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Foot arthroplasty

Yves Gramlich, Oliver Neun, Alexander Klug, Johannes Buckup, Thomas Stein, Arvid Neumann, Sebastian Fischer, Hans-Peter Abt, Reinhard Hoffmann
INTRODUCTION: Extremely heterogeneous revision rates in total ankle arthroplasty (TAA) of the upper ankle joint are reported and result to heterogeneous collectives and to short follow-up times. The aim is to investigate revision rates and the underlying reasons, as well as treatment outcome and quality of life after TAA in post-traumatic cases with sufficient follow-up. METHODS: In 2008-2013, 74 patients with post-traumatic arthrosis were treated using TAA with a Tornier Salto prosthesis, and 60 (35 males and 25 females; mean age 56) were followed-up (mean: 59 months; range 24-91 months)...
March 20, 2018: International Orthopaedics
Thomas Rosteius, Hinnerk Baecker, Thomas Armin Schildhauer, Dominik Seybold, Jan Geßmann
BACKGROUND: Supramalleolar deformities require surgical correction to avoid posttraumatic osteoarthrosis of the knee or ankle joint and to prevent definitive treatment options, such as total ankle arthroplasty or arthrodesis of the ankle joint. Various methods for the operative correction of supramalleolar deformities have been described in the literature. OBJECTIVE: What results can be achieved with focal dome osteotomy to correct posttraumatic supramalleolar deformities? MATERIAL AND METHODS: A total of 10 patients (mean age 37 years) with a supramalleolar posttraumatic deformity were treated by focal dome osteotomy...
March 19, 2018: Der Unfallchirurg
Danielle Thomas, David Thordarson
BACKGROUND: Hallux rigidus is a common osteoarthritic disease of the first metatarsophalangeal joint (MTPJ). Few salvage treatment options exist that preserve motion for patients who have failed an initial procedure and who are not amenable to fusion, typically patients who are active or who would like to wear high heels. Allograft tendon interpositional arthroplasty is an unconventional salvage treatment option that may preserve motion and prevent bone loss. METHODS: A retrospective chart review is reported of 19 patients who failed previous procedures and refused fusion who underwent allograft tendon interpositional arthroplasty of the hallux MTPJ by a single surgeon between 2012 and 2015...
March 1, 2018: Foot & Ankle International
Aharon S Finestone, Eran Tamir, Guy Ron, Itay Wiser, Gabriel Agar
Background: Diabetic foot ulcers are frequently related to elevated pressure under a bony prominence. Conservative treatment includes offloading with orthopaedic shoes and custom made orthotics or plaster casts. While casting in plaster is usually effective in achieving primary closure of foot ulcers, recurrence rates are high. Minimally invasive surgical offloading that includes correction of foot deformities has good short and long term results. The surgery alleviates the pressure under the bony prominence, thus enabling prompt ulcer healing, negating the patient's dependence on expensive shoes and orthotics, with a lower chance of recurrence...
2018: Journal of Foot and Ankle Research
Mitchell C Weiser, Shai Shemesh, Darwin D Chen, Michael J Bronson, Calin S Moucha
INTRODUCTION: Door openings and increased foot traffic in operating rooms (ORs) during total joint arthroplasty are thought to increase the risk of surgical site infection. METHODS: Digital manometers were used to collect pressure data during off-hours at the thresholds of both the outer door (ie, the door to the common OR hallway) and the inner substerile door, which opens to the substerile hallway, of six empty ORs used for total joint arthroplasty. Airflow patterns were visualized with smoke studies to determine whether outside air entered the ORs during single or multiple door openings...
February 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
Masahiro Horita, Keiichiro Nishida, Kenzo Hashizume, Yoshihisa Nasu, Kenta Saiga, Ryuichi Nakahara, Takahiro Machida, Hideki Ohashi, Toshifumi Ozaki
BACKGROUND: We investigated the clinical outcomes of resection and joint-preserving arthroplasty for forefoot deformities in patients with rheumatoid arthritis. METHODS: Sixteen feet of 14 women (average age, 67.1 years; range, 53-82) underwent resection arthroplasty of the metatarsal head (resection group), and 18 feet of 15 women (average age, 61.3 years; range, 40-73) underwent a metatarsophalangeal joint-preserving procedure with shortening oblique metatarsal osteotomies of the lesser toes (joint preservation group)...
February 1, 2018: Foot & Ankle International
Marco A Martínez Bocanegra, Javier Bayod Lopez, A Vidal-Lesso, Ricardo Becerro de Bengoa Vallejo, Raúl Lesso-Arroyo
BACKGROUND: Currently, the metatarsophalangeal joint replacement through a restorative arthroplasty, where implants are used, is a viable invasive surgical medical procedure in the treatment of severe cases of osteoarthritis in this joint, better known as hallux rigidus. However, few things are known about the postoperative complications that implants can cause on the joint, like Swanson and Tornier implants.Research in this field can provide a valuable information that would help the specialist surgeon in the decision-making during the selection of the more suitable joint implant in each patient, as well as the redesign of the devices, to make them more efficient, durable and biocompatible with the human body...
