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Sorin Siegler, Tobias Konow, Claudio Belvedere, Andrea Ensini, Rewati Kulkarni, Alberto Leardini
Joint surface interaction and ligament constraints determine the kinematic characteristics of the ankle and subtalar joints. Joint surface interaction is characterized by joint contact mechanics and by relative joint surface position potentially characterized by distance mapping. While ankle contact mechanics was investigated, limited information is available on joint distance mapping and its changes during motion. The purpose of this study was to use image-based distance mapping to quantify this interaction at the ankle and subtalar joints during tri-planar rotations of the ankle complex...
June 7, 2018: Journal of Biomechanics
Can Chen, Hongbin Lu, Jianzhong Hu, Xuqiang Qiu, Xiong Li, Deyi Sun, Jin Qu, Tao Zhang, Daqi Xu
INTRODUCTION: Anatomic repair of the anterior talofibular ligament (ATFL) is challenging when the local ligamentous tissue is severely attenuated. Anatomic reconstruction of the ATFL with tibial tuberosity-patellar tendon (TT-PT) autograft is a feasible choice that can avoid the complicated tendon-bone healing and restore ankle stability. MATERIALS AND METHODS: From 2009 to 2015, 31 chronic lateral ankle instability (CLAI) patients (31 ankles), who had a serious injury on the ATFL only, were treated with anatomic reconstruction of ATFL with TT-PT...
May 2018: Journal of Orthopaedic Surgery
Mandeep S Dhillon, Balvinder Rana, Inayat Panda, Sandeep Patel, Prasoon Kumar
Avascular necrosis (AVN) of the talus can be a cause of significant disability and is a difficult problem to treat. The most common cause is a fracture of the talus. We have done a systematic review of the literature with the following aims: (1) identify and summarize the available evidence in literature for the treatment of talar AVN, (2) define the usefulness of radiological Hawkins sign and magnetic resonance imaging in early diagnosis, and (3) provide patient management guidelines. We searched MEDLINE and PUBMED using keywords and MESH terminology...
May 2018: Indian Journal of Orthopaedics
Marcos Hideyo Sakaki, Rodrigo Sousa Macedo, Alexandre Leme Godoy Dos Santos, Rafael Trevisan Ortiz, Rafael Barban Sposeto, Túlio Diniz Fernandes
Background: Talar body and neck nonunions and malunions may undergo a reconstructive surgery when joint cartilage is still viable, and no talar collapse or infection has occurred. This is a rare condition and the studies supporting the procedure have small number of cases. The objective of the present study is to report a case series of six patients who underwent talar reconstructions. Materials and Methods: Six patients with talar malunions or nonunions who underwent surgical treatment were reviewed in this retrospective study...
May 2018: Indian Journal of Orthopaedics
Michael Swords, John Shank, Stephen Benirschke
Background: The aim of this study is to describe a surgical technique for successful treatment of posteromedial talar body fractures and establish treatment recommendations for fractures of the posterior aspect of the talus. Materials and Methods: Ten patients treated operatively for a posteromedial talar body fractures entering both the subtalar and ankle articulations with a minimum of 1-year followup were identified from a trauma database. Age, mechanism of injury, associated injuries, time to surgery, complications, the range of motion, secondary procedures, and need for arthrodesis were evaluated...
May 2018: Indian Journal of Orthopaedics
S R Sundararajan, Abdul Azeem Badurudeen, R Ramakanth, Shanmuganathan Rajasekaran
Fractures of talar body are uncommon injuries often associated with fractures of other long bones and in polytraumatized patients. The integrity of the talus is essential for the normal function of the ankle, subtalar, and midtarsal joints. The relative infrequency of this injury limits the number of studies available to guide treatment. They occur as a result of high-velocity trauma and are therefore associated with considerable soft tissue damage. Axial compression with supination or pronation is the common mechanism of injury...
May 2018: Indian Journal of Orthopaedics
Michael Swords, Harrison Lakehomer, Michael McDonald, Jay Patel
Talus fractures are rare orthopedic injuries. Surgical fixation is challenging for treating surgeons. The clear majority of fractures require operative treatment. The indication and use of plates in fixation of talus fractures are reviewed. Specific applications including fractures of the lateral process, posterior fractures, extreme comminution, bone grafting, and spring plating to hold key segments are reviewed in this article.
