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Total ankle arthroplasty

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https://www.readbyqxmd.com/read/29688960/design-rationale-for-total-ankle-arthroplasty-systems-an-update
#1
Christopher E Gross, Ariel A Palanca, James K DeOrio
The design of total ankle arthroplasty systems is evolving as a result of findings from longer-term studies. Our understanding of modes of failure has increased, and surgical techniques have become more refined. Currently, five total ankle arthroplasty systems are used in the United States. The landscape has changed considerably in the decade since the latest article reviewing total ankle design was published. Some implants with acceptable intermediate results had much poorer outcomes at 7- to 10-year follow-up...
April 23, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29685566/routine-use-of-low-molecular-weight-heparin-for-deep-venous-thrombosis-prophylaxis-after-foot-and-ankle-surgery-a-cost-effectiveness-analysis
#2
Richmond Robinson, T Craig Wirt, Carolina Barbosa, Arezou Amidi, Shirley Chen, Robert M Joseph, Adam E Fleischer
The purpose of the present study was to determine whether certain foot/ankle surgeries would benefit from the routine use of low-molecular-weight heparin (LMWH) as postoperative deep venous thrombosis prophylaxis. We conducted a formal cost-effectiveness analysis using a decision analytic tree to explore the healthcare costs and health outcomes associated with a scenario of no prophylaxis and a scenario of routine LMWH prophylaxis for 4 weeks. The 2 scenarios were compared for 5 procedures: (1) Achilles tendon repair (ATR), (2) total ankle arthroplasty (TAA), (3) hallux valgus surgery (HVS), (4) hindfoot arthrodesis (HA), and (5) ankle fracture surgery (AFS)...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29663012/medial-joint-line-elevation-of-the-tibia-measured-during-surgery-has-a-significant-correlation-with-the-limb-alignment-changes-following-medial-unicompartmental-knee-arthroplasty
#3
Yuichi Kuroda, Koji Takayama, Kazunari Ishida, Shinya Hayashi, Shingo Hashimoto, Masanori Tsubosaka, Takehiko Matsushita, Takahiro Niikura, Kotaro Nishida, Ryosuke Kuroda, Tomoyuki Matsumoto
PURPOSE: This study aimed to determine the correlation between the change in joint line height calculated from the resected bone and insert thickness during surgery and the change in limb alignment following unicompartmental knee arthroplasty (UKA). It was hypothesized that joint line elevation is correlated with the change in limb alignment. METHODS: A total of 74 consecutive patients diagnosed with either isolated medial compartmental osteoarthritis (38 patients) or spontaneous osteonecrosis of the knee (36 patients) were included...
April 16, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29662779/finite-element-analysis-of-biomechanical-effects-of-total-ankle-arthroplasty-on-the-foot
#4
Yan Wang, Zengyong Li, Duo Wai-Chi Wong, Cheng-Kung Cheng, Ming Zhang
Background: Total ankle arthroplasty is gaining popularity as an alternation to ankle arthrodesis for end-stage ankle arthritis. Owing to the complex anatomical characteristics of the ankle joint, total ankle arthroplasty has higher failure rates. Biomechanical exploration of the effects of total ankle arthroplasty on the foot and ankle is imperative for the precaution of postoperative complications. The objectives of this study are (1) to investigate the biomechanical differences of the foot and ankle between the foot with total ankle arthroplasty and the intact foot and (2) to investigate the performance of the three-component ankle prosthesis...
