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https://www.readbyqxmd.com/read/28534175/-aseptic-loosening-of-total-ankle-replacement-two-stage-revision-with-bone-augmentation-of-osseous-defects-and-secondary-prosthesis-implantation
#1
A Barg, M Wiewiorski, V Valderrabano
OBJECTIVE: To remove loosened ankle prosthesis components, perform osseous defect augmentation, and reimplant definitive prosthesis components to preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components with substantial bone defect. CONTRAINDICATIONS: General surgical/anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy, substantial nonreconstructable osseous defects with or without cysts on the tibial and/or talar side, noncompliance, primary total ankle replacement (TAR) using intramedullary fixation (stem fixation), severely reduced bone quality, insulin-dependent diabetes mellitus, smoking, unrealistic patients' expectations, high activity in sports...
May 22, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28509825/vascularized-pedicle-bone-grafting-from-the-cuboid-for-talar-osteonecrosis-results-of-a-novel-salvage-procedure
#2
James A Nunley, Kamran S Hamid
BACKGROUND: Osteonecrosis of the talar body represents a complex clinical challenge with treatment options currently limited to core decompression, vascularized and nonvascularized bone-grafting, total talar replacement, and hindfoot arthrodesis. Vascularized pedicle bone-grafting from the cuboid to the talus is a potential alternative to contemporary operative options for replacement of necrotic talar tissue with viable bone. We aimed to analyze functional and radiographic outcomes of vascularized pedicle bone-grafting from the cuboid for the treatment of talar osteonecrosis in a consecutive series of patients spanning a 12-year period...
May 17, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28502353/management-of-talar-component-subsidence
#3
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
#4
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/28502350/current-update-in-total-ankle-arthroplasty-salvage-of-the-failed-total-ankle-arthroplasty-with%C3%A2-anterior-translation-of-the-talus
#5
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
#6
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/28497248/-aseptic-loosening-of-total-ankle-replacement-one-stage-revision-ankle-arthroplasty
#7
G Pagenstert, M D Wimmer, M Jacxsens, C L Saltzman, A Barg
OBJECTIVE: To revise one or both loosened prosthesis components, to achieve postoperative pain relief, and preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components without substantial bone defect of the tibial or talar bone stock. CONTRAINDICATIONS: General surgical or anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy (e...
May 11, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28484797/painful-stress-reaction-in-the-posterior-subtalar-joint-after-resection-of-os-trigonum-or-posterior-talar-process
#8
Arno Frigg, Gerardo Maquieira, Monika Horisberger
INTRODUCTION: The resection of os trigonum or posterior talar process as treatment for posterior ankle impingement is an established operation. However, the authors encountered several painful stress reactions in the posterior subtalar joint during follow-up resulting in persisting incapacity to do sports. METHODS: From March 2011 to July 2015, 29 patients with 30 feet were operated (22 endoscopic, 8 open resections). Average follow-up time was 43 ± 13 months...
May 8, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28460264/flow-cytometry-analysis-reveals-different-activation-profiles-of-thrombin-or-trap-stimulated-platelets-in-db-db-mice-the-regulatory-role-of-par-3
#9
Hassan Kassassir, Karolina Siewiera, Marcin Talar, Tomasz Przygodzki, Cezary Watala
INTRODUCTION: Recent studies have shown that it may be the concentration of thrombin, which is discriminative in determining of the mechanism of platelet activation via protease activated receptors (PARs). Whether the observed phenomenon of differentiated responses of mouse platelets to various thrombin concentrations in non-diabetic db/+ and diabetic db/db mice depends upon the concerted action of various PARs, remains to be established. RESULTS: We found elevated reactivity of platelets, as well as the enhanced PAR-3 expression in response to both the used concentrations of AYPGKF in db/db mice, as compared to db/+ heterozygotes...
March 22, 2017: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/28458936/anterior-impingement-syndrome-of-the-ankle-caused-by-osteoid-osteoma-in-the-talar-neck-treated-with-arthroscopy-and-3d-c-arm-based-imaging
#10
Masachika Ikegami, Takumi Matsumoto, Song Ho Chang, Hiroshi Kobayashi, Yusuke Shinoda, Sakae Tanaka
Osteoid osteoma in periarticular lesions tends to have an unusual presentation that likely leads to a delayed or missed diagnosis compared with a typical osteoid osteoma in the metaphysis or diaphysis of the long bone. In cases that are unresponsive to conservative treatment, surgical interventions including en bloc resection, computed tomography-guided percutaneous treatment, and arthroscopic resection have been performed; however, these methods frequently result in inadequate tumor resection and recurrence...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28458187/torsional-stiffness-after-subtalar-arthrodesis-using-second-generation-headless-compression-screws-biomechanical-comparison-of-2-screw-and-3-screw-fixation
#11
Markus Riedl, Richard R Glisson, Takumi Matsumoto, Stefan G Hofstaetter, Mark E Easley
BACKGROUND: Subtalar joint arthrodesis is a common operative treatment for symptomatic subtalar arthrosis. Because excessive relative motion between the talus and calcaneus can delay or prohibit fusion, fixation should be optimized, particularly in patients at risk for subtalar arthrodesis nonunion. Tapered, fully-threaded, variable pitch screws are gaining popularity for this application, but the mechanical properties of joints fixed with these screws have not been characterized completely...
