifactorial. Talar subsidence is more frequently met than tibial subsidence, and the subsequent big bone loss is demanding to handle. As a revision treatment option, neither a revision TAA nor a salvage ankle and/or hindfoot arthrodesis procedure is easy to perform or can obtain a definite outcome. The Salto XT can be used to treat most of the TAA systems available for use in the United States with acceptable short-term outcomes...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502352/revision-of-stemmed-agility-implants
#9
REVIEW
Michael M Brage, Uma E Ramadorai
Total ankle arthroplasty has advanced rapidly in the last 20 years. Early agility implants enjoyed improved survivability compared with more archaic total ankle implants. When talar subsidence occurs, the revision options include a stemmed component to improve stability by spanning the subtalar joint. Removal and revision of these stemmed components can be difficult because of ingrowth and bone loss.
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502351/malalignment-correction-of-the-lower-limb-before-during-and-after-total-ankle-arthroplasty
#10
REVIEW
Taggart T Gauvain, Michael A Hames, William C McGarvey
One of the main challenges in ankle replacement is correction of any deformities in the operative limb. Deformity can be found proximal and distal to the ankle joint as well as in the ankle joint. There are static and dynamic deformities that can create unbalanced ankle joints causing early and often catastrophic failure. Surgeons must recognize the deformities that are present and use sound judgment to balance the ankle joint with procedures before, during, or after total ankle implantation. This article helps clinicians to identify deformity and provides a basic template to consider how to address each challenge...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502350/current-update-in-total-ankle-arthroplasty-salvage-of-the-failed-total-ankle-arthroplasty-with%C3%A2-anterior-translation-of-the-talus
#11
REVIEW
Alastair Younger, Andrea Veljkovic
Ankle replacement results may be compromised by malposition of the components. An anterior displacement can be measured on a lateral standing radiograph. The ankle may appear anteriorly translated because the ankle is overstuffed, the heel cord is tight, or the posterior capsule is tight. In ankle instability with degenerative arthritis, the talus may be anteriorly translated, internally rotated, and in varus. In an ankle replacement, this deformity may persist and will require correction. On occasion, the talus is inserted too anterior; revision to a flat cut talar component and posterior translation of the talar component will result in correction...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502349/total-ankle-replacement-in-the-presence-of-talar-varus-or-valgus-deformities
#12
REVIEW
Andrew Dodd, Timothy R Daniels
Patients presenting with end-stage ankle arthritis with coronal plane talar deformities have a variety of complex multidirectional deformities that require careful preoperative assessment and a clear understanding of the pathophysiology. Surgeons managing these patients with total ankle arthroplasty need to be familiar with extra-articular and intra-articular surgical methods to correct pes planus and pes cavus deformities, including bony procedures and soft tissue procedures. Performing these procedures in 1 or 2 stages depends on surgeon preference and the severity of the deformities...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502348/osteolysis-in-total-ankle-replacement-how-does-it-work
#13
REVIEW
Norman Espinosa, Georg Klammer, Stephan H Wirth
Aseptic loosening of implants remains the most common reason for revision surgery for hip, knee, or ankle prostheses. Although a great scientific effort has been made to explain the underlying mechanisms it remains poorly understood, complex, and multifactorial. Many factors, including age, body weight, activity lesions, implant design, fixation methods, material proprieties, immunologic responses, and biomechanical adaptations to total ankle replacement all contribute to the development of periprosthetic osteolysis...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502347/ankle-arthrodesis-versus-total-ankle-arthroplasty
#14
REVIEW
Joel Morash, David M Walton, Mark Glazebrook
Reoperation rates are higher in total ankle arthroplasties (TAAs) compared with ankle arthrodesis. Infection rates for primary TAAs are 1.4% to 2.4%. The survival rate of TAA is approximately 75% to 90% at 10 years. Arc of motion is maintained with TAAs compared with ankle arthrodesis. Ankle arthrodesis increases arc of motion through the talonavicular joint. Several factors are strong reasons to favor ankle fusion rather than TAA. TAA and ankle arthrodesis are effective treatments of end-stage ankle arthritis but the choice must be tailored to individual patients...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502346/kinematics-and-function-of-total-ankle-replacements-versus-normal-ankles
#15
REVIEW
Justin M Kane, Scott Coleman, James W Brodsky
End-stage ankle arthritis produces severe functional disability, quantifiable by gait abnormalities. In all categories of gait parameters, total ankle arthroplasty (TAA) satistically significantly improves function, compared to patients' preoperative function. There are increases in step length, cadence and velocity; in sagittal plane motion of the ankle, as well has hip and knee motion, and in ankle power and moment. These functional gait improvements correspond to clinical improvements of pain relief and satisfaction...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167068/current-controversies-in-foot-and-ankle-trauma
#16
EDITORIAL
Michael P Swords
No abstract text is available yet for this article.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167067/early-fixation-of-calcaneus-fractures
#17
REVIEW
Michael P Swords, Phillip Penny
The treatment of calcaneus fractures is controversial. Historically, most operatively treated fractures have been approached with a lateral extensile incision requiring delay in operative treatment until swelling has improved. There is a current trend and interest in small incision approaches allowing, and in some cases requiring, earlier operative fixation. Clinical scenarios amenable to consideration for early fixation are reviewed. The sinus tarsi surgical approach and reduction techniques are outlined in detail...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167066/calcaneal-fracture-management-extensile-lateral-approach-versus-small-incision-technique
#18
REVIEW
Nathan J Kiewiet, Bruce J Sangeorzan
Calcaneal fracture management has historically been a controversial topic and represents an area of sustained interest over the past several decades. The authors review current methods for calcaneal fracture fixation with an extensile lateral approach and small incision techniques. Early reports of small incision techniques have reported promising outcomes and reduced risks for complications. These techniques may be beneficial to reduce the risk of soft tissue complications and improve the rate of recovery.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167065/late-treatment-of-syndesmotic-injuries
#19
REVIEW
Michael P Swords, Andrew Sands, John R Shank
Normal syndesmosis anatomy and alignment are essential to ankle function. Although injuries to the syndesmosis are common with ankle injuries, accurate diagnosis and reduction continue to be a challenge. Late reconstruction for syndesmosis is reviewed. A surgical technique for late reconstruction is outlined in detail.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167064/syndesmosis-stabilisation-screws-versus-flexible-fixation
#20
REVIEW
Matthew C Solan, Mark S Davies, Anthony Sakellariou
Orthopedic surgery is not short of situations where there is controversy regarding optimum management. Treating ankle syndesmosis injuries is an example where practice varies widely and there are many questions that remain unsatisfactorily answered. When addressing the type of syndesmosis stabilization that is required it is essential to ascertain the extent of instability. Only then can a logical approach to restoring the ankle mortise be achieved. Fixation of fibula shaft fractures and posterior malleolus fractures can restore sufficient stability to render syndesmosis stabilization unnecessary...
March 2017: Foot and Ankle Clinics
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