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Ankle arthrodesis

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https://www.readbyqxmd.com/read/27935562/current-conservative-management-and-classification-of-club-foot-a-review
#1
Ganesan Balasankar, Ameersing Luximon, Adel Al-Jumaily
Clubfoot, known as congenital talipes equinovarus, is one of the complex paediatric foot deformity with the incidence of 1 in every 1000 live births. It consists of four complex foot abnormalities such as forefoot adductus, midfoot cavus, and hindfoot varus and ankle equinus. There are a number of surgical techniques (soft tissue releases, arthrodesis) used to correct clubfoot. However currently the conservative management (manipulation, serial casting, and braces) of clubfoot is considered as the best choice and it is widely accepted among orthopaedists...
November 30, 2016: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/27926682/clinical-outcomes-of-nonunions-of-hindfoot-and-ankle-fusions
#2
Fabian Krause, Alastair S E Younger, Judith F Baumhauer, Timothy R Daniels, Mark Glazebrook, Peter T Evangelista, Michael S Pinzur, Gowreeson Thevendran, Rafe M J Donahue, Christopher W DiGiovanni
BACKGROUND: While nonunion after foot and ankle fusion surgery has been associated with poor outcomes, we are not aware of any longitudinal study on this subject. Thus, we prospectively evaluated the impact of nonunion on clinical outcomes of foot and ankle fusions and identified potential risk factors for nonunion after these procedures. METHODS: Using data from a randomized clinical trial on recombinant human platelet-derived growth factor-BB (rhPDGF-BB; Augment Bone Graft, BioMimetic Therapeutics), union was defined either by assessment of computed tomography (CT) scans at 24 weeks by a reviewer blinded to the type of treatment or by the surgeon's composite assessment of clinical and radiographic findings at 52 weeks and CT findings at 24 or 36 weeks...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27923216/efficacy-of-a-cellular-bone-allograft-for-foot-and-ankle-arthrodesis-and-revision-nonunion-procedures
#3
Travis J Dekker, Peter White, Samuel B Adams
BACKGROUND: Bone graft substitutes are often required in patients at risk for nonunion, and therefore, an allograft that most closely mimics an autograft is highly sought after. This study explored the utility and efficacy of a cellular bone allograft used for foot and ankle arthrodesis and revision nonunion procedures in a patient population at risk for nonunion. METHODS: An institutional review board-approved retrospective review of consecutive patients who underwent arthrodesis and revision nonunion procedures with a cellular bone allograft was performed at a single academic institution...
October 23, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27920332/comparison-of-ankle-fusion-rates-with-and-without-anterior-plate-augmentation
#4
Phillip M Mitchell, Diana G Douleh, A Brian Thomson
BACKGROUND: The optimal fixation construct for tibiotalar arthrodesis continues to be debated. While biomechanical data and clinical series support anterior plate augmentation, comparative studies assessing its use are sparse. The purpose of this study was to compare the rates of successful tibiotalar arthrodesis with and without anterior plate augmentation of a compression screw construct. METHODS: We studied 64 patients (65 ankles) undergoing tibiotalar arthrodesis done by a single surgeon over a 10-year period (2006-2016) with anterior plate augmentation beginning in 2010...
December 5, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27909032/midterm-outcomes-of-polyvinyl-alcohol-hydrogel-hemiarthroplasty-of-the-first-metatarsophalangeal-joint-in-advanced-hallux-rigidus
#5
Timothy R Daniels, Alastair S E Younger, Murray J Penner, Kevin J Wing, Sara Lyn Miniaci-Coxhead, Ellie Pinsker, Mark Glazebrook
BACKGROUND: Hallux rigidus is the most common arthritic condition of the foot. A randomized clinical trial of first metatarsophalangeal (MTP) joint hemiarthroplasty with a polyvinyl alcohol (PVA) hydrogel implant (Cartiva) demonstrated pain relief and functional outcomes equivalent to first MTP arthrodesis at 2 years postoperation, with no cases of implant fragmentation, wear, or bone loss. We prospectively determined 5-year outcomes of first MTP hemiarthroplasty with the PVA hydrogel implant...
November 30, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27908492/fragility-fractures-of-the-ankle-in-the-elderly-open-reduction-and-internal-fixation-versus-tibio-talo-calcaneal-nailing-short-term-results-of-a-prospective-randomized-controlled-study
#6
D Georgiannos, V Lampridis, I Bisbinas
INTRODUCTION: The management of ankle fractures in the elderly remains unpredictable, secondary to their various co-morbidities. Although tibiotalocalcaneal (TTC) nailing has been an effective option for ankle arthrodesis due to ankle arthritis or Charcot arthropathy there are few reports regarding the use of TTC nail for the treatment of ankle fractures. PURPOSE: Aim of this study was to compare the results of ORIF versus TTC nailing for the treatment of unstable ankle fractures in the elderly...
November 17, 2016: Injury
https://www.readbyqxmd.com/read/27903929/a-comparison-of-outcomes-of-particulated-juvenile-articular-cartilage-and-bone-marrow-aspirate-concentrate-for-articular-cartilage-lesions-of-the-talus
#7
Nathan S Lanham, John J Carroll, Minton T Cooper, Venkat Perumal, Joseph S Park
Background Articular cartilage lesions of the talus remain a challenging clinical problem because of the lack of natural regeneration and limited treatment options. Microfracture is often the first-line therapy, however lesions larger than 1.5 cm(2) have been shown to not do as well with this treatment method. Methods The objective of this retrospective study was to evaluate the outcomes of iliac crest bone marrow aspirate concentrate/collagen scaffold (ICBMA) and particulated juvenile articular cartilage (PJAC) for larger articular cartilage lesions of the talus...
