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Ankle arthroplasty

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https://www.readbyqxmd.com/read/28645703/mapping-of-the-anterior-tibial-profile-to-identify-accurate-reference-points-for-sagittal-alignment-of-tibial-component-in-total-knee-arthroplasty
#1
Gianluca Cinotti, Ettore Caruso, Luigi Orsina, Giuseppe La Torre, Francesca Romana Ripani
BACKGROUND: Although standard instrumentation is the procedure most frequently used to implant a total knee arthroplasty (TKA), high rates of malalignment of tibial component are reported using this technique. Anatomical landmarks for sagittal alignment have been little investigated and the best reference axis which parallels the mechanical axis is yet to be established. HYPOTHESIS: Mapping the anterior tibial profile (ATP) may allow the identification of segmental zones of the ATP parallel to the mechanical axis which can be use to align the extramedullary rod...
June 20, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28645549/staged-treatment-of-infected-tibiotalar-fusion-using-a-combination-antibiotic-spacer-and-antibiotic-coated-intramedullary-nail
#2
Justin Miller, Victor Hoang, Richard S Yoon, Frank A Liporace
Pilon fractures are notoriously difficult injuries to treat. The current published data on salvage procedures after failed pilon fractures includes both total ankle arthroplasty (TAA) and tibiotalar fusion, each with its own specific indications. However, no acceptable treatment algorithm addressing the complications of these limb salvage procedures is available. We present the case of a 23-year-old patient, who sustained a complex pilon fracture after a motor vehicle accident. The patient was referred to our institution after an initial fixation attempt, followed by subsequent failed TAA, which was complicated by an infected fusion attempt...
June 20, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28645548/perioperative-complications-and-initial-alignment-of-lateral-approach-total-ankle-arthroplasty
#3
J George DeVries, Todd A Derksen, Brandon M Scharer, Robert Limoni
Total ankle replacement continues to become a more common treatment of end-stage ankle arthritis. A lateral approach total ankle implant system is an innovative approach for this treatment. We performed a retrospective review of 16 patients treated with lateral approach total ankle replacement. The implant was successful and retained in all cases during a follow-up period of 769 ± 221.3 days (25.3 ± 7.3 months). Initial satisfactory alignment was achieved in all cases. For patients in whom a frontal plane incongruent deformity was present preoperatively, a statistically significant correction was obtained (p = ...
June 20, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28641973/changes-in-hip-knee-and-ankle-coronal-alignments-after-total-hip-arthroplasty-with-transverse-femoral-shortening-osteotomy-for-unilateral-crowe-type-iv-developmental-dysplasia-of-the-hip
#4
Abdulhamit Misir, Turan B Kizkapan, Kadir I Yildiz, Mehmet A Kaygusuz, Yakup Alpay, Atakan Ezici
BACKGROUND: To investigate changes in lower extremity coronal alignment in patients with unilateral Crowe type IV developmental dysplasia of the hip who underwent total hip arthroplasty with transverse femoral shortening osteotomy. METHODS: We reviewed the preoperative and 1-year postoperative full-length lower extremity radiographs of 25 patients. Femoral offset (FO), mechanical hip-knee-ankle angle, anatomical axis, mechanical axis deviation (MAD), mechanical lateral proximal femoral angle, anatomical medial proximal femoral angle, mechanical lateral distal femoral angle, anatomical lateral distal femoral angle, knee joint line congruency angle, mechanical medial proximal tibial angle, mechanical lateral distal tibial angle, ankle joint line orientation angle, tibial plafond talus angle, extremity length, and pelvic obliquity were measured on both the operative and nonoperative sides...
