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Ankle replacement

Nicola Krähenbühl, Lukas Zwicky, Lilianna Bolliger, Sabine Schädelin, Beat Hintermann, Markus Knupp
BACKGROUND: Good clinical and radiographic short-term results have been reported for patients who underwent realignment surgery of the hindfoot for treatment of early- and mid-stage ankle osteoarthrosis (OA). However, no mid- to long-term results have been reported. The aim of this study was to gain a better insight into the indications and contraindications for realignment surgery. METHODS: Two hundred ninety-four patients (298 ankles) underwent realignment surgery between December 1999 and June 2013...
October 10, 2016: Foot & Ankle International
Nathanael Heckmann, Alexander Bradley, Lakshmanan Sivasundaram, Ram Kiran Alluri, Eric W Tan
BACKGROUND: Several studies have examined the effect of insurance on the management of various orthopedic conditions. The purpose of our study was to assess the effect of insurance and other demographic factors on the operative management of tibiotalar osteoarthritis. METHODS: The National Inpatient Sample (NIS) database was used to identify patients who underwent a total ankle arthroplasty (TAA) or tibiotalar arthrodesis (TTA) for tibiotalar osteoarthritis. Insurance status was identified for each patient, and the proportions of each insurance type were computed for each operative modality...
October 18, 2016: Foot & Ankle International
Kamran S Hamid, Andrew P Matson, Benedict U Nwachukwu, Daniel J Scott, Richard C Mather, James K DeOrio
BACKGROUND: Traditional intraoperative referencing for total ankle replacements (TARs) involves multiple steps and fluoroscopic guidance to determine mechanical alignment. Recent adoption of patient-specific instrumentation (PSI) allows for referencing to be determined preoperatively, resulting in less steps and potentially decreased operative time. We hypothesized that usage of PSI would result in decreased operating room time that would offset the additional cost of PSI compared with standard referencing (SR)...
September 20, 2016: Foot & Ankle International
Shirley Chen, Adam Fleischer, Craig Wirt, Richmond Robinson, Carolina Barbosa, Arezou Amidi, Robert Joseph
INTRODUCTION AND OBJECTIVES: The purpose of this study was to determine whether some foot/ankle surgeries would benefit from routine use of low molecular weight heparin (LMWH) as postoperative DVT prophylaxis. METHODS: We conducted a formal cost-effectiveness analysis using a decision analytic tree to represent the risk of complications under a scenario of no prophylaxis and a scenario of routine LMWH prophylaxis for 4 weeks. The two scenarios were compared for five procedures: 1) Achilles tendon repair (ATR), 2) total ankle replacement (TAR), 3) hallux valgus surgery (HVS), 4) hindfoot arthrodesis (HA), and 5) ankle fracture surgery (AFS)...
September 2016: Journal of the American Podiatric Medical Association
Elisa S Arch, Bretta L Fylstra
The large, late-stance energy generated by the ankle is believed to be critical during gait. However, the distal foot absorbs/dissipates a considerable amount of energy during the same phase. Thus, the energy generated by the combined ankle-foot system is more modest, which raises questions regarding the necessity of such a large ankle power and the interplay between foot and ankle energetics. This study aimed to evaluate our conservation of energy hypothesis, which predicted if distal foot energy absorption/dissipation was reduced, less energy would be generated at the ankle and thus the same combined ankle-foot energetics would be achieved...
September 6, 2016: Journal of Applied Biomechanics
Lidia Anguiano, Marta Riera, Julio Pascual, José Manuel Valdivielso, Clara Barrios, Angels Betriu, Sergi Clotet, Sergi Mojal, Elvira Fernández, María José Soler
BACKGROUND AND AIMS: Circulating Angiotensin Converting Enzyme 2 (ACE2) activity in chronic kidney disease (CKD) patients without previous history of cardiovascular disease (CVD) has been associated with classical risk factors (older age, diabetes and male gender). Furthermore, silent atherosclerosis has been described as a pathological link between CKD and CVD. We analyzed baseline ACE2 activity in non-dialysis CKD stages 3-5 (CKD3-5) patients as a biomarker of renal progression, silent atherosclerosis and CV events after 2 years of follow-up...