June 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28449249/t2-mapping-evaluation-of-early-cartilage-alteration-of-talus-for-chronic-lateral-ankle-instability-with-isolated-anterior-talofibular-ligament-tear-or-combined-with-calcaneofibular-ligament-tear
#12
Hongyue Tao, Yiwen Hu, Yang Qiao, Kui Ma, Xu Yan, Yinghui Hua, Shuang Chen
PURPOSE: To quantitatively evaluate the cartilage alteration of talus for chronic lateral ankle instability (LAI) with isolated anterior talofibular ligament (ATFL) tear and combined ATFL and calcaneofibular ligament (CFL) tear using T2 -mapping at 3.0T. MATERIALS AND METHODS: In all, 27 patients including 17 with isolated ATFL tear and 10 with ATFL+CFL tear, and 21 healthy subjects were recruited. All participants underwent T2 -mapping scan at 3T and patients completed American Orthopaedic Foot and Ankle Society (AOFAS) scoring...
April 27, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28444407/-aseptic-loosening-of-total-ankle-replacement-and-conversion-to-ankle-arthrodesis
#13
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/28436373/fatco-syndrome-fibular-aplasia-tibial-campomelia-oligosyndactyly-with-talar-aplasia-a-case-study
#14
Khurshid Ahmad, Hilal Ahmad Malla, Sheikh Dawood
FATCO syndrome consists of fibular hemimelia, tibial campomelia and oligosyndactyly. FATCO syndrome can also be associated with other congenital anomalies; therefore, every case needs thorough evaluation so as to make the management of the patient easier. A few cases of this syndrome have been described in literature but only two cases have been reported in India so far. We present a 3-year-old male child born of a non-con-sanguinous marriage with FATCO syndrome and ipilateral talar aplasia without any other congenital anomalies...
January 26, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28434534/comparative-analysis-of-trabecular-bone-structure-and-orientation-in-south-african-hominin-tali
#15
Anne Su, Kristian J Carlson
Tali of several hominin taxa are preserved in the fossil record and studies of the external morphology of these often show a mosaic of human-like and ape-like features. This has contributed to a growing recognition of variability characterizing locomotor kinematics of Australopithecus. In contrast, locomotor kinematics of another Plio-Pleistocene hominin, Paranthropus, are substantially less well-documented, in part, because of the paucity of postcranial fossils securely attributed to the genus. Since the talus transmits locomotor-based loads through the ankle and its internal structure is hypothesized to reflect accommodation to such loads, it is a cornerstone structure for reconstructing locomotor kinematics...
May 2017: Journal of Human Evolution
https://www.readbyqxmd.com/read/28425054/can-a-three-component-prosthesis-be-used-for-conversion-of-painful-ankle-arthrodesis-to-total-ankle-replacement
#16
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/28419804/simultaneous-reconstruction-of-the-medial-and-lateral-collateral-ligaments-for-chronic-combined-ligament-injuries-of-the-ankle
#17
Toshito Yasuda, Hiroaki Shima, Katsunori Mori, Seiya Tsujinaka, Masashi Neo
BACKGROUND: Objective data on chronic injuries of the medial collateral ligament (MCL) of the ankle are scarce. Chronic MCL injuries are frequently associated with lateral collateral ligament (LCL) injuries. For patients with chronic combined MCL and LCL injuries, the authors have performed simultaneous surgery of the 2 ligaments. HYPOTHESIS: Simultaneous surgery of the 2 ligaments may be effectively used to treat chronic combined MCL and LCL injuries. STUDY DESIGN: Case series; Level of evidence, 4...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28419612/delayed-gadolinium-enhanced-mri-of-cartilage-dgemric-and-t2-mapping-of-talar-osteochondral-lesions-indicators-of-clinical-outcomes
#18
Christoph Rehnitz, Benita Kuni, Felix Wuennemann, Dimitrios Chloridis, Anand Kirwadi, Iris Burkholder, Hans-Ulrich Kauczor, Marc-André Weber
PURPOSE: To evaluate the utility of delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and T2 mapping in evaluation of type II osteochondral lesions (OCLs) of the talus and define cutoff values for identifying patients with good/poor clinical outcomes. MATERIALS AND METHODS: 28 patients (mean age, 42.3 years) underwent T2 mapping and dGEMRIC at least 1.5 years (mean duration, 3.5 years) after microfracture (n = 12) or conservative (n = 16) treatment for type II OCL...
April 17, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28419034/complications-and-functional-outcomes-after-pantalar-dislocation
#19
Kaeleen A Boden, Douglas S Weinberg, Heather A Vallier
BACKGROUND: Pantalar dislocations without associated talar fracture are rare and have high risks of complications, including infection, osteonecrosis, and posttraumatic osteoarthrosis. Limited information on later function exists. This study evaluated complications and outcomes following pantalar dislocation without talar fracture. METHODS: Nineteen patients were identified with open (n = 14) or closed (n = 5) pantalar dislocations without talar fracture. Ten male and 9 female patients with a mean age of 39...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28417165/comparative-study-of-outcomes-after-ankle-arthrodesis-shows-higher-complication-rates-in-cases-operated-upon-by-general-orthopaedic-surgeons
#20
Krenn Sabine, Albers Sascha, Bock Peter, Mansfield Clemens, Chraim Michel, Trnka Hans-Joerg
INTRODUCTION: A functional assessment of 38 patients after ankle arthrodesis for the evaluation of the necessity of surgeons-specialisation was carried out by means of clinical evaluation and gait analysis after an average follow up of 30 months. METHODS: Scores were used to grade ankle function. Gate analysis was examined to determine the effect of arthrodesis on the ankle in relation to the surgeons' experience. Under conditions of normal daily living, we found significant differences in life quality between patients operated upon by experts in orthopaedic foot and ankle surgery (group A) and patients operated by general orthopaedic surgeons (group B)...
April 18, 2017: International Orthopaedics
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