June 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28633799/interposition-ankle-arthroplasty-using-acellular-dermal-matrix-a%C3%A2-small-series
#5
Brian Carpenter, Kyle Duncan, Jordan Ernst, Dalton Ryba, Sumihiro Suzuki
Although ankle arthrodesis is the reference standard for end-stage ankle arthritis, loss of mobility and adjacent joint arthritis are consequences that alternatives to arthrodesis attempt to avoid. The purpose of the present study was to report the clinical results of interpositional arthroplasty using acellular dermal matrix in 4 patients (age 32 to 42 years) for the treatment of advanced ankle osteoarthritis. The primary findings included relief of pain, with improvement in tibiotalar joint range of motion from a mean of 16...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28633782/factors-predicting-length-of-hospital-stay-and-extended-care-facility-admission-after-hindfoot-arthrodesis-procedures
#6
Jacob Deister, Brian G Cothern, Chad Williams, Andrew W Froehle, Richard T Laughlin
Delayed identification of patients requiring admission to extended care facilities (ECFs) can lead to greater healthcare costs through an increased length of hospital stay (LOHS). Previous studies of hip and knee arthroplasty identified factors associated with a likely discharge to an ECF. These issues have not been extensively studied for major hindfoot procedures. We conducted a retrospective review of 198 cases treated during a 3-year period to identify the risk factors for an extended LOHS and ECF admission after ankle arthrodesis, triple arthrodesis, pantalar arthrodesis, and subtalar arthrodesis...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28592074/-effects-of-iassist-navigation-system-and-personal-specific-instrument-assisted-total-knee-arthroplasty-in-the-treatment-of-osteoarthritis
#7
S C Tian, Q Q Yao, X D Yin, S Liu, J Zhou, J Hu, J Y Li, R Shan, H B Jiang, L M Wang
Objective: To compare the application of iASSIST assisted total knee arthroplasty (TKA) and three-dimentional(3D) printing personal specific instrument (PSI) assist TKA in the treatment of osteoarthritis (OA). Methods: Clinical data of 47 patients with OA admitted at Department of Orthopaedic Surgery in Nanjing Medical University Nanjing Hospital between April and September 2016 were retrospectively reviewed, including 20 males and 27 females, aging from 57 to 77 years with mean age of (63.8±8.2) years. They were randomly divided into iASSIST-TKA group (23 patients) and PSI-TKA group (24 patients)...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28589334/are-there-differences-in-gait-mechanics-in-patients-with-a-fixed-versus-mobile-bearing-total-ankle-arthroplasty-a-randomized-trial
#8
Robin M Queen, Christopher T Franck, Daniel Schmitt, Samuel B Adams
BACKGROUND: Total ankle arthroplasty (TAA) is an alternative to arthrodesis, but no randomized trial has examined whether a fixed bearing or mobile bearing implant provides improved gait mechanics. QUESTIONS/PURPOSES: We wished to determine if fixed- or mobile-bearing TAA results in a larger improvement in pain scores and gait mechanics from before surgery to 1 year after surgery, and to quantify differences in outcomes using statistical analysis and report the standardized effect sizes for such comparisons...
June 6, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28583023/safety-of-outpatient-total-ankle-arthroplasty-vs-traditional-inpatient-admission-or-overnight-observation
#9
Ryan P Mulligan, Selene G Parekh
BACKGROUND: Total joint surgeons have successfully performed hip, knee, and shoulder arthroplasty procedures in the outpatient setting without compromising safety, satisfaction, or results. The purpose of this study was to evaluate outpatient total ankle arthroplasty (TAA) as compared with overnight or extended inpatient stay, with regard to 90-day medical and operative complications, reoperations, readmissions or emergency room visits, and pain control. METHODS: The medical records of patients who underwent TAA with 1 fellowship-trained orthopedic foot and ankle surgeon were reviewed...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28580856/short-term-perioperative-complications-and-mortality-after-total-ankle-arthroplasty-in-the-united-states
#10
Kenneth A Heida, Brian Waterman, Eric Tatro, Julia Bader, Andrew C McCoy, Nicholas Rensing, Justin Orr
This study sought to identify patient and operative demographics associated with 30-day perioperative complications in patients undergoing total ankle arthroplasty as recorded in the National Surgical Quality Improvement Project database. Complications were divided into local and systemic and further subcategorized as major and minor. A total of 404 patients underwent total ankle arthroplasty between 2007 and 2014 as captured in the National Surgical Quality Improvement Project database. The overall complication rate was 2...
June 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28580056/a-pictorial-review-of-reconstructive-foot-and-ankle-surgery-elective-lesser-forefoot-procedures
#11
REVIEW
Andrew J Meyr, Laura Sansosti, Sayed Ali
This pictorial review focuses on basic procedures performed within the field of podiatric surgery, specifically for elective procedures of the lesser forefoot including the correction of hammertoes and lesser metatarsal deformities. Our goal is to demonstrate objective radiographic parameters that surgeons utilize to initially define the deformity, lead to procedure selection and judge post-operative outcomes. We hope that radiologists will employ this information to improve their assessment of post-operative radiographs following reconstructive foot surgeries...
November 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/28579444/three-dimensional-computed-tomography-analysis-of-the-posterior-tibial-slope-in-100-knees
#12
Jade Pei Yuik Ho, Azhar M Merican, Muhammad Sufian Hashim, Azlina A Abbas, Chee Ken Chan, Jamal A Mohamad
BACKGROUND: The posterior tibial slope (PTS) is an important consideration in knee arthroplasty. However, there is still no consensus for the optimal slope. The objectives of this study were (1) to reliably determine the native PTS in this population using 3-dimensional computed tomography scans and (2) to determine the normal reference range for PTS in this population. METHODS: One hundred computed tomography scans of disease-free knees were analyzed. A 3-dimensional reconstructed image of the tibia was generated and aligned to its anatomic axis in the coronal and sagittal planes...
