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Total ankle arthroplasty

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https://www.readbyqxmd.com/read/28592074/-effects-of-iassist-navigation-system-and-personal-specific-instrument-assisted-total-knee-arthroplasty-in-the-treatment-of-osteoarthritis
#1
S C Tian, Q Q Yao, X D Yin, S Liu, J Zhou, J Hu, J Y Li, R Shan, H B Jiang, L M Wang
Objective: To compare the application of iASSIST assisted total knee arthroplasty (TKA) and three-dimentional(3D) printing personal specific instrument (PSI) assist TKA in the treatment of osteoarthritis (OA). Methods: Clinical data of 47 patients with OA admitted at Department of Orthopaedic Surgery in Nanjing Medical University Nanjing Hospital between April and September 2016 were retrospectively reviewed, including 20 males and 27 females, aging from 57 to 77 years with mean age of (63.8±8.2) years. They were randomly divided into iASSIST-TKA group (23 patients) and PSI-TKA group (24 patients)...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28589334/are-there-differences-in-gait-mechanics-in-patients-with-a-fixed-versus-mobile-bearing-total-ankle-arthroplasty-a-randomized-trial
#2
Robin M Queen, Christopher T Franck, Daniel Schmitt, Samuel B Adams
BACKGROUND: Total ankle arthroplasty (TAA) is an alternative to arthrodesis, but no randomized trial has examined whether a fixed bearing or mobile bearing implant provides improved gait mechanics. QUESTIONS/PURPOSES: We wished to determine if fixed- or mobile-bearing TAA results in a larger improvement in pain scores and gait mechanics from before surgery to 1 year after surgery, and to quantify differences in outcomes using statistical analysis and report the standardized effect sizes for such comparisons...
June 6, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28583023/safety-of-outpatient-total-ankle-arthroplasty-vs-traditional-inpatient-admission-or-overnight-observation
#3
Ryan P Mulligan, Selene G Parekh
BACKGROUND: Total joint surgeons have successfully performed hip, knee, and shoulder arthroplasty procedures in the outpatient setting without compromising safety, satisfaction, or results. The purpose of this study was to evaluate outpatient total ankle arthroplasty (TAA) as compared with overnight or extended inpatient stay, with regard to 90-day medical and operative complications, reoperations, readmissions or emergency room visits, and pain control. METHODS: The medical records of patients who underwent TAA with 1 fellowship-trained orthopedic foot and ankle surgeon were reviewed...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28580856/short-term-perioperative-complications-and-mortality-after-total-ankle-arthroplasty-in-the-united-states
#4
Kenneth A Heida, Brian Waterman, Eric Tatro, Julia Bader, Andrew C McCoy, Nicholas Rensing, Justin Orr
This study sought to identify patient and operative demographics associated with 30-day perioperative complications in patients undergoing total ankle arthroplasty as recorded in the National Surgical Quality Improvement Project database. Complications were divided into local and systemic and further subcategorized as major and minor. A total of 404 patients underwent total ankle arthroplasty between 2007 and 2014 as captured in the National Surgical Quality Improvement Project database. The overall complication rate was 2...
June 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28578802/spontaneous-resolution-of-posterior-ankle-joint-loose-bodies-after-total-ankle-replacement-a-case-report
#5
Raymond P Lee, Sally H S Cheng
Late stage ankle osteoarthritis often presents with debilitating pain. It is common to find osteophytes and loose body formation around the joint. Total ankle arthroplasty can preserve joint mobility and pain relieve for such patient. However, when trying to remove the osteophytes and loose bodies at the posterior ankle joint, there is risk of damaging posterior structures such as the neurovascular bundle during the procedure. We are presenting a case where the posterior loose bodies remained untouched during the operation, and patient showed spontaneous resolution of the lesions with time...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578800/geometric-analysis-of-the-talus-and-development-of-a-generic-talar-prosthetic
#6
Alexandra Trovato, Marwan El-Rich, Samer Adeeb, Suki Dhillon, Nadr Jomha
BACKGROUND: Trauma to the talus can result in fracture, avascular necrosis and structural collapse. Treatment has been limited to surgical fusion and total ankle arthroplasty. Total ankle arthroplasty may not be an appropriate treatment for avascular necrosis while surgical fusion of the joint limits mobility. Custom-made implants have recently been used to address these limitations but have lengthy delays between injury and surgery and higher associated costs. A generic talar prosthesis available in various sizes may serve as a suitable alternative...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578799/tibial-slope-in-total-ankle-arthroplasty-anterior-or-lateral-approach
#7
Federico Giuseppe Usuelli, Camilla Maccario, Cristian Indino, Luigi Manzi, Christopher Edward Gross