October 2016: Atherosclerosis
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
Andrew J Goldberg, Razi Zaidi, Claire Thomson, Caroline J Doré, Simon S Skene, Suzie Cro, Jeff Round, Andrew Molloy, Mark Davies, Michael Karski, Louise Kim, Paul Cooke
INTRODUCTION: Total ankle replacement (TAR) or ankle arthrodesis (fusion) is the main surgical treatments for end-stage ankle osteoarthritis (OA). The popularity of ankle replacement is increasing while ankle fusion rates remain static. Both treatments have efficacy but to date all studies comparing the 2 have been observational without randomisation, and there are no published guidelines as to the most appropriate management. The TAR versus arthrodesis (TARVA) trial aims to compare the clinical and cost-effectiveness of TAR against ankle arthrodesis in the treatment of end-stage ankle OA in patients aged 50-85 years...
September 6, 2016: BMJ Open
Christopher E Gross, Samuel B Adams, Mark Easley, James A Nunley, James K DeOrio
: Background Impingement may be an underreported problem following modern total ankle replacements (TARs). The etiology of impingement is unclear and likely multifactorial. Because of the lack of conservative treatment options for symptomatic impingement after TAR, surgery is often necessary. Methods We retrospectively identified a consecutive series of 1001 primary TARs performed between January 1998 and December 2014. We identified patients who required a secondary surgery to treat soft-tissue and bony impingement by either an open or arthroscopic procedure...
September 5, 2016: Foot & Ankle Specialist
J Chris Coetzee, Daryle Petersen, Rebecca M Stone
BACKGROUND: Ankle replacement surgery is an established and accepted way to treat end stage ankle arthritis. Though there are multiple publications looking at results with various ankle replacement systems, most of them are single implant longitudinal studies from a single institution. There are, however, no prospective randomized studies evaluating the outcomes of different total ankle arthroplasty (TAA) systems; in fact, there are no comparative studies at all. METHODS: The comparative results of 3 different total ankle systems (INBONE, STAR, and Salto Talaris) were evaluated...
September 5, 2016: Foot & Ankle Specialist
Claire L Brockett, Graham J Chapman
This paper provides an introduction to the biomechanics of the ankle, introducing the bony anatomy involved in motion of the foot and ankle. The complexity of the ankle anatomy has a significant influence on the biomechanical performance of the joint, and this paper discusses the motions of the ankle joint complex, and the joints at which it is proposed they occur. It provides insight into the ligaments that are critical to the stability and function of the ankle joint. It describes the movements involved in a normal gait cycle, and also highlights how these may change as a result of surgical intervention such as total joint replacement or fusion...
June 2016: Orthopaedics and Trauma
J Zou, Z Shi, G Mei, J Xue, W Gu, X Li
INTRODUCTION: Tuberculosis (TB) in midfoot is often secondary to tuberculosis elsewhere in the body. The experience and literatures to treat midfoot tuberculosis are rare. Up until now, no successful method is reported to treat midfoot tuberculosis. HYPOTHESIS: Stage surgery is an effective method to treat midfoot bone TB. MATERIAL AND METHODS: Between January 2008 to January 2011, 14 patients who were diagnosed midfoot tuberculosis and suffered stage operation were enrolled...
August 26, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Richard J VanTienderen, John C Dunn, Nicholas Kusnezov, Justin D Orr
PURPOSE: The purpose of this study is to present a systematic review of the literature regarding the use of fresh bulk osteochondral allograft transfer for treatment of large osteochondral lesions of the talus (OCLT) in an effort to characterize the functional outcomes, complications, and reoperation rates. METHODS: A search of the PubMed, CINAHL, Embase, and Cochrane Databases was performed between January 1, 1990, and March 1, 2016, and included all articles related to outcomes after fresh talar allograft transplantation for OCLT...
August 18, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Stacey M Rigney, Anne Simmons, Lauren Kark
Lower-limb amputees commonly utilize non-articulating energy storage and return (ESAR) prostheses for high impact activities such as sprinting. Despite these prostheses lacking an articulating ankle joint, amputee gait analysis conventionally features a two-link segment model of the prosthetic foot. This paper investigated the effects of the selected link segment model׳s marker-set and geometry on a unilateral amputee sprinter׳s calculated lower-limb kinematics, kinetics and energetics. A total of five lower-limb models of the Ottobock(®) 1E90 Sprinter were developed, including two conventional shank-foot models that each used a different version of the Plug-in-Gait (PiG) marker-set to test the effect of prosthesis ankle marker location...