May 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28578802/spontaneous-resolution-of-posterior-ankle-joint-loose-bodies-after-total-ankle-replacement-a-case-report
#13
Raymond P Lee, Sally H S Cheng
Late stage ankle osteoarthritis often presents with debilitating pain. It is common to find osteophytes and loose body formation around the joint. Total ankle arthroplasty can preserve joint mobility and pain relieve for such patient. However, when trying to remove the osteophytes and loose bodies at the posterior ankle joint, there is risk of damaging posterior structures such as the neurovascular bundle during the procedure. We are presenting a case where the posterior loose bodies remained untouched during the operation, and patient showed spontaneous resolution of the lesions with time...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578800/geometric-analysis-of-the-talus-and-development-of-a-generic-talar-prosthetic
#14
Alexandra Trovato, Marwan El-Rich, Samer Adeeb, Suki Dhillon, Nadr Jomha
BACKGROUND: Trauma to the talus can result in fracture, avascular necrosis and structural collapse. Treatment has been limited to surgical fusion and total ankle arthroplasty. Total ankle arthroplasty may not be an appropriate treatment for avascular necrosis while surgical fusion of the joint limits mobility. Custom-made implants have recently been used to address these limitations but have lengthy delays between injury and surgery and higher associated costs. A generic talar prosthesis available in various sizes may serve as a suitable alternative...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578799/tibial-slope-in-total-ankle-arthroplasty-anterior-or-lateral-approach
#15
Federico Giuseppe Usuelli, Camilla Maccario, Cristian Indino, Luigi Manzi, Christopher Edward Gross
BACKGROUND: A new total ankle arthroplasty (TAA) system performed through a lateral approach provides direct visualization of the centre of rotation, allowing for accurate reconstruction of the joint alignment and less bone resection. Radiographic references are needed to describe deformities and plan the surgical procedures. The tibial slope is an important factor when treating malalignment. The aim of this study is to show if there is any difference regarding the post-operative tibial slope (β angle) measurement comparing a fixed-bearing TAA through a lateral approach and a mobile-bearing TAA through an anterior approach...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578798/identifying-the-learning-curve-for-total-ankle-replacement-using-a-mobile-bearing-prosthesis
#16
Federico G Usuelli, Camilla Maccario, Andrea Pantalone, Nicola Serra, Eric W Tan
BACKGROUND: Total ankle arthroplasty remains a technically demanding surgery highly influenced by the operator experience. However, no consensus exists regarding the ideal number of cases that need to be performed before a surgeon is considered proficient. The aim of this study was to identify the learning curve of a specific replacement system with regards to intraoperative and postoperative outcomes. METHODS: The first 31 patients undergoing total ankle arthroplasty were examined...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578796/are-periprosthetic-osteolytic-lesions-in-ankle-worth-bone-grafting
#17
Ia Kohonen, Helka Koivu, Hannu Tiusanen, Jussi Kankare, Tero Vahlberg, Kimmo Mattila
BACKGROUND: We retrospectively evaluated the medium-term follow-up of bone grafting due to periprosthetic osteolytic lesions in ankles. METHODS: 34 ankles (32 patients) with total ankle arthroplasty (TAA) underwent re operation. Indications were large periprosthetic osteolytic lesions or continuous growing of the lesions. The osteolytic lesions were imaged by CT before reoperation and once a year after that. The mean CT follow-up after re operation was 3.8 years (range, 2-6...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578795/heterotopic-ossification-after-total-ankle-replacement-the-role-of-prosthesis-alignment
#18
Sebastian Manegold, Alexander Springer, Kristin Landvoigt, Serafim Tsitsilonis
BACKGROUND: The aetiology of heterotopic ossifications (HO) after total ankle arthroplasty (TAR) remains controversial. The aim of the study was to evaluate the prevalence and localisation of HO and the effect of alignment. METHODS: 88 TARs with a series of radiological controls and follow-up of 36 months were evaluated. Frontal and sagittal alignment parameters (alfa and beta angle defined by Hintermann) and tibial coverage were evaluated. RESULTS: The prevalence and grading of HO increased over time, mostly in the posterior gutter...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578792/functional-and-clinical-outcomes-of-total-ankle-arthroplasty-in-elderly-compared-to-younger-patients
#19
Shay Tenenbaum, Jason Bariteau, Scott Coleman, James Brodsky
BACKGROUND: Total ankle arthroplasty (TAA) is becoming an increasingly utilized procedure for the management of end-stage ankle arthritis. Elderly patients are the fastest growing segment of the population in the western world, creating a unique challenge to the health economics of our era. Determining if elderly patients with end-stage ankle arthritis demonstrate the same improvements in clinical outcomes and functional measures of gait following TAA would be valuable. This can aid to evaluate the utilization of TAA in this enlarging cohort of our population...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28576194/operative-fixation-options-for-elective-and-diabetic-ankle-arthrodesis
#20
REVIEW
Crystal L Ramanujam, John J Stapleton, Thomas Zgonis
Ankle arthrodesis remains one of the most definitive treatment options for end-stage arthritis, paralysis, posttraumatic and postinfectious conditions, failed total ankle arthroplasty, and severe deformities. The general aims of ankle arthrodesis are to decrease pain and instability, correct the accompanying deformity, and create a stable plantigrade foot. Several surgical approaches have been reported for ankle arthrodesis with internal fixation options. External fixation has also evolved for ankle arthrodesis in certain clinical scenarios...
July 2017: Clinics in Podiatric Medicine and Surgery
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