January 2018: Journal of Orthopaedic Translation
https://www.readbyqxmd.com/read/29652187/blood-transfusion-during-total-ankle-arthroplasty-is-associated-with-increased-in-hospital-complications-and-costs
#5
Michael A Ewing, Samuel R Huntley, Dustin K Baker, Kenneth S Smith, Parke W Hudson, Gerald McGwin, Brent A Ponce, Michael D Johnson
INTRODUCTION: Total ankle arthroplasty (TAA) is an increasingly used, effective treatment for end-stage ankle arthritis. Although numerous studies have associated blood transfusion with complications following hip and knee arthroplasty, its effects following TAA are largely unknown. This study uses data from a large, nationally representative database to estimate the association between blood transfusion and inpatient complications and hospital costs following TAA. METHODS: Using the Nationwide Inpatient Sample (NIS) database from 2004 to 2014, 25 412 patients who underwent TAA were identified, with 286 (1...
April 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29648889/patient-reported-allergies-do-not-predict-poorer-promis-function-pain-and-depression-scores-following-foot-and-ankle-surgery
#6
Devon C Nixon, Brian M Cusworth, Jeremy J McCormick, Jeffrey E Johnson, Sandra E Klein
BACKGROUND: Identifying preoperative risk factors that may portend poorer operative outcomes remains a topic of current interest. In hip and knee arthroplasty patients, the presence of patient-reported allergies (PRAs) has been associated with worse pain and function after joint replacement. However, these results have not been replicated across studies, including in shoulder arthroplasty cases. The impact of PRAs on foot and ankle outcomes has yet to be studied. The purpose of our study was to evaluate whether PRAs influence patient-reported outcome in foot and ankle surgery...
April 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29629592/revision-of-failed-total-ankle-arthroplasty-to-a-hindfoot-fusion
#7
A A Ali, R A Forrester, P O'Connor, N J Harris
Aims The aim of this study was to present a series of patients with aseptic failure of a total ankle arthroplasty (TAA) who were treated with fusion of the hindfoot using a nail. Patients and Methods A total of 23 TAAs, in 22 patients, were revised for aseptic loosening and balloon osteolysis to a hindfoot fusion by a single surgeon (NH) between January 2012 and August 2014. The procedure was carried out without bone graft using the Phoenix, Biomet Hindfoot Arthrodesis Nail. Preoperative investigations included full blood count, CRP and ESR, and radiological investigations including plain radiographs and CT scans...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29626655/complications-and-cost-of-single-stage-vs-two-stage-bilateral-unicompartmental-knee-arthroplasty-a-case-control-study
#8
C Siedlecki, P Beaufils, B Lemaire, N Pujol
BACKGROUND: Single-stage bilateral knee arthroplasty, even when unicompartmental, remains controversial, chiefly due to the risk of peri-operative complications. The primary objective of this study was to compare the short-term complication rate and cost of single- vs. two-stage bilateral unicompartmental knee arthroplasty (UCA). The secondary objective was to compare total hospital stay lengths and motion-range recovery. HYPOTHESIS: Single-stage bilateral UCA is a cost-saving alternative that is not associated with higher complication rates compared to two-stage bilateral UCA...
April 4, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29623234/the-positive-benefits-of-negative-movement-patterns-following-total-knee-arthroplasty
#9
Jesse C Christensen, K Bo Foreman, Paul C LaStayo
Introduction: Eccentric (negative) resistance exercise of the legs using specialized machines has been reported to be useful and often superior to standard exercise following total knee arthroplasty (TKA). Movements that utilize body mass and gravity as a mode of eccentric resistance exercise in a more pragmatic rehabilitation paradigm may also be useful in reversing chronic muscle impairments observed years following surgery. This study explores whether an eccentrically biased, body mass resistance exercise induces greater magnitude of sagittal plane extensor angular impulse of the support torque and individual net joint torque contributions during both squatting and lunging movement patterns 6 weeks following TKA...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29609637/primary-total-knee-arthroplasty-using-constrained-condylar-knee-design-for-severe-deformity-and-stiffness-of-knee-secondary-to-post-traumatic-arthritis
#10
Saroj Rai, Xianzhe Liu, Xiaobo Feng, Bimal Rai, Nira Tamang, Jing Wang, Shunan Ye, Shuhua Yang
BACKGROUND: Key to a successful outcome of total knee arthroplasty (TKA) is to attain optimum alignment, adequate balance, and deformity correction. In primary TKA, this can be achieved efficiently by posterior stabilized (PS) design with or without the sub-periosteal release. However, certain circumstances such as post-traumatic arthritis are often associated with severe deformities with a significant bone defect, stiffness, and instability. Such deformities are extremely difficult to balance with soft tissue release only and require additionally constrained prostheses even in primary TKA...