November 30, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27903299/arthroscopic-arthrodesis-for-ankle-arthritis-without-bone-graft
#8
Xiaojun Duan, Liu Yang, Li Yin
BACKGROUND: Ankle arthrodesis is considered by many to be the standard operative treatment for end-stage ankle arthritis. The purpose of this study was to perform a new technique for ankle joint surface and determine the outcome for the union rates of ankle arthroscopic arthrodesis. METHODS: A total of 68 patients with posttraumatic arthritis, primary osteoarthritis, and rheumatoid arthritis were treated by ankle arthroscopic arthrodesis between May 2007 and December 2012...
December 1, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27900266/ankle-arthrodesis-a-systematic-approach-and-review-of-the-literature
#9
REVIEW
Youichi Yasui, Charles P Hannon, Dexter Seow, John G Kennedy
Ankle arthrodesis is a common treatment used for patients with end-stage ankle arthritis (ESAA). The surgical goal of ankle arthrodesis is to obtain bony union between the tibia and talus with adequate alignment [slight valgus (0°-5°)], neutral dorsiflexion, and slight external rotation positions) in order to provide a pain-free plantigrade foot for weightbearing activities. There are many variations in operative technique including deferring approaches (open or arthroscopic) and differing fixation methods (internal or external fixation)...
November 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27871418/efficacy-of-a-cellular-allogeneic-bone-graft-in-foot-and-ankle-arthrodesis-procedures
#10
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
#11
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
#12
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/27871413/b2a-polypeptide-in-foot-and-ankle-fusion
#13
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/27871410/vancouver-experience-of-recombinant-human-platelet-derived-growth-factor
#14
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
#15
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/27866887/quality-of-early-union-after-first-metatarsophalangeal-joint-arthrodesis
#16
Florian Wanivenhaus, Norman Espinosa, Philippe M Tscholl, Fabian Krause, Stephan H Wirth
The aim of the present retrospective cohort study was to assess the quality of union and the clinical outcomes in patients who had undergone first metatarsophalangeal joint (MTPJ) fusion using a dorsal plate and plantar lag screw. From March 2011 to December 2012, the clinical and radiographic data of 39 patients (41 feet) who had undergone first MTPJ fusion using a compressive locking plate were retrospectively reviewed. All patients had undergone postoperative computed tomography at 6 weeks postoperatively to assess union...
November 17, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27865315/surgical-treatment-options-for-the-diabetic-charcot-hindfoot-and-ankle-deformity
#17
REVIEW
Tahir Ögüt, Necip Selcuk Yontar
Charcot neuroarthropathy is associated with progressive, noninfectious, osteolysis-induced bone and joint destruction. When the ankle and/or hindfoot is affected by the destruction process, management is further complicated with collapse and destruction of the talar body, which increases instability around the ankle. In this patient population, arthrodesis is the most commonly used surgical procedure. Internal fixation, external fixation, or a combination of both can be used for the treatment. Decision making between them should be individualized according to the patient characteristics...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27846395/mid-term-functional-outcome-of-a-total-arthroplasty-of-the-first-metatarsophalangeal-joint
#18
Corina Nüesch, Annegret Mündermann, Monika Horisberger
BACKGROUND: Arthroplasty of the first metatarsophalangeal joint is an alternative treatment option for end-stage hallux rigidus to the current gold standard of arthrodesis. The aim of this study was to investigate the mid-term functional outcome of an anatomically shaped prosthesis for the first metatarsophalangeal joint using pedobarography. METHODS: Ten patients (12 affected feet; age at surgery: 62.1 (SD: 7.2) years) were investigated preoperatively and 52 (SD: 3) months postoperatively using pedobarography (EMED, novel GmbH, Munich, Germany)...
November 10, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/27821660/limb-salvage-after-failed-initial-operative-management-of-bimalleolar-ankle-fractures-in-diabetic-neuropathy
#19
Nicholas J Vaudreuil, Mitchell S Fourman, Dane K Wukich
BACKGROUND: Ankle fractures in patients with diabetes mellitus (DM) can be difficult to manage, especially in the presence of peripheral neuropathy. In patients who fail initial operative management, attempts at limb salvage can be challenging, and no clear treatment algorithm exists. This study examined outcomes of different procedures performed for limb salvage in this population. METHODS: This study retrospectively reviewed 17 patients with DM complicated by peripheral neuropathy who sustained a bimalleolar ankle fracture and failed initial operative management...
November 7, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27818800/new-technique-for-tibiotalar-arthrodesis-using-a-new-intramedullary-nail-device-a-cadaveric-study
#20
Emmanuel D Eisenstein, Mario Rodriguez, Amr A Abdelgawad
Introduction. Ankle arthrodesis is performed in a variety of methods. We propose a new technique for tibiotalar arthrodesis using a newly designed intramedullary nail. Methods. We proposed development of an intramedullary device for ankle arthrodesis which spared the subtalar joint using a sinus tarsi approach. Standard saw bones models and computer assisted modeling and stress analysis were used to develop different nail design geometries and determine the feasibility of insertion. After the final design was constructed, the device was tested on three cadaveric specimens...
2016: Advances in Orthopedics
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