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Triple arthrodesis

Kun Zhang, Yanxi Chen, Minfei Qiang, Yini Hao
Single, double, and triple hindfoot arthrodeses are used to correct hindfoot deformities and relieve chronic pain. However, joint fusion may lead to dysfunction in adjacent articular surfaces. We compared range of motion in adjacent joints before and after arthrodesis to determine the effects of each procedure on joint motion. The theory of moment of couple, bending moment and balanced loading was applied to each of 16 fresh cadaver feet to induce dorsiflexion, plantarflexion, internal rotation, external rotation, inversion, and eversion...
October 18, 2016: Scientific Reports
Vipul Vijay, Nishint Gupta, Raju Vaishya
Osteoarticular TB around the tarsal navicular is a chronic, uncommon condition affecting the midfoot, which causes significant morbidity to the patient. Tuberculosis around the tarsal navicular is rarely described in the literature. A series of three cases - two involving the talo-navicular joint and one involving the naviculo-cuneiform joint is described. Biopsy was used in all the cases for achieving diagnosis. All patients had good to fair outcome following medical management with anti-tubercular therapy...
September 20, 2016: Foot
M Tyrrell Burrus, Brian C Werner, James B Carr, Venkat Perumal, Joseph S Park
For rigid pes planovalgus deformities, modified double and triple arthrodeses have had high union rates and subjective outcomes reported. Increased rates of talonavicular nonunions after modified double arthrodesis have led to concern regarding this procedure. A retrospective medical record review was performed of patients who had undergone either a modified double (n = 9) or triple (n = 7) arthrodesis for stage 3 pes planovalgus deformity. Radiographs were reviewed for hindfoot alignment, bony union, and hardware failure...
September 7, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Alexandra I Stavrakis, Nelson F SooHoo
BACKGROUND: This study provides an updated comparison of the reoperation rates following primary ankle arthrodesis and total ankle replacement on the basis of observational, population-based data from California. We previously reported data from 1995 to 2004, and our current study includes new data from 2005 to 2010. Our hypothesis was that total ankle replacement would demonstrate increasing utilization and lower complication rates given advances in implant design and growth in surgeon experience...
September 7, 2016: Journal of Bone and Joint Surgery. American Volume
Richard Walter, Stephen Parsons, Ian Winson
Arthroscopic approaches to subtalar, double, and triple arthrodesis allow relative preservation of the soft tissue envelope compared with traditional open approaches. The surgical technique involving the use of a 4.5-mm 30° arthroscope via sinus tarsi portals is described. All 3 joints of the triple joint can be prepared for fusion with motorized burrs. Rigid fixation is achieved with cannulated screws. High union rates and low complication rates have been reported.
September 2016: Foot and Ankle Clinics
S Hejazi, G Rouhi, J Rasmussen
This paper presents a finite element model of the ankle, taking into account the effects of muscle forces, determined by a musculoskeletal analysis, to investigate the contact stress distribution in the tibio-talar joint in patients with triple arthrodesis and in normal subjects. Forces of major ankle muscles were simulated and corresponded well with the trend of their EMG signals. These forces were applied to the finite element model to obtain stress distributions for patients with triple arthrodesis and normal subjects in three stages of the gait cycle, i...
July 11, 2016: Computer Methods in Biomechanics and Biomedical Engineering
Martinus Richter, Stefan Zech
BACKGROUND: The aim of the study was to analyze the clinical aspects including 2-year follow-up of tibiotalocalcaneal arthrodesis (TTCA) with a triple-bend retrograde intramedullary nail (A3, Stryker, Airview Boulevard, MN, USA). METHODS: All patients with TTCA with A3 between October 18, 2011 and April 29, 2013 were included. Visual Analogue Scale Foot and Anklenkle (VAS FA), indications for surgery, details of surgery, radiographic measurements, and complications were analyzed...
June 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Nicholas E Ohly, Jonathan G Cowie, Steffen J Breusch
BACKGROUND: Triple arthrodesis may be performed using various surgical approaches, most typically through two incisions and without structural bone graft. We have found that a single lateral incision allows adequate surgical exposure and structural bone graft facilitates lateral column reconstruction. METHODS: A consecutive series of 30 triple arthrodeses with additive bone graft using a single lateral incision. Outcome measures were SF12 score, Manchester-Oxford Foot Questionnaire index score, visual analogue pain score and satisfaction scores, and radiographic assessment at 3, 6 and 12 months post-operatively...
