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Total ankle replacement

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https://www.readbyqxmd.com/read/28444407/-aseptic-loosening-of-total-ankle-replacement-and-conversion-to-ankle-arthrodesis
#1
M D Wimmer, M Hettchen, M M Ploeger, B Hintermann, D C Wirtz, A Barg
OBJECTIVE: To remove loosened prosthesis components, to perform augmentation, to address osseous defects, to perform neutrally aligned ankle arthrodesis, and to achieve postoperative pain relief. INDICATIONS: Symptomatic, aseptic loosening of total ankle replacement (TAR) with/without substantial bone defect of the tibial and/or talar bone stock. CONTRAINDICATIONS: General surgical or anesthesiological risks, periprosthetic infection, local or systemic infection, nonmanageable soft tissue problems...
April 25, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28425054/can-a-three-component-prosthesis-be-used-for-conversion-of-painful-ankle-arthrodesis-to-total-ankle-replacement
#2
Markus Preis, Travis Bailey, Lucas S Marchand, Alexej Barg
BACKGROUND: In patients with painful ankle arthrodesis, the surgical treatment is challenging, and may include takedown of ankle arthrodesis and conversion to a total ankle replacement (TAR). This procedure is technically demanding given the altered anatomy after arthrodesis. Few studies have evaluated TAR in the setting of prior arthrodesis. QUESTIONS/PURPOSES: (1) What intraoperative and perioperative complications were observed in patients who underwent conversion of an ankle arthrodesis to a TAR? (2) Was durable fixation achieved at short term, and what was the alignment of the components? (3) What subsequent surgical procedures were performed, including revisions? (4) What improvements were observed in pain, tibiotalar range of motion (ROM), and quality of life? METHODS: Between January 2007 and December 2014, 18 patients with a painful ankle arthrodesis underwent conversion to TAR at our tertiary referral center...
April 19, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28423941/guide-pin-placement-technique-for-total-ankle-replacement-in-patients-who-had-ipsilateral-total-knee-arthroplasty
#3
Natalie Hua, Aprajita Nakra, Jerome K Steck
We describe a simple technique for guide pin placement for total ankle replacement in patients who underwent previous ipsilateral total knee arthroplasty. LEVELS OF EVIDENCE: Level V.
April 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28405708/-supramalleolar-osteotomy-in-asymmetric-ankle-osteoarthritis-short-term-clinical-and-radiographic-results
#4
A Barg, M Wiewiorski, J Paul, M Wurm, M Jacxsens, K Nykytina, V Valderrabano
BACKGROUND: The main indication for the supramalleolar osteotomy is asymmetric ankle osteoarthritis with concomitant supramalleolar valgus or varus deformity. The aim of this prospective study was to analyze short-term clinical and radiographic outcomes in patients with asymmetric ankle osteoarthritis. METHODS: A total of 16 patients with asymmetric ankle osteoarthritis and concomitant supramalleolar deformity - 7 patients with valgus deformity, 9 patients with varus deformity - were treated...
April 12, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28375890/ratio-of-range-of-motion-of-the-ankle-and-surrounding-joints-after-total-ankle-replacement-a-radiographic-cohort-study
#5
Travis J Dekker, Kamran S Hamid, Mark E Easley, James K DeOrio, James A Nunley, Samuel B Adams
BACKGROUND: This study attempted to identify where motion occurs after total ankle replacement, the difference in range-of-motion contributions between fixed-bearing and mobile-bearing total ankle replacements, and the contribution of abnormal peritalar motion. We hypothesized that sagittal plane radiographic assessment would demonstrate that actual ankle motion through the prosthesis is less than the total arc of ankle motion that may be observed clinically secondary to contributions from adjacent joints...
April 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28367694/long-term-follow-up-of-arthrodesis-vs-total-joint-arthroplasty-for-hallux-rigidus
#6
Oliver D Stone, Robbie Ray, Colin E Thomson, J N Alastair Gibson
BACKGROUND: The optimal operative management of hallux rigidus is still a matter for debate among surgeons. Despite arthrodesis widely considered to be the gold standard treatment, many surgeons advocate arthroplasty as a suitable alternative. There are, however, few long-term or high-quality studies evaluating these modalities. We present the 15-year follow-up of a randomized controlled trial. METHODS: This data is the follow-up to the original study published in 2005...
April 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28367692/operative-wound-complications-following-total-ankle-arthroplasty
#7
Christopher E Gross, Kamran S Hamid, Cynthia Green, Mark E Easley, James K DeOrio, James A Nunley
BACKGROUND: Wound complications following total ankle replacement (TAR) potentially lead to devastating consequences. The aim of this study was to compare the operative and demographic differences in patients with and without major wound problems which required operative management. We hypothesized that increased tourniquet and operative time would negatively influence wound healing. METHODS: We identified a consecutive series of 762 primary TARs performed between December 1999 and April 2014 whose data were prospectively collected...