October 3, 2016: Journal of Biomechanics
Yvonne R A Kerkhoff, Nienke M Kosse, Wieneke P Metsaars, Jan Willem K Louwerens
BACKGROUND: Total ankle arthroplasty is an accepted alternative to arthrodesis of the ankle. However, complication and failure rates remain high. Long-term results of the Scandinavian Total Ankle Replacement (STAR) are limited, with variable complication and failure rates observed. This prospective study presents the long-term survivorship and postoperative complications of the STAR prosthesis. METHODS: Between May 1999 and June 2008, 134 primary total ankle arthroplasties were performed using the STAR prosthesis in 124 patients...
August 18, 2016: Foot & Ankle International
Alastair S E Younger, Mark Glazebrook, Andrea Veljkovic, Gordon Goplen, Timothy R Daniels, Murray Penner, Kevin J Wing, Peter J Dryden, Hubert Wong, Karl-André Lalonde
BACKGROUND: Repeated surgery can be a measure of failure of the primary surgery. Future reoperations might be avoided if the cause is recognized and procedures or devices modified accordingly. Reoperations result in costs to both patient and the health care system. This paper proposes a new classification system for reoperations in end-stage ankle arthritis, and analyzes reoperation rates for ankle joint replacement and arthrodesis surgeries from a multicenter database. METHODS: A total of 213 ankle arthrodeses and 474 total ankle replacements were prospectively followed from 2002 to 2010...
August 16, 2016: Foot & Ankle International
Hirokazu Shiraishi, Takeshi Shirayama, Naoki Maruyama, Satoshi Kaimoto, Asako Otakara, Ritsuko Kurimoto, Naohiko Nakanishi, Takeshi Nakamura, Tetsuhiro Yamano, Akiyoshi Matsumuro, Kiyoshi Doi, Hitoshi Yaku, Satoaki Matoba
BACKGROUND: Early diagnosis and optimal timing of surgical repair for chronic aortic regurgitation (AR) are topics of interest, because left ventricular compensation delays the clinical signs of the early stages of left ventricular dysfunction. Various physical signs have been described as indicators of chronic AR, but AR screening can be difficult depending on the proficiency of primary care providers. The recent use of the cardio-ankle vascular index (CAVI) measurement to assess peripheral atherosclerosis may detect AR objectively and simply because its arterial pulse wave configuration is closely related to the physical signs of AR...
August 5, 2016: Journal of Cardiology
Emilie R C Williamson, Constantine A Demetracopoulos, Scott J Ellis
Few reports in the literature have described the conversion of a surgically fused ankle to a total ankle replacement. The takedown of an autofusion and conversion to a prosthesis has not been described. We report the case of a patient with severe rheumatoid arthritis with an ankle autofusion fixed in equinus and severe talonavicular arthritis that was converted to ankle replacement using the Salto XT revision system. We describe the reasons why the decision was made to perform total ankle arthroplasty while concomitantly fusing the talonavicular joint, and discuss the rationale of the various surgical treatment options considered...
September 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
A Jordan Grier, Abigail C Schmitt, Samuel B Adams, Robin M Queen
BACKGROUND: Gait mechanics following total ankle replacement (TAR) have reported improved ankle motion following surgery. However, no studies have addressed the impact of preoperative radiographic tibiotalar alignment on post-TAR gait mechanics. We therefore investigated whether preoperative tibiotalar alignment (varus, valgus, or neutral) resulted in significantly different coronal plane mechanics or ground reaction forces post-TAR. METHODS: We conducted a non-randomized study of 93 consecutive end-stage ankle arthritis patients...
July 2016: Gait & Posture
Swati Chopra, Julien Favre, Xavier Crevoisier
Today, ankle joint kinematic assessment gives important information regarding the intersegment range of motion. It does not, however, provide information regarding coordination between the segments. This study aimed to determine whether or not intersegment coordination can provide valuable, otherwise missed information in relation to kinematic alterations of the ankle joint. The study consisted of 40 participants, including 12 total ankle replacement (TAR) patients, 12 ankle arthrodesis (AA) patients, and 16 controls...
July 30, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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