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Ankle arthroplasty

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https://www.readbyqxmd.com/read/28079703/metal-artifact-reduction-magnetic-resonance-imaging-around-arthroplasty-implants-the-negative-effect-of-long-echo-trains-on-the-implant-related-artifact
#1
Neil M Kumar, Cesar de Cesar Netto, Lew C Schon, Jan Fritz
OBJECTIVES: Long echo train length (ETL) is an often recommended but unproven technique to decrease metal artifacts on magnetic resonance imaging (MRI) scans. Therefore, we quantitatively and qualitatively assessed the effects of ETL on metal artifact on MRI scans using a cobalt-chromium-containing arthroplasty implant system. MATERIALS AND METHODS: Using a total ankle arthroplasty system implanted into a human cadaver ankle and a clinical 1.5 T MRI system, turbo spin echo (TSE) pulse sequences were acquired with ETL ranging from 3 to 23 and receiver bandwidth (BW) from 100 to 750 Hz/pixel, whereas effective echo time and spatial resolution were controlled...
January 9, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28061741/economic-analysis-and-patient-satisfaction-associated-with-outpatient-total-ankle-arthroplasty
#2
Tyler Gonzalez, Erica Fisk, Christopher Chiodo, Jeremy Smith, Eric Bluman
BACKGROUND: Total ankle arthroplasty (TAA) is a rapidly growing treatment for end-stage ankle arthritis that is generally performed as an inpatient procedure. The feasibility of outpatient total ankle arthroplasty (OTAA) has not been reported in the literature. We sought to establish proof of concept for OTAA by comparing outpatient vs inpatient perioperative complications, postoperative emergency department (ED) visits, readmissions, patient satisfaction, and cost analysis. METHODS: From July 2010 to September 2015, a total of 36 patients underwent TAA...
December 1, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/28053250/the-painful-total-ankle-arthroplasty-a-diagnostic-and-treatment-algorithm
#3
REVIEW
E Vulcano, M S Myerson
The last decade has seen a considerable increase in the use of in total ankle arthroplasty (TAA) to treat patients with end-stage arthritis of the knee. However, the longevity of the implants is still far from that of total knee and hip arthroplasties. The aim of this review is to outline a diagnostic and treatment algorithm for the painful TAA to be used when considering revision surgery. Cite this article: Bone Joint J 2017;99-B:5-11.
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28043936/do-foot-ankle-assessments-assist-the-explanation-of-one-year-knee-arthroplasty-outcomes
#4
L S Gates, C J Bowen, M T Sanchez-Santos, A Delmestri, N K Arden
OBJECTIVE: Whilst a number of risk factors for poor patient reported outcomes (PROMs) following knee arthroplasty (KA) have been identified, unexplained variability still remains. The role of pre-operative foot and ankle status on such outcomes has not been investigated. The aim of this study was therefore to determine the association of clinical foot and ankle assessments with patient reported outcomes one year following KA. DESIGN: One hundred and fifteen participants from the Clinical Outcomes in Arthroplasty Study (COASt), underwent detailed foot and ankle assessments at baseline, prior to KA (2012-2014) and were followed up for self-reported outcomes one year after surgery...
December 30, 2016: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28030511/ankle-distraction-arthroplasty-indications-technique-and-outcomes
#5
Mitchell Bernstein, Jay Reidler, Austin Fragomen, S Robert Rozbruch
Ankle distraction is an alternative to ankle arthrodesis or total ankle arthroplasty in younger patients with arthritis. Ankle distraction involves the use of external fixation to mechanically unload the ankle joint, which allows for stable, congruent range of motion in the setting of decreased mechanical loading, potentially promoting cartilage repair. Adjunct surgical procedures are frequently done to address lower-extremity malalignment, ankle equinus contractures, and impinging tibiotalar osteophytes. Patients can bear full weight during the treatment course...
February 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28029391/off-hour-surgery-among-orthopedic-subspecialties-at-an-urban-quaternary-care-level-1-trauma-center
#6
Amanda Lans, Stein J Janssen, David Ring
PURPOSE: We sought to determine and quantify which subspecialties of orthopedic surgeons are operating off hours in an urban, quaternary-care, level 1 trauma center. MATERIALS AND METHODS: We used our clinical registry to identify 43,211 orthopedic surgeries performed between January 2008 and December 2011. Our outcome measures were the number and proportion of off-hour surgeries performed as well as the number and proportion of off-hours per subspecialty. The denominators were the total number of surgeries and the total number of surgical hours worked per subspecialty...
