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https://www.readbyqxmd.com/read/28534175/-aseptic-loosening-of-total-ankle-replacement-two-stage-revision-with-bone-augmentation-of-osseous-defects-and-secondary-prosthesis-implantation
#1
A Barg, M Wiewiorski, V Valderrabano
OBJECTIVE: To remove loosened ankle prosthesis components, perform osseous defect augmentation, and reimplant definitive prosthesis components to preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components with substantial bone defect. CONTRAINDICATIONS: General surgical/anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy, substantial nonreconstructable osseous defects with or without cysts on the tibial and/or talar side, noncompliance, primary total ankle replacement (TAR) using intramedullary fixation (stem fixation), severely reduced bone quality, insulin-dependent diabetes mellitus, smoking, unrealistic patients' expectations, high activity in sports...
May 22, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28529013/bipolar-fresh-total-osteochondral-allograft-in-the-ankle-is-it-a-successful-long-term-solution
#2
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
#3
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
#4
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/28523426/-revision-and-complications-after-total-ankle-replacement
#5
EDITORIAL
D C Wirtz
No abstract text is available yet for this article.
May 18, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28509825/vascularized-pedicle-bone-grafting-from-the-cuboid-for-talar-osteonecrosis-results-of-a-novel-salvage-procedure
#6
James A Nunley, Kamran S Hamid
BACKGROUND: Osteonecrosis of the talar body represents a complex clinical challenge with treatment options currently limited to core decompression, vascularized and nonvascularized bone-grafting, total talar replacement, and hindfoot arthrodesis. Vascularized pedicle bone-grafting from the cuboid to the talus is a potential alternative to contemporary operative options for replacement of necrotic talar tissue with viable bone. We aimed to analyze functional and radiographic outcomes of vascularized pedicle bone-grafting from the cuboid for the treatment of talar osteonecrosis in a consecutive series of patients spanning a 12-year period...
May 17, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28502359/pearls-and-pitfalls-for-a-surgeon-new-to-ankle-replacements
#7
REVIEW
Federico Giuseppe Usuelli, Camilla Maccario
The role of the surgeon learning curve in total ankle replacement (TAR) has produced contradictory results. It is important for a new surgeon to know what clinical and radiological parameters are considered reliable and ideal. It is clear that exposure to a high-volume center will increase the reliability of a new surgeon approaching TAR. Implant choice may be influenced by surgeon training, and the debate of mobile versus fix-bearing prosthesis is still open. Anterior versus lateral approach is still an open debate, with any hypothetical advantages given by the direct vision on the center of rotation to be proven...
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/28502356/dealing-with-the-stiff-ankle-preoperative-and-late-occurrence
#9
REVIEW
Beat Hintermann, Roxa Ruiz, Alexej Barg
In patients with a stiff ankle replacement, appropriate resection of scarred capsular structures, hypertrophic bone debridement, and careful release of tendons should be performed to achieve good outcomes. Appropriately sized and correctly implanted components are required to restore ankle function to as normal as possible. Although not proven, the better a total ankle replacement is balanced, the less likely scar and heterotopic bone formation will occur. In patients with a stiff and painful ankle replacement, a preoperative diagnostic workup is mandatory to understand the underlying pathologic process and plan appropriate treatment...
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/28502351/malalignment-correction-of-the-lower-limb-before-during-and-after-total-ankle-arthroplasty
#11
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
#12
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
#13
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/28502348/osteolysis-in-total-ankle-replacement-how-does-it-work
#14
REVIEW
Norman Espinosa, Georg Klammer, Stephan H Wirth
Aseptic loosening of implants remains the most common reason for revision surgery for hip, knee, or ankle prostheses. Although a great scientific effort has been made to explain the underlying mechanisms it remains poorly understood, complex, and multifactorial. Many factors, including age, body weight, activity lesions, implant design, fixation methods, material proprieties, immunologic responses, and biomechanical adaptations to total ankle replacement all contribute to the development of periprosthetic osteolysis...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502346/kinematics-and-function-of-total-ankle-replacements-versus-normal-ankles
#15
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
#16
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/28487630/analysis-of-interrelationships-among-voluntary-and-prosthetic-leg-joint-parameters-using-cyclograms
#17
Farahiyah Jasni, Nur Azah Hamzaid, Nor Elleeiana Mohd Syah, Tze Y Chung, Noor Azuan Abu Osman
The walking mechanism of a prosthetic leg user is a tightly coordinated movement of several joints and limb segments. The interaction among the voluntary and mechanical joints and segments requires particular biomechanical insight. This study aims to analyze the inter-relationship between amputees' voluntary and mechanical coupled leg joints variables using cyclograms. From this analysis, the critical gait parameters in each gait phase were determined and analyzed if they contribute to a better powered prosthetic knee control design...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28470862/first-report-on-the-safety-and-efficacy-of-an-extended-half-life-glycopegylated-recombinant-fviii-for-major-surgery-in-severe-haemophilia-a
#18
K Hampton, P Chowdary, S Dunkley, S Ehrenforth, L Jacobsen, A Neff, E Santagostino, J Sathar, H Takedani, C M Takemoto, C Négrier
BACKGROUND: N8-GP (turoctocog alfa pegol) is an extended half-life glycoPEGylated recombinant factor VIII (FVIII) product developed for the prevention and treatment of bleeds in haemophilia A patients. AIM: This is a planned interim analysis of pathfinder™3, an international, open-label, Phase 3 trial evaluating the efficacy and safety (including immunogenicity) of N8-GP administered before, during and after major surgery in severe haemophilia A patients aged ≥12 years...
May 4, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28466759/knee-ankle-foot-orthosis-with-powered-knee-for-support-in-the-elderly
#19
Peter Paul Pott, Sebastian Immanuel Wolf, Julia Block, Stefan van Drongelen, Markus Grün, Daniel Ww Heitzmann, Jürgen Hielscher, Andreas Horn, Roman Müller, Oliver Rettig, Ulrich Konigorski, Roland Werthschützky, Helmut Friedrich Schlaak, Thorsten Meiß
A prototype of a powered knee orthotic device was developed to determine whether fractional external torque and power support to the knee relieves the biomechanical loads and reduces the muscular demand for a subject performing sit-to-stand movements. With this demonstrator, consisting of the subsystems actuation, kinematics, sensors, and control, all relevant sensor data can be acquired and full control is maintained over actuator parameters. A series-elastic actuator based on a direct current motor provides up to 30 Nm torque to the knee via a hinge joint with an additional sliding degree of freedom...
May 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28455729/corr-insights-%C3%A2-can-a-three-component-prosthesis-be-used-for-conversion-of-painful-ankle-arthrodesis-to-total-ankle-replacement
#20
Andrew Haskell
No abstract text is available yet for this article.
April 28, 2017: Clinical Orthopaedics and related Research
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