April 2, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29589784/short-term-complications-reoperations-and-radiographic-outcomes-of-a-new-fixed-bearing-total-ankle-arthroplasty
#11
Guilherme H Saito, Austin E Sanders, Cesar de Cesar Netto, Martin J O'Malley, Scott J Ellis, Constantine A Demetracopoulos
BACKGROUND: With the increasing use of total ankle arthroplasty (TAA), new implants with varied configurations are being developed every year. This study aimed to assess the early complications, reoperations, and radiographic and clinical outcomes of the Infinity TAA. To date, clinical results of this novel implant have not been published. METHODS: A retrospective analysis of 64 consecutive ankles that underwent a primary Infinity TAA from July 2014 to April 2016 was performed...
March 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29576488/can-a-single-use-and-patient-specific-instrumentation-be-reliably-used-in-primary-total-knee-arthroplasty-a-multicenter-controlled-study
#12
Laurent Abane, Amine Zaoui, Philippe Anract, Nicolas Lefevre, Serge Herman, Moussa Hamadouche
BACKGROUND: The aim of this controlled multicenter study is to evaluate the clinical and radiologic outcomes of primary total knee arthroplasty (TKA) using single-use fully disposable and patient-specific cutting guides (SU) and compare the results to those obtained with traditional patient-specific cutting guides (PSI) vs conventional instrumentation (CI). METHODS: Seventy consecutive patients had their TKA performed using SU. They were compared to 140 historical patients requiring TKA that were randomized to have the procedure performed using PSI vs CI...
February 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29576311/inter-joint-coordination-of-kinematics-and-kinetics-before-and-after-total-hip-arthroplasty-compared-to-asymptomatic-subjects
#13
Jessica A Longworth, Sebastian Chlosta, Kharma C Foucher
While differences in joint kinematics and kinetics between control subjects and patients before and after total hip arthroplasty (THA) has often been studied, inter-joint coordination has not been fully characterized. We hypothesized that in patients undergoing THA, inter-joint coordination (i) is different from control subjects before surgery, (ii) changes from pre-operative to post-operative, and (iii) remains different from control subjects after surgery. Seventy-eight subjects underwent gait analysis before and ∼1 year after primary unilateral THA...
March 16, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29560526/total-ankle-replacement-leads-to-high-revision-rates-in-post-traumatic-end-stage-arthrosis
#14
Yves Gramlich, Oliver Neun, Alexander Klug, Johannes Buckup, Thomas Stein, Arvid Neumann, Sebastian Fischer, Hans-Peter Abt, Reinhard Hoffmann
INTRODUCTION: Extremely heterogeneous revision rates in total ankle arthroplasty (TAA) of the upper ankle joint are reported and result to heterogeneous collectives and to short follow-up times. The aim is to investigate revision rates and the underlying reasons, as well as treatment outcome and quality of life after TAA in post-traumatic cases with sufficient follow-up. METHODS: In 2008-2013, 74 patients with post-traumatic arthrosis were treated using TAA with a Tornier Salto prosthesis, and 60 (35 males and 25 females; mean age 56) were followed-up (mean: 59 months; range 24-91 months)...