April 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28367690/histological-analysis-of-early-osteolysis-in-total-ankle-arthroplasty
#8
Oliver N Schipper, Steven L Haddad, Peter Pytel, Ying Zhou
BACKGROUND: The purpose of this study was to perform a histological comparative analysis of tibiotalar joint samples taken from areas of osteolysis adjacent to total ankle arthroplasties vs control synovial specimens to determine the reaction to and presence of polyethylene (PE) particles. METHODS: A total of 57 pathology samples were identified in the osteolysis group, while 11 were identified in the control group. For each sample, hematoxylin and eosin, Oil Red O (ORO), and macrophage marker CD163-stained slides were created...
April 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28361015/development-of-an-internally-braced-prosthesis-for-total-talus-replacement
#9
Markus Regauer, Mirjam Lange, Kevin Soldan, Steffen Peyerl, Sebastian Baumbach, Wolfgang Böcker, Hans Polzer
Total loss of talus due to trauma or avascular necrosis, for example, still remains to be a major challenge in foot and ankle surgery with severely limited treatment options. Implantation of a custom made total talar prosthesis has shown promising results so far. Most important factors for long time success are degree of congruence of articular surfaces and ligamentous stability of the ankle. Therefore, our aim was to develop an optimized custom made prosthesis for total talus replacement providing a high level of primary stability...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28358975/age-related-outcome-of-mobile-bearing-total-ankle-replacement
#10
Federico G Usuelli, Camilla Maccario, Riccardo D'Ambrosi, Michele F Surace, Ettore Vulcano
The aim of this study was to investigate clinical and radiographic outcomes in patients 50 years and younger vs patients older than 50 years undergoing total ankle replacement. Seventy consecutive patients who underwent primary total ankle replacement were included in this retrospective study. Patients were assessed clinically and radiographically. There was a statistically significant difference between the 2 groups for the American Orthopaedic Foot & Ankle Society score at final follow-up. The younger group had significantly greater improvement compared with the older group...
March 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28306181/total-ankle-replacement-in-patients-with-haemophilic-arthropathy-primary-arthroplasty-and-conversion-of-painful-ankle-arthrodesis-to-arthroplasty
#11
M Preis, T Bailey, M Jacxsens, A Barg
INTRODUCTION: There are two general surgical approaches for operative treatment of end-stage haemophilic ankle arthropathy: ankle arthrodesis and total ankle replacement (TAR). AIM: The aim of this study was to determine intraoperative and postoperative complications and evaluate the mid-term clinical and radiographic outcomes of TAR in patients with haemophilic arthropathy. METHODS: Fourteen patients with a mean age of 51.4 ± 10.2 years (range = 32...
March 17, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28276651/realignment-surgery-for-malunited-ankle-fracture
#12
Chang-Jun Guo, Xing-Cheng Li, Mu Hu, Yang Xu, Xiang-Yang Xu
OBJECTIVE: To investigate the characteristics and the results of realignment surgery for the treatment of malunited ankle fracture. METHODS: Thirty-three patients with malunited fractures of the ankle who underwent reconstructive surgery at our hospital from January 2010 to January 2014 were reviewed. The tibial anterior surface angle (TAS), the tibiotalar tilt angle (TTA), the malleolar angle (MA), and the tibial lateral surface angle (TLS) were measured. Clinical assessment was performed with use of the American Orthopaedic Foot and Ankle Society (AOFAS) scale and visual analogue scale (VAS) scores, and the osteoarthritis stage was determined radiographically with the modified Takakura classification system...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28268144/total-ankle-replacement-with-severe-valgus-deformity-technique-and-surgical-strategy
#13
John M Schuberth, Jeff C Christensen, Chad L Seidenstricker
Correction of severe valgus deformity of the foot and ankle with ankle replacement is challenging. We describe the controversies and specific issues of surgical management and provide a detailed surgical strategy for management of this common deformity. A reliable technique for deltoid reconstruction is also described and illustrated in detail.
March 3, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28216304/ankle-arthrodesis-a-retrospective-analysis-comparing-single-column-locked-anterior-plating-to-crossed-lag-screw-technique
#14
Mark A Prissel, G Alex Simpson, Sean A Sutphen, Christopher F Hyer, Gregory C Berlet
Ankle arthrodesis is performed to eliminate pain due to end-stage osteoarthritis, regardless of etiology. This procedure remains the reference standard treatment for end-stage ankle arthritis, despite recent advancements in total ankle replacement. The objective of the present study was to retrospectively evaluate the radiographic and clinical fusion rates and time to bony fusion for patients who underwent ankle arthrodesis using an anterior approach with a single column locked plate construct versus crossed lag screws...