June 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Eric D Wicks, Melanie A Morscher, Meadow Newton, Richard P Steiner, Dennis S Weiner
PURPOSE: Triple arthrodesis is a commonly performed salvage procedure to correct hindfoot deformity. Non-union is considered an undesirable radiographic outcome; however, the clinical ramifications of this are not as well defined. The purpose of this study was to determine the incidence of partial or complete radiographic non-union after triple arthrodesis in children and characterize the clinical consequences. METHODS: An IRB-approved retrospective review of triple arthrodesis surgeries in patients less than 16 years of age performed by a single surgeon (DSW) identified 159 cases meeting the inclusion criteria...
April 2016: Journal of Children's Orthopaedics
Christopher E Gross, John S Lewis, Samuel B Adams, Mark Easley, James K DeOrio, James A Nunley
BACKGROUND: While it is thought that stresses through the subtalar and talonavicular joints will be decreased after total ankle replacement (TAR) relative to ankle fusion, progressive arthritis or deformity of these joints may require a fusion after a successful TAR. However, after ankle replacement, it is unknown how hindfoot biomechanics and blood supply may be affected. Consequently, subsequent hindfoot joint fusion may be adversely affected. METHODS: We retrospectively identified a consecutive series of 1001 primary TARs performed between January 1998 and December 2014...
July 2016: Foot & Ankle International
Imraan Muradin, Huub J L van der Heide
PURPOSE: This study examines the responsiveness of the Foot Functional Index (FFI) and Leeds Foot Impact Scale for Rheumatoid Arthritis (LFIS-RA) in rheumatoid arthritis (RA) patients receiving a forefoot or hindfoot reconstruction. METHODS: This was a prospective cohort study including 30 rheumatoid arthritis patients with severe rheumatoid foot deformities in need for surgical correction. Responsiveness was measured using distribution-based methods (standardized effect size, standardized response mean and Guyatt responsiveness ratio) and anchor-based methods (receiver operating characteristics curves and correlation analyses) by making use of an anchor question...
April 2016: International Orthopaedics
Ian D Hutchinson, Josh R Baxter, Susannah Gilbert, MaCalus V Hogan, Jeff Ling, Stuart M Saunders, Hongsheng Wang, John G Kennedy
BACKGROUND: While successful subtalar joint arthrodesis provides pain relief, resultant alterations in ankle biomechanics need to be considered, as this procedure may predispose the remaining hindfoot and tibiotalar joint to accelerated degenerative changes. However, the biomechanical consequences of isolated subtalar joint arthrodesis and additive fusions of the Chopart's joints on tibiotalar joint biomechanics remain poorly understood. QUESTIONS/PURPOSES: We asked: What is the effect of isolated subtalar fusion and sequential Chopart's joint fusions of the talonavicular and calcaneocuboid joints on tibiotalar joint (1) mechanics and (2) kinematics during loading for neutral, inverted, and everted orientations of the foot? METHODS: We evaluated the total force, contact area, and the magnitude and distribution of the contact stress on the articular surface of the talar dome, while simultaneously tracking the position of the talus relative to the tibia during loading in seven fresh-frozen cadaver feet...
April 2016: Clinical Orthopaedics and related Research
Hendryk Vieweg, Sebastian Radmer, Robert Fresow, Arash Mehdi Tabibzada, Peter Kamusella, Fabian Scheer, Reimer Andresen
CONTEXT: Carpal bossing is an osseous formation at the dorsal portion of the quadrangular joint, which rarely becomes symptomatic. However, in some patients it causes pain, restricted mobility and can lead to complications like tendon rupture, inflammatory and degenerative joint disease. AIM: In this article, we present our experiences with this rare disorder in order to improve diagnostic and therapeutic proceedings. SETTINGS DESIGN: This is a multicenter and interdisciplinary observation made by orthopaedic surgeons and radiologists in the years 2010 to 2015...