October 28, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28017574/correcting-severe-varus-deformity-using-trial-components-during-total-knee-arthroplasty
#7
Man S Kim, In J Koh, Young J Choi, Yong D Kim, Yong In
BACKGROUND: Extensive medial soft tissue release may be necessary to correct severe varus deformity during total knee arthroplasty (TKA). However, this procedure may result in instability. Here, we describe a novel soft tissue balancing technique, which can minimize medial release in severe varus deformity during TKA. METHODS: Fifty knees (40 patients) with hip-knee-ankle angle of more than 20° of varus were corrected using this technique (group 1). After achieving flexion gap balancing by needle puncturing and spreading of the superficial medial collateral ligament, extension gap balancing was obtained by gradual extension with the trial components in place...
December 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28008240/a-comparison-between-metatarsal-head-resurfacing-hemiarthroplasty-and-total-metatarsophalangeal-joint-arthroplasty-as-surgical-treatments-for-hallux-rigidus-a-retrospective-study-with-short-to-midterm-follow-up
#8
Musa Ugur Mermerkaya, Houman Adli
PURPOSE: We evaluated the short- to midterm outcomes of metatarsal head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty (total joint replacement [TJR]) as surgical treatments for advanced-stage hallux rigidus (HR). PATIENTS AND METHODS: From 2012 to 2014, all data from patients who underwent surgery for the treatment of grades 2-3 HR were retrospectively reviewed, and 45 patients were included in this study. Of these patients, 26 underwent metatarsal head-resurfacing hemiarthroplasty (Group I) and 19 underwent TJR (Group II)...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28002366/salto-talaris-total-ankle-arthroplasty-clinical-results-at-a-mean-of-5-2-years-in-78-patients-treated-by-a-single-surgeon
#9
Kurt J Hofmann, Zabrina M Shabin, Eric Ferkel, Jeffrey Jockel, Mark P Slovenkai
BACKGROUND: In recent years, the number of total ankle arthroplasty procedures performed has increased dramatically. We sought to report the clinical results of the largest cohort of patients treated with a modern fixed-bearing total ankle arthroplasty by a single surgeon. METHODS: We retrospectively reviewed the charts of 78 consecutive patients (81 ankles) who underwent total ankle arthroplasty with a minimum clinical follow-up of 2 years. Sixty-three patients completed standardized questionnaires including the Foot and Ankle Disability Index (FADI), the Short Musculoskeletal Function Assessment (SMFA), the Short Form (SF)-36v2, and a visual analog scale (VAS) for pain...
December 21, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27999685/impact-of-active-ankle-movement-frequency-on-velocity-of-lower-limb-venous-flow-following-total-hip-arthroplasty
#10
Tsutomu Nakayama, Sachiyuki Tsukada, Takayuki Hiyama, Tatsuya Yamada, Naoyuki Hirasawa
Background. Although active ankle movement plays a predominant role in mechanical thromboprophylaxis following total hip arthroplasty (THA), the most effective frequency of movement remains unclear. Materials and Methods. In 29 consecutive patients undergoing THA, the velocity of blood flow in the profunda femoris was measured after various frequencies of ankle movement two days after THA using a pulse wave Doppler ultrasound system. To test the interobserver reliabilities for the velocity measured with Doppler ultrasound system, the intraclass correlation coefficient was calculated based on the measurement in 10 limbs of healthy volunteers...
2016: Advances in Orthopedics
https://www.readbyqxmd.com/read/27995304/patient-specific-instrumentation-versus-conventional-knee-arthroplasty-comparative-study
#11
Vlad Predescu, Catalin Prescura, Razvan Olaru, Liliana Savin, Paul Botez, Bogdan Deleanu
BACKGROUND: The key to a successful knee replacement is restoring normal kinematics with a neutral alignment, thus a hip-knee-ankle (HKA) angle of 180° (within 3° limits). Conventional TKR is proven to have excellent results but relies in extensive visual referencing of bony landmarks. Customised cutting blocks provide accurate bone cuts, also lowering the risk of fat embolism, blood loss and operating time. METHOD: We share our experience comparing two different TKA techniques using patient specific instrumentation (PSI) with the Visionaire knee and conventional instrumentation (CVI) from the same system (Genesis II Smith&Nephew)...
December 19, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27989350/iatrogenic-arteriovenous-fistula-with-associated-pseudoaneurysm-of-posterior-tibial-artery-after-revision-total-ankle-arthroplasty-a-case-report
#12
Benjamin M Wooster, Nathan L Grimm, James K DeOrio, Suhail K Mithani
Iatrogenic vascular injuries in elective orthopedic surgery are rare. However, these are important complications to recognize early and treat appropriately because the potential sequelae can be devastating. Arteriovenous fistula of the lower extremity after total ankle arthroplasty has not been previously described in published studies. The proper diagnosis of arteriovenous fistulas can be difficult without a high index of suspicion, and treatment often involves surgical intervention. We present the case of a 62-year-old male who developed an iatrogenic arteriovenous fistula with associated pseudoaneurysm of the posterior tibial artery after revision total ankle arthroplasty that was treated with surgical ligation and excision, followed by reverse saphenous vein grafting...
