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Ankle arthroplasty

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https://www.readbyqxmd.com/read/28545175/the-effect-of-sagittal-knee-deformity-on-preoperative-measurement-of-coronal-mechanical-alignment-during-total-knee-arthroplasty
#1
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
#2
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
#3
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
#4
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
#5
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...
May 18, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28521779/total-ankle-arthroplasty-versus-ankle-arthrodesis-a-comparison-of-outcomes-over-the-last-decade
#6
REVIEW
Cort D Lawton, Bennet A Butler, Robert G Dekker, Adam Prescott, Anish R Kadakia
BACKGROUND: The surgical treatment of end-stage tibiotalar arthritis continues to be a controversial topic. Advances in surgical technique and implant design have lead to improved outcomes after both ankle arthrodesis (AA) and total ankle arthroplasty (TAA), yet a clear consensus regarding the most ideal form of treatment is lacking. In this study, the outcomes and complications following AA and TAA are compared in order to improve our understanding and decision-making for care and treatment of symptomatic tibiotalar arthritis...
May 18, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28502358/is-there-anything-to-learn-from-a-national-joint-registry
#7
REVIEW
Dawson Muir
National joint registries (NJRs) have been established in Northern Europe for over 20 years. Since then, many other countries have begun collecting and reporting national data for total ankle arthroplasty (TAA). With relatively small numbers implanted, a large variety of available designs, and with any long-term reports dominated by designer groups, TAA is ideally placed to benefit from large national or even pooled national registries. This article reviews the existing registry-based literature with respect to what is already known...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502357/experience-with-navigation-in-total-ankle-arthroplasty-is-it-worth-the-cost
#8
REVIEW
Christopher W Reb, Gregory C Berlet
Optimal placement of correctly sized total ankle replacement (TAR) implants is elemental to prolonging the working life. The negative mechanical effects of implant malalignment are well characterized. There is one FDA-approved navigated TAR system with limited but encouraging outcomes data. Therefore, its value can be estimated only based on benefits other than a proven clinical outcomes improvement over conventional systems. These include unique preoperative planning through 3-dimensional templating and virtual surgery and the patient-specific cut guides, which also reduce overall instrumentation needed for the case...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502355/how-to-diagnose-and-treat-infection-in-total-ankle-arthroplasty
#9
REVIEW
Yousef Alrashidi, Ahmed E Galhoum, Martin Wiewiorski, Mario Herrera-Pérez, Raymond Y Hsu, Alexej Barg, Victor Valderrabano
Periprosthetic infection after total ankle arthroplasty (TAA) is a serious complication, often requiring revision surgery, including revision arthroplasty, conversion to ankle arthrodesis, or even amputation. Risk factors for periprosthetic ankle infection include prior surgery at the site of infection, low functional preoperative score, diabetes, and wound healing problems. The clinical presentation of patients with periprosthetic ankle joint infection can be variable and dependent on infection manifestation: acute versus chronic...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502354/soft-tissue-reconstruction-after-total-ankle-arthroplasty
#10
REVIEW
Yash J Avashia, Ronnie L Shammas, Suhail K Mithani, Selene G Parekh
Wound complications following total ankle replacement are common. A team approach, including plastic surgeons, should be utilized to manage these wound issues. The handling of the wound, from the index procedure, to a variety of flaps, can be utilized to provide a successful outcome following an ankle replacement.
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502353/management-of-talar-component-subsidence
#11
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
#12
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/28502351/malalignment-correction-of-the-lower-limb-before-during-and-after-total-ankle-arthroplasty
#13
REVIEW
Taggart T Gauvain, Michael A Hames, William C McGarvey
One of the main challenges in ankle replacement is correction of any deformities in the operative limb. Deformity can be found proximal and distal to the ankle joint as well as in the ankle joint. There are static and dynamic deformities that can create unbalanced ankle joints causing early and often catastrophic failure. Surgeons must recognize the deformities that are present and use sound judgment to balance the ankle joint with procedures before, during, or after total ankle implantation. This article helps clinicians to identify deformity and provides a basic template to consider how to address each challenge...
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
#14
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
#15
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/28502347/ankle-arthrodesis-versus-total-ankle-arthroplasty
#16
REVIEW
Joel Morash, David M Walton, Mark Glazebrook
Reoperation rates are higher in total ankle arthroplasties (TAAs) compared with ankle arthrodesis. Infection rates for primary TAAs are 1.4% to 2.4%. The survival rate of TAA is approximately 75% to 90% at 10 years. Arc of motion is maintained with TAAs compared with ankle arthrodesis. Ankle arthrodesis increases arc of motion through the talonavicular joint. Several factors are strong reasons to favor ankle fusion rather than TAA. TAA and ankle arthrodesis are effective treatments of end-stage ankle arthritis but the choice must be tailored to individual patients...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502346/kinematics-and-function-of-total-ankle-replacements-versus-normal-ankles
#17
REVIEW
Justin M Kane, Scott Coleman, James W Brodsky
End-stage ankle arthritis produces severe functional disability, quantifiable by gait abnormalities. In all categories of gait parameters, total ankle arthroplasty (TAA) satistically significantly improves function, compared to patients' preoperative function. There are increases in step length, cadence and velocity; in sagittal plane motion of the ankle, as well has hip and knee motion, and in ankle power and moment. These functional gait improvements correspond to clinical improvements of pain relief and satisfaction...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28497248/-aseptic-loosening-of-total-ankle-replacement-one-stage-revision-ankle-arthroplasty
#18
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/28481385/an-assessment-of-the-safety-of-an-orthopedic-specialty-hospital-a-5-year-experience
#19
Eric M Padegimas, Matthew L Ramsey, Matthew Austin, Javad Parvizi, Gerald R Williams, Kelly Doyle, Michael E West, Richard H Rothman, Alexander R Vaccaro, Surena Namdari
One of the goals of orthopedic specialty hospitals is to provide safe and efficient care to medically optimized patients. The authors' orthopedic specialty hospital is a physician-owned, 24-bed facility that accommodates a multispecialty orthopedic practice in the areas of spine, hip and knee arthroplasty, shoulder and elbow, sports, foot and ankle, and hand surgery. The purpose of this study was to examine the first 5 years of an institutional experience with an orthopedic specialty hospital and to determine if any procedures were at increased risk of postoperative transfer...
May 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/28476393/is-it-worth-discriminating-against-patients-who-smoke-a-systematic-literature-review-on-the-effects-of-tobacco-use-in-foot-and-ankle-surgery
#20
REVIEW
Jason H Kim, Sandeep Patel
Although numerous studies have linked smoking with lower extremity wound and bone healing complications, a comprehensive study on the effects of smoking in foot and ankle surgery has not yet been reported. The purpose of the present study was to report the results of our systemic literature review, identifying the effects of tobacco use on common foot and ankle procedures. The systematic literature review was performed according to guidelines set by the PRIMSA statement (Preferred Reporting Items for Systematic Review and Meta-Analyses)...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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