October 2015: Journal of Clinical and Diagnostic Research: JCDR
Timothy R Daniels, D Joshua Mayich, Murray J Penner
BACKGROUND: The Scandinavian Total Ankle Replacement (STAR) prosthesis has been in clinical use since 1981, with investigational use in the U.S. since 1998. Few studies of the North American version of the STAR are available. This prospective cohort study analyzed intermediate to long-term outcomes of total ankle arthroplasty with use of the STAR prosthesis at two Canadian centers. METHODS: Consecutive patients who received the STAR prosthesis between 2001 and 2005 were enrolled at two large, urban teaching hospitals...
June 3, 2015: Journal of Bone and Joint Surgery. American Volume
Orhan Akıncı, Yavuz Akalın
OBJECTIVE: This study aimed to evaluate the implementation, in a single session, of both massive posteromedial release and triple arthrodesis for rigid neglected clubfoot deformities in adult patients, and its effects on clinical and radiological results. METHODS: The procedures were performed in one session on 15 feet of 11 patients [7 male, 4 female; mean age 26 (range: 15 to 50)]. Staples were used for fixation in all patients. For clinical assessment, the AOFAS (American Orthopaedic Foot and Ankle Society) ankle- hindfoot scale was used...
2015: Acta Orthopaedica et Traumatologica Turcica
N A Jagodzinski, A M J Parsons, S W Parsons
BACKGROUND: Arthroscopic arthrodesis is an accepted technique for the ankle but less commonly reported for multiple hindfoot joints. We present a case series review to establish the feasibility of this surgery. METHODS: In a consecutive series of 112 arthroscopic hindfoot arthrodeses, 18 involved decortication and fusion of 2 or 3 hindfoot joints. These were reviewed to identify complications, union rates and improvement over preoperative state. RESULTS: Mean age was 62 (45-78)...
June 2015: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
J Röhm, L Zwicky, T Horn Lang, Y Salentiny, B Hintermann, M Knupp
Talonavicular and subtalar joint fusion through a medial incision (modified triple arthrodesis) has become an increasingly popular technique for treating symptomatic flatfoot deformity caused by posterior tibial tendon dysfunction. The purpose of this study was to look at its clinical and radiological mid- to long-term outcomes, including the rates of recurrent flatfoot deformity, nonunion and avascular necrosis of the dome of the talus. A total of 84 patients (96 feet) with a symptomatic rigid flatfoot deformity caused by posterior tibial tendon dysfunction were treated using a modified triple arthrodesis...
May 2015: Bone & Joint Journal
N Hartig, S Krenn, H-J Trnka
BACKGROUND: Because of extensive bone loss and the associated complex instability and deformity of the feet, Charcot arthropathy or neuroosteoarthropathy is a challenge for the orthopedic surgeon. Ulcerations offer entry of various bacteria; thus, infections are a frequent serious issue and complication. The careful choice of treatment is not only very important for the correct alignment of the foot and the loading capacity, but also contributes significantly to the prevention of skin irritation or the healing of existing ulcers...
January 2015: Der Orthopäde
T Natsakis, J Burg, G Dereymaeker, I Jonkers, J Vander Sloten
In vitro gait simulations are a preferential platform to study new intervention techniques or surgical procedures as they allow studying the isolated effect of surgical interventions. Commonly, simulations are performed by applying pre-defined setpoints for the kinetics and kinematics on all degrees of freedom (DOFs) of the cadaveric specimen. This however limits the applicability of the experiment to simulations for which pre-defined kinematics and kinetics can be measured in vivo. In this study we introduce inertial control as a new methodology for gait simulations that omits the need for pre-defined setpoints for the externally applied vertical ground reaction force (vGRF) and therefore allows the effect of interventions to be reflected upon it...
January 21, 2015: Journal of Biomechanics
Gregory C Berlet, Christopher F Hyer, Ryan T Scott, Melissa M Galli
Correction of valgus hindfoot deformity can be successfully achieved with arthrodesis of the subtalar and talonavicular joints through a single medial based incision. The advantages of medial double arthrodesis compared with the standard triple arthrodesis 2-incision approach include the absence of a lateral incision and a few degrees of residual mobility through the unfused calcaneocuboid joint (CCJ). The CCJ has often been noted to distract and decompress with the abduction correction achieved through medial double fusion...
May 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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