January 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27920333/accuracy-and-reproducibility-using-patient-specific-instrumentation-in-total-ankle-arthroplasty
#13
Justin Daigre, Gregory Berlet, Bryan Van Dyke, Kyle S Peterson, Robert Santrock
BACKGROUND: Implant survivorship is dependent on accuracy of implantation and successful soft tissue balancing. System instrumentation for total ankle arthroplasty implantation has a key influence on surgeon accuracy and reproducibility. The purpose of this study was to determine the accuracy and reproducibility of implant position with patient-specific guides for total ankle arthroplasty across multiple surgeons at multiple facilities. METHODS: This retrospective, multicenter study included 44 patients who received a total ankle implant (INBONE II Total Ankle System; Wright Medical Technology, Memphis, TN) using PROPHECY patient-specific guides from January 2012 to December 2014...
December 5, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27909123/comparative-study-of-computer-assisted-total-knee-arthroplasty-after-opening-wedge-osteotomy-versus-after-unicompartmental-arthroplasty
#14
R Pailhé, J Cognault, J Massfelder, A Sharma, R-C Rouchy, B Rubens-Duval, D Saragaglia
AIMS: The role of high tibial osteotomy (HTO) is being questioned by the use of unicompartmental knee arthroplasty (UKA) in the treatment of medial compartment femorotibial osteoarthritis. Our aim was to compare the outcomes of revision HTO or UKA to a total knee arthroplasty (TKA) using computer-assisted surgery in matched groups of patients. PATIENTS AND METHODS: We conducted a retrospective study to compare the clinical and radiological outcome of patients who underwent revision of a HTO to a TKA (group 1) with those who underwent revision of a medial UKA to a TKA (group 2)...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27896394/the-orientation-of-the-surgical-epicondylar-axis-varies-in-varus-and-non-varus-knees-in-the-coronal-plane
#15
Yunjie Zhang, Xiaofeng Wang, Yunchao Shao, Qing Xia
PURPOSE: To investigate the orientations of the surgical epicondylar axis (SEA) of varus and non-varus knees in the coronal plane. METHODS: One-hundred and sixty-two knees from 81 Chinese patients undergoing total knee arthroplasty (TKA) were retrospectively investigated. The angle between the medial side of the femoral mechanical axis and the SEA (MA-SEA), as well as the physiological valgus angle, was measured in the coronal plane using three-dimensional reconstruction...
November 28, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#16
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27871417/large-bm-intra-articular-allograft
#17
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/27856127/radiographic-assessment-of-knee-ankle-alignment-after-total-knee-arthroplasty-for-varus-and-valgus-knee-osteoarthritis
#18
Fuqiang Gao, Jinhui Ma, Wei Sun, Wanshou Guo, Zirong Li, Weiguo Wang
BACKGROUND: There are unanswered questions about knee-ankle alignment after total knee arthroplasty (TKA) for varus and valgus osteoarthritis (OA) of the knee. The aim of this retrospective study was to assess knee-ankle alignment after TKA. METHODS: The study consisted of 149 patients who had undergone TKA due to varus and valgus knee OA. The alignment and angles in the selected knees and ankles were measured on full-length standing anteroposterior radiographs, both pre-operatively and post-operatively...
November 14, 2016: Knee
https://www.readbyqxmd.com/read/27846395/mid-term-functional-outcome-of-a-total-arthroplasty-of-the-first-metatarsophalangeal-joint
#19
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/27830485/lateral-compartment-osteophytes-are-not-associated-with-lateral-compartment-cartilage-degeneration-in-arthritic-varus-knees
#20
Wenzel Waldstein, Maximilian F Kasparek, Martin Faschingbauer, Reinhard Windhager, Friedrich Boettner
BACKGROUND: Progression of arthritis in the lateral compartment is one of the main failure modes of unicompartmental knee arthroplasty (UKA). The decision regarding whether to perform a medial UKA sometimes is made based on whether lateral-compartment osteophytes are visible on plain radiographs obtained before surgery, but it is not clear whether the presence of lateral-compartment osteophytes signifies that the cartilage in the lateral compartment is arthritic. QUESTIONS/PURPOSES: (1) Is the presence of lateral compartment osteophytes associated with biomechanical properties of lateral-compartment cartilage, and (2) are osteophytes in the lateral compartment associated with particular histologic features of cartilage in the lateral compartment? METHODS: Between May 2010 and January 2012, we performed 201 TKAs for varus osteoarthritis confirmed on standardized AP hip-to-ankle standing radiographs...
November 9, 2016: Clinical Orthopaedics and related Research
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