May 2018: Indian Journal of Orthopaedics
Jun-Young Lee, Jae Hwan Lim, Gu-Hee Jung
PURPOSE: We introduced the intraoperative radiological indicator to assess the reduction adequacy without additional procedure or instrument, and propose the optimal syndesmotic screw trajectory. METHODS: Thirty adult cadavers (15 males and 15 females) without ankle problems were enrolled and subjected to continuous 0.75 mm-slice computed tomography (CT) scans. CT images were imported into Mimics® software to reconstruct three-dimensional (3D) model of ankle...
June 4, 2018: Injury
Christopher E Talbot, Derrick M Knapik, Shana N Miskovsky
BACKGROUND: Anterior ankle impingement (AAI) results from repetitive microtrauma leading to pain and decreased dorsiflexion due to spur formation and synovial hypertrophy. Information about the prevalence of anterior spur formation in a large population, and the individual contributions of the talus and tibia to osseous impingement, is limited. MATERIALS AND METHODS: A total of 670 ankle specimens from 344 individuals (n=111 females, n=233 males) aged 20 to 40 years at the time of death were examined...
June 5, 2018: Clinical Anatomy
Yoshiharu Shimozono, Johanna C E Donders, Youichi Yasui, Eoghan T Hurley, Timothy W Deyer, Joseph T Nguyen, John G Kennedy
BACKGROUND: Uncontained-type osteochondral lesions of the talus (OLTs) have been shown to have inferior clinical outcomes after treatment with bone marrow stimulation. While autologous osteochondral transplantation (AOT) is indicated for larger lesions, no study has reported on the prognostic significance of the containment of OLTs treated with the AOT procedure. PURPOSE: To clarify the effect of the containment of OLTs on clinical and radiological outcomes in patients who underwent AOT for OLTs...
June 1, 2018: American Journal of Sports Medicine
Alessio Bernasconi, Nazim Mehdi, Julien Laborde, Cesar de Cesar Netto, Louis Dagneaux, François Lintz
Ankle arthrodesis has been widely reported as an effective solution in treating tibiotalar joint osteoarthritis. The arthroscopic tibiotalar approach for arthrodesis has also been proven to give excellent results in terms of bone fusion rates and reduction of wound-related pain and complications. Historically, ankle malalignment has represented one of the main contraindications for the arthroscopic procedure, but interestingly some investigators have shown that the coronal joint deformity may be addressed arthroscopically as well...
May 2018: Arthroscopy Techniques
Evelyn P Murphy, Christopher Fenelon, Niall P McGoldrick, Stephen R Kearns
Osteochondral lesions of the talus refer to a chondral or subchondral defect of the articular cartilage and potentially the underlying bone. Ankle sprains are an extremely common injury; approximately 27,000 ankle sprains occur per day in America. Fifty percent of these can lead to a cartilage injury to the ankle. There has been a high quoted rate of failure with conservative measures of up to 45% in some series. Surgical options are largely broken down into 2 groups, namely, reparative or regenerative treatments...
April 2018: Arthroscopy Techniques
Seiji Shimomura, Hiroaki Inoue, Yuji Arai, Shuji Nakagawa, Yuta Fujii, Tsunao Kishida, Shohei Ichimaru, Shinji Tsuchida, Toshiharu Shirai, Kazuya Ikoma, Osam Mazda, Toshikazu Kubo
We analyzed the influence of treadmill running on rheumatoid arthritis (RA) joints using a collagen-induced arthritis (CIA) rat model. Eight-week-old male Dark Agouti rats were randomly divided into four groups: The control group, treadmill group (30 min/day for 4 weeks from 10-weeks-old), CIA group (induced CIA at 8-weeks-old), and CIA + treadmill group. Destruction of the ankle joint was evaluated by histological analyses. Morphological changes of subchondral bone were analyzed by μ-CT. CIA treatment-induced synovial membrane invasion, articular cartilage destruction, and bone erosion...