BACKGROUND: A new total ankle arthroplasty (TAA) system performed through a lateral approach provides direct visualization of the centre of rotation, allowing for accurate reconstruction of the joint alignment and less bone resection. Radiographic references are needed to describe deformities and plan the surgical procedures. The tibial slope is an important factor when treating malalignment. The aim of this study is to show if there is any difference regarding the post-operative tibial slope (β angle) measurement comparing a fixed-bearing TAA through a lateral approach and a mobile-bearing TAA through an anterior approach...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578798/identifying-the-learning-curve-for-total-ankle-replacement-using-a-mobile-bearing-prosthesis
#8
Federico G Usuelli, Camilla Maccario, Andrea Pantalone, Nicola Serra, Eric W Tan
BACKGROUND: Total ankle arthroplasty remains a technically demanding surgery highly influenced by the operator experience. However, no consensus exists regarding the ideal number of cases that need to be performed before a surgeon is considered proficient. The aim of this study was to identify the learning curve of a specific replacement system with regards to intraoperative and postoperative outcomes. METHODS: The first 31 patients undergoing total ankle arthroplasty were examined...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578796/are-periprosthetic-osteolytic-lesions-in-ankle-worth-bone-grafting
#9
Ia Kohonen, Helka Koivu, Hannu Tiusanen, Jussi Kankare, Tero Vahlberg, Kimmo Mattila
BACKGROUND: We retrospectively evaluated the medium-term follow-up of bone grafting due to periprosthetic osteolytic lesions in ankles. METHODS: 34 ankles (32 patients) with total ankle arthroplasty (TAA) underwent re operation. Indications were large periprosthetic osteolytic lesions or continuous growing of the lesions. The osteolytic lesions were imaged by CT before reoperation and once a year after that. The mean CT follow-up after re operation was 3.8 years (range, 2-6...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578795/heterotopic-ossification-after-total-ankle-replacement-the-role-of-prosthesis-alignment
#10
Sebastian Manegold, Alexander Springer, Kristin Landvoigt, Serafim Tsitsilonis
BACKGROUND: The aetiology of heterotopic ossifications (HO) after total ankle arthroplasty (TAR) remains controversial. The aim of the study was to evaluate the prevalence and localisation of HO and the effect of alignment. METHODS: 88 TARs with a series of radiological controls and follow-up of 36 months were evaluated. Frontal and sagittal alignment parameters (alfa and beta angle defined by Hintermann) and tibial coverage were evaluated. RESULTS: The prevalence and grading of HO increased over time, mostly in the posterior gutter...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578792/functional-and-clinical-outcomes-of-total-ankle-arthroplasty-in-elderly-compared-to-younger-patients
#11
Shay Tenenbaum, Jason Bariteau, Scott Coleman, James Brodsky
BACKGROUND: Total ankle arthroplasty (TAA) is becoming an increasingly utilized procedure for the management of end-stage ankle arthritis. Elderly patients are the fastest growing segment of the population in the western world, creating a unique challenge to the health economics of our era. Determining if elderly patients with end-stage ankle arthritis demonstrate the same improvements in clinical outcomes and functional measures of gait following TAA would be valuable. This can aid to evaluate the utilization of TAA in this enlarging cohort of our population...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28576194/operative-fixation-options-for-elective-and-diabetic-ankle-arthrodesis
#12
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/28566397/mediolateral-force-distribution-at-the-knee-joint-shifts-across-activities-and-is-driven-by-tibiofemoral-alignment
#13
I Kutzner, A Bender, J Dymke, G Duda, P von Roth, G Bergmann
AIMS: Tibiofemoral alignment is important to determine the rate of progression of osteoarthritis and implant survival after total knee arthroplasty (TKA). Normally, surgeons aim for neutral tibiofemoral alignment following TKA, but this has been questioned in recent years. The aim of this study was to evaluate whether varus or valgus alignment indeed leads to increased medial or lateral tibiofemoral forces during static and dynamic weight-bearing activities. PATIENTS AND METHODS: Tibiofemoral contact forces and moments were measured in nine patients with instrumented knee implants...
June 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28552044/assessing-the-utilization-of-total-ankle-replacement-in-the-united-states
#14
Sudheer Reddy, Lane Koenig, Berna Demiralp, Jennifer T Nguyen, Qian Zhang
BACKGROUND: Total ankle arthroplasty (TAR) has been shown to be a cost-effective procedure relative to conservative management and ankle arthrodesis. Although its use has grown considerably over the last 2 decades, it is less common than arthrodesis. The purpose of this investigation was to analyze the cost and utilization of TAR across hospitals. METHODS: Our analytical sample consisted of Medicare claims data from 2011 and 2012 for Inpatient Prospective Payment System hospitals...