February 16, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28196041/change-in-talar-translation-in-the-coronal-plane-after-mobile-bearing-total-ankle-replacement-and-its-association-with-lower-limb-and-hindfoot-alignment
#15
Young Yi, Jae-Ho Cho, Ji-Beom Kim, Jae-Young Kim, Su-Yeon Park, Woo Chun Lee
BACKGROUND: Mobile-bearing total ankle replacement (TAR) enables motion at the tibial implant-polyethylene insert interface. This motion could lead to coronal translation of the talus relative to the tibia and may affect radiographic outcome. We aimed to assess the translation of the talus before and after mobile-bearing TAR to determine whether translation of the talus after TAR is associated with coronal plane alignment of the lower limb and hindfoot as well as to investigate the complications associated with talar translation...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28196036/a-prospective-study-of-four-total-ankle-arthroplasty-implants-by-non-designer-investigators
#16
Tina Lefrancois, Alastair Younger, Kevin Wing, Murray J Penner, Peter Dryden, Hubert Wong, Timothy Daniels, Mark Glazebrook
BACKGROUND: There are several types of prostheses available to surgeons when performing a total ankle arthroplasty (TAA). The main objective of this study was to summarize the clinical and functional outcomes of 4 TAA prostheses: the Hintegra implant (Integra LifeSciences), the Agility implant (DePuy), the Mobility implant (DePuy), and the Scandinavian Total Ankle Replacement (STAR) implant (Small Bone Innovations [SBi]). METHODS: Patients were prospectively recruited...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28169136/in-vitro-wear-of-ultrahigh-molecular-weight-polyethylene-and-vitamin-e-blended-highly-cross-linked-polyethylene-in-linked-semiconstrained-total-elbow-replacement-prostheses
#17
Oludele O Popoola, Brian L Kincaid, Kimberly Mimnaugh, Mark Marqueling
BACKGROUND: The objectives of this study were to develop a clinically relevant in vitro elbow wear test and to compare the polyethylene wear of 2 total elbow replacement prostheses, one that uses conventional gamma-irradiated polyethylene (CPE) and one that uses vitamin E blended and cross-linked polyethylene (VE-HXPE) bushings. MATERIALS AND METHODS: The test protocol applied 0° to 85° flexion-extension motions and imposed a constant 4.5° varus malalignment of the ulnar relative to the humeral implant under a variable joint load profile at a frequency of 1 Hz...
February 3, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28144149/can-achilles-tendon-be-used-as-a-new-distal-landmark-for-coronal-tibial-component-alignment-in-total-knee-replacement-surgery-an-observational-mri-study
#18
Uğur Tiftikçi, Sancar Serbest, Veysel Burulday
BACKGROUND: In total knee arthroplasty, it is better to use more than one reference point for correct alignment of the components. By measuring the distances of Achilles tendon (AT) and other conventional landmarks from the mechanical axis in magnetic resonance imaging (MRI) of the ankle, we aimed to demonstrate that, as a novel landmark which can help for correct alignment in the coronal plane, AT is a better option than other landmarks. MATERIALS AND METHODS: This retrospective study was done on 53 ankle MRIs that met the criteria for inclusion to the study among 158 ankle MRIs...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28139190/patient-specific-instrumentation-for-total-knee-arthroplasty
#19
Arash Nabavi, Caroline M Olwill, Mike Do, Tanya Wanasawage, Ian A Harris
PURPOSE: To assess the accuracy of total knee replacements (TKRs) performed using CT-based patient-specific instrumentation by postoperative CT scan. METHOD: Approval from the Ethics Committee was granted prior to commencement of this study. Fifty prospective and consecutive patients who had undergone TKR (Evolis, Medacta International) using CT-based patient-specific instrumentation (MY KNEE, Medacta International) were assessed postoperatively using a CT scan and the validated Perth protocol measurement technique...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28129322/perioperative-physiotherapy-for-total-ankle-replacement-in-patients-with-inherited-bleeding-disorders-outline-of-an-algorithm
#20
Andrzej Kotela, Magdalena Wilk-Frańczuk, Joanna Jaczewska, Piotr Żbikowski, Paweł Łęgosz, Paweł Ambroziak, Ireneusz Kotela
The treatment of end-stage hemophilic arthropathy of the ankle joint remains a controversial problem, and total ankle replacement (TAR) is considered to be a valuable management option. Physiotherapy continues to be an extremely important part of TAR and has a tremendous impact on the outcomes of this procedure. Given the lack of data on the latter, this study details a protocol of perioperative physiotherapy in TAR in patients with inherited bleeding disorders (IBD). The protocol outlined in this paper was devised via consultations within an interdisciplinary group, the authors' own experiences with TAR in hemophilic and non-hemophilic patients, previous reports on this issue in the literature, and patient opinions...
January 27, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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