June 3, 2018: International Journal of Molecular Sciences
Lauren E Roberts, Martim Pinto, Jackson R Staggers, Alexandre Godoy-Santos, Ashish Shah, Cesar de Cesar Netto
BACKGROUND: Fractures of the talar neck and body can be fixed with percutaneously placed screws directed from anterior to posterior or posterior to anterior. The latter has been found to be biomechanically and anatomically superior. Percutaneous guidewire and screw placement poses anatomic risks for posterolateral and posteromedial neurovascular and tendinous structures. The objective of this study was to determine the injury rate to local neurovascular and tendinous structures using this technique in a cadaveric model...
June 1, 2018: Foot & Ankle International
D C T Nguyen, S Benameur, M Mignotte, F Lavoie
X-ray image segmentation is an important and crucial step for three-dimensional (3D) bone reconstruction whose final goal remains to increase effectiveness of computer-aided diagnosis, surgery and treatment plannings. However, this segmentation task is rather challenging, particularly when dealing with complicated human structures in the lower limb such as the patella, talus and pelvis. In this work, we present a multi-atlas fusion framework for the automatic segmentation of these complex bone regions from a single X-ray view...
May 18, 2018: Medical Image Analysis
Qing Liu, Wei Luo, Can Zhang, Zhan Liao, Jun Wan, Yupeng Liu, Hongbo He
Objective: To explore the effectiveness of expanded curettage in the treatment of chondroblastoma. Methods: The clinical data of 37 patients with chondroblastoma who were treated with expanded curettage between January 2011 and May 2016 were retrospectively analyzed. There were 24 males and 13 females, with a median age of 17 years (range, 12-30 years). There were 32 primary patients and 5 recurrent patients. Local pain was the first symptom in all patients. The average disease duration was 4...
December 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Zhenhui Sun, Chengli Zhao, Yifei Chen, Nan Li, Tao Zhang, Jingyi Xin, Xinlong Ma
Objective: To investigate the anatomical characters of the sustentaculum tali (ST), accurate entry point and direction for the placement of ST screw from posterior subtalar joint facet to the constant fragment (CF) in calcaneal fractures. Methods: A total of 100 patients with calcaneal fractures performed ankle CT scans were enrolled between January 2016 and April 2016. According to the inclusion criteria, the clinical data of 33 patients were analyzed, including 18 males and 15 females, with a median age of 41...
May 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Bibo Wang, Bo Chen, Xingchen Li, Yang Xu, Zhijie Peng, Xiangyang Xu
Objective: To explore the feasibility of the repair and reconstruction of large talar lesions with three-dimensional (3D) printed talar components by biomechanical test. Methods: Six cadaveric ankle specimens were used in this study and taken CT scan and reconstruction. Then, 3D printed talar component and osteotomy guide plate were designed and made. After the specimen was fixed on an Instron mechanical testing machine, a vertical pressure of 1 500 N was applied to the ankle when it was in different positions (neutral, 10° of dorsiflexion, and 14° of plantar flexion)...
March 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Jun Li, Zeyu Huang, Yue Fang, Fuguo Huang, Lei Liu
Objective: To evaluate the effectiveness of Ilizarov external fixation and ankle arthrodesis in the treatment of late traumatic ankle arthritis. Methods: Between June 2013 and June 2015, 27 patients with late traumatic ankle arthritis were treated with Ilizarov external fixation technique. There were 16 males and 11 females with an age of 27-69 years (mean, 45.7 years). Sixteen cases were on the left side, 11 on the right side. All the patients suffered from traumatic ankle fractures or ligament damages caused by initial traumas...
November 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Jan Hubert, Lukas Weiser, Sandra Hischke, Annemarie Uhlig, Tim Rolvien, Tobias Schmidt, Sebastian Karl Butscheidt, Klaus Püschel, Wolfgang Lehmann, Frank Timo Beil, Thelonius Hawellek
BACKGROUND: Cartilage calcification (CC) is associated with osteoarthritis (OA) in weight-bearing joints, such as the hip and the knee. However, little is known about the impact of CC and degeneration on other weight-bearing joints, especially as it relates to the occurrence of OA in the ankles. The goal of this study is to analyse the prevalence of ankle joint cartilage calcification (AJ CC) and to determine its correlation with factors such as histological OA grade, age and BMI in the general population...
May 24, 2018: BMC Musculoskeletal Disorders
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