June 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28549406/supramalleolar-osteotomy-for-tibial-component-malposition-in-total-ankle-replacement
#15
Manja Deforth, Nicola Krähenbühl, Lukas Zwicky, Markus Knupp, Beat Hintermann
BACKGROUND: Persistent pain despite a total ankle replacement is not uncommon. A main source of pain may be an insufficiently balanced ankle. An alternative to the revision of the existing arthroplasty is the use of a corrective osteotomy of the distal tibia, above the stable implant. This strictly extraarticular procedure preserves the integrity of the replaced joint. The aim of this study was to review a series of patients in whom a corrective supramalleolar osteotomy was performed to realign a varus misaligned tibial component in total ankle replacement...
May 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28545175/the-effect-of-sagittal-knee-deformity-on-preoperative-measurement-of-coronal-mechanical-alignment-during-total-knee-arthroplasty
#16
Gautam M Shetty, Arun Mullaji, Ahmed Adel Khalifa, Abhik Ray, Vivek Nikumbha
Purpose: The purpose of this prospective study was to determine correlation between coronal mechanical alignment measured on preoperative standing full-length radiographs and navigation during total knee arthroplasty (TKA) in the presence of an associated sagittal deformity (hyperextension and flexion deformity). Materials and Methods: Coronal mechanical alignment measured on preoperative, standing, full-length, hip-to-ankle anteroposterior radiographs was compared with intraoperative measurements recorded with computer navigation in 200 primary navigated TKAs...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28543369/directing-clinical-care-using-lower-extremity-biomechanics-in-patients-with-ankle-osteoarthritis-and-ankle-arthroplasty
#17
REVIEW
Robin Queen
Ankle osteoarthritis is a debilitating disease with approximately 50,000 new cases per year leading to skeletal deformity, severe and recurrent pain, cartilage breakdown, and gait dysfunction limiting patient mobility and well-being. Although many treatments (total ankle arthroplasty [TAA], ankle fusion [arthrodesis], and ankle distraction arthroplasty) relieve pain, it is not clear that these procedures significantly improve patient mobility. The goal of the research presented here is to summarize what is presently known about lower extremity gait mechanics and outcomes and to quantify the impact of ankle osteoarthritis and TAA have on these measures using an explicitly holistic and mechanistic approach...
May 19, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28529013/bipolar-fresh-total-osteochondral-allograft-in-the-ankle-is-it-a-successful-long-term-solution
#18
S Giannini, A Mazzotti, F Vannini
INTRODUCTION: Severe post-traumatic ankle arthritis poses a reconstructive challenge in young and active patients. Although technically demanding and despite unsolved immunological issues, bipolar fresh total osteochondral allograft (BFTOA) represent an intriguing option to arthrodesis and prosthetic replacement. The purpose of this paper is to evaluate the outcomes of a series of 48 ankle BFTOA at 10 years follow up and to investigate the rate of survival long term. METHODS: 58 patients underwent BFTOA, of these 48 were available for follow up...
May 11, 2017: Injury
https://www.readbyqxmd.com/read/28527700/failure-of-hightibialvarus-osteotomy-for-lateral-tibio-femoral-osteoarthritis-with-10%C3%A2-of-valgus-outcomes-in-19-patients
#19
G Mirouse, A Dubory, F Roubineau, A Poignard, P Hernigou, J Allain, C H Flouzat Lachaniette
BACKGROUND: Osteotomy is a rational approach to slowing knee osteoarthritis progression by modifying loads, thereby avoiding joint replacement in younger individuals. Varus femoral osteotomy is recommended only in patients with more than 10° of valgus. The objective here was to assess outcomes of tibialvarus osteotomy in patients with lateral compartment tibio-femoral osteoarthritis and less than 10° of valgus. MATERIAL AND METHODS: A single-centre retrospective study was conducted in 19 consecutive patients managed by high tibialvarus osteotomy between January 2005 and May 2012...
May 17, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28523427/-total-ankle-arthroplasty-with-simultaneous-subtalar-fusion
#20
J Mainzer, P Rippstein
OBJECTIVE: Pain free weight bearing ability with orthograde hindfoot position and preserved tibiotalar motion. INDICATIONS: Symptomatic arthritis of the ankle and subtalar joint, additional subtalar hindfoot malalignment. CONTRAINDICATIONS: Absolute: acute infection, noncorrectable ligamentous instability or bony defects, restricted perfusion, diabetic foot syndrome. Relative: inability to comply with postoperative partial weight bearing, only moderate symptoms of subtalar arthritis, smoking, intricate soft tissue situation...
June 2017: Operative Orthopädie und Traumatologie
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