March 20, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29560400/a-computer-assisted-tibia-first-technique-for-improved-femoral-component-rotation-in-total-knee-arthroplasty
#15
Chong Meng Lee, Malkit K Dhillon, Mohd Amin Sulaiman
Background: The use of navigation for total knee arthroplasty (TKA) improves limb alignment in the coronal and sagittal planes. However, similar improvements in femoral and tibial component rotation have not yet been realized using currently available systems. Methods: We developed a modified navigated TKA technique in which femoral rotation was set using the resected tibial plane as the reference with the aim of achieving a rectangular flexion gap. Limb alignment was assessed in a cohort of 30 knees using the navigation system...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29557875/a-new-total-ankle-arthroplasty-implant-with-promising-level-iv-results-commentary-on-an-article-by-alexej-barg-md-et-al-early-clinical-and-radiographic-outcomes-of-trabecular-metal-total-ankle-replacement-using-a-transfibular-approach
#16
https://www.readbyqxmd.com/read/29557867/early-clinical-and-radiographic-outcomes-of-trabecular-metal-total-ankle-replacement-using-a-transfibular-approach
#17
Alexej Barg, Clayton C Bettin, Albert H Burstein, Charles L Saltzman, Jeremy Gililland
BACKGROUND: In the last 2 decades, total ankle replacement has gained greater acceptance as a treatment option in patients with end-stage ankle osteoarthritis. However, there is a lack of literature on total ankle replacement using a lateral transfibular approach. Therefore, we sought to report early clinical and radiographic results for a patient cohort treated with total ankle replacement using a lateral transfibular approach, performed by a single surgeon. METHODS: From October 2012 to December 2014, 55 primary total ankle arthroplasties using the Zimmer Trabecular Metal Total Ankle implant were performed in 54 patients (29 male and 25 female; mean age, 67...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29556687/-correction-of-posttraumatic-deformities-of-the-distal-tibia-with-focal-dome-osteotomy
#18
Thomas Rosteius, Hinnerk Baecker, Thomas Armin Schildhauer, Dominik Seybold, Jan Geßmann
BACKGROUND: Supramalleolar deformities require surgical correction to avoid posttraumatic osteoarthrosis of the knee or ankle joint and to prevent definitive treatment options, such as total ankle arthroplasty or arthrodesis of the ankle joint. Various methods for the operative correction of supramalleolar deformities have been described in the literature. OBJECTIVE: What results can be achieved with focal dome osteotomy to correct posttraumatic supramalleolar deformities? MATERIAL AND METHODS: A total of 10 patients (mean age 37 years) with a supramalleolar posttraumatic deformity were treated by focal dome osteotomy...
March 19, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29506397/prospective-cohort-study-on-the-employment-status-of-working-age-patients-after-recovery-from-ankle-arthritis-surgery
#19
Oliver J Gagné, Andrea Veljkovic, Mark Glazebrook, Timothy R Daniels, Murray J Penner, Kevin J Wing, Alastair S E Younger
BACKGROUND: People who are affected by end-stage ankle arthritis are as disabled as those suffering from arthritis in other main articulations of the lower extremity. Once these patients become unable to perform their job duties, they leave the workforce and require financial aid from government agencies, which represents a considerable economic burden. Regardless of whether arthrodesis or arthroplasty is performed, we hypothesized that patients younger than 55 years at the time of surgery should be able to return to work within 2 years and require less social assistance...
March 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29482305/relationship-between-lateral-femoral-bowing-and-varus-knee-deformity-based-on-two-dimensional-assessment-of-side-to-side-differences
#20
Myung-Rae Cho, Young Sik Lee, Won-Kee Choi
Purpose: The objective was to evaluate the relationship between side-to-side differences of lateral femoral bowing and varus knee deformity based on two-dimensional (2D) assessment in unilateral total knee arthroplasty (TKA). Materials and Methods: A total of 143 patients with varus knee osteoarthritis who underwent unilateral TKA were enrolled. We evaluated the side-to-side differences of the frontal lower limb alignment by assessing lateral femoral bowing, anatomical medial distal femoral angle, and anatomical medial proximal tibial angle (aMPTA)...
March 1, 2018: Knee Surgery & related Research
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