October 20, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Stefan R Beekhuizen, Timothy Voskuijl, Ron Onstenk
If operative treatment is opted for grade 3 and 4 osteoarthritis of the first metatarsophalangeal joint, arthrodesis is considered the standard of care. However, if preservation of joint mobility is preferred, implant arthroplasty could be favored. Previous studies have suggested hemiarthroplasty might result in less pain, better function, and greater patient satisfaction compared with arthrodesis. However, these studies only evaluated short-term results (range 2.2 to 6.6 years). The aim of our study was to determine whether patients treated with hemiarthroplasty would show better postoperative outcomes compared with those treated with arthrodesis after ≥5 years after surgery...
January 20, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Florian Gaul, Luís E P Tírico, Julie C McCauley, William D Bugbee
BACKGROUND: Osteochondral allograft (OCA) transplantation is a useful alternative for treatment of posttraumatic ankle arthritis in young patients but has a relatively high failure rate and further procedures are often required. The purpose of this study was to evaluate outcomes of patients who underwent revision OCA transplantation of the ankle after failed primary OCA transplantation. METHODS: Twenty patients underwent revision OCA transplantation of the ankle between 1988 and 2015...
January 1, 2018: Foot & Ankle International
Bi O Jeong, Tae Yong Kim, Jong Hun Baek, Hyuk Jung, Seung Hyun Song
PURPOSE: This study aimed to assess radiological changes of the ankle joint, subtalar joint and foot following the correction of varus deformity of the knee with total knee arthroplasty (TKA). It was hypothesized that following the correction of varus deformity by TKA, compensatory reactions would occur at the subtalar joint in accordance with the extent of the correction. METHODS: For this prospective study, 375 knees of patients who underwent TKA between 2011 and 2012 were enrolled...
January 18, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jean Y Lazennec, Dominique Folinais, Caroline Florequin, Aidin E Pour
BACKGROUND: This study assessed the correlation among the patients' perception of the leg length discrepancy (LLD) after total hip arthroplasty (THA) and the anatomical and functional leg length, pelvic and knee alignments, and foot height. METHODS: Patients without significant spinal pathology or previous spine or lower extremity surgery who underwent primary THA (101 patients) were evaluated using EOS images obtained in standing position. All 3-dimensional measures were evaluated and compared for the repeatability and reproducibility and correlation with patients' perception of leg length...
December 13, 2017: Journal of Arthroplasty
Laura E Sansosti, Jennifer C Van, Andrew J Meyr
Total ankle arthroplasty has become an increasingly used alternative to ankle arthrodesis for the treatment of end-stage ankle arthritis. However, despite progressive technological advances and the advent of multiple commercial implant systems, some concern remains for the relatively high complication and failure rates. The objective of the present investigation was to perform a systematic review of the incidence of complications in obese patients undergoing total ankle arthroplasty. We performed a review of electronic databases with the inclusion criteria of retrospective case series, retrospective clinical cohort analyses, and prospective clinical trials with ≥15 total participants, a mean follow-up period of ≥12 months, ≥1 defined cohort with a body mass index of ≥30 kg/m2, and a reported incidence rate of complications requiring revisional surgery at the final follow-up point...
December 25, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jin-Hyeok Seo, Seung-Suk Seo, Do-Hun Kim, Byung-Yoon Park, Chan-Ho Park, Ok-Gul Kim
Purpose: We compared adductor canal block (ACB) alone and a combination of ACB and sciatic nerve block (SNB) to control early postoperative pain after total knee arthroplasty. Materials and Methods: One hundred patients received continuous ACB alone (group A), and another 100 patients received continuous ACB and single popliteal SNB (group B). Pain was evaluated at rest and 45° knee flexion using the numeric rating scale (NRS). The number of times the patient pressed the intravenous patient-controlled analgesia (PCA) button, total PCA volume infused, and the total dosage of additional analgesics were evaluated...
December 1, 2017: Knee Surgery & related Research
Weronika Woźniak-Czekierda, Kamil Woźniak, Anna Hadamus, Dariusz Białoszewski
BACKGROUND: Proprioception and body balance after knee arthroplasty have a considerable impact on restoration of joint function and a normal gait pattern. Kinesiology Taping (KT) is a method that may be able to influence these factors. The aim of this study was to assess the effects of KT application on sensorimotor efficiency, balance and gait in patients undergoing rehabili-ta--tion after knee replacement surgery. MATERIAL AND METHODS: The study involved 120 male and female patients (mean age was 69 years) after total knee repla-cement...
October 31, 2017: Ortopedia, Traumatologia, Rehabilitacja
John M Schuberth, Jeffrey C Christensen, Chad Seidenstricker
Conversion of ankle arthrodesis to total ankle arthroplasty has recently gained popularity. However, technical challenges are present when treating patients without a sufficient fibular buttress. We describe a technique for restoration of an adequate fibular buttress using an iliac crest bone graft or malleolar relocation. The results of 10 patients with an average follow-up period of 56 (range 24 to 123) months are presented. Of the 10 patients, 3 underwent tricortical iliac bone augmentation of the fibula, 4 underwent repositioning of the remnant fibula, and in 3, the in situ fibula was used...
March 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Kazuhiro Shirozu, Tetsuya Kai, Hidekazu Setoguchi, Nobuyasu Ayagaki, Sumio Hoka
BACKGROUND: Forced air warming systems are used to maintain body temperature during surgery. Benefits of forced air warming have been established, but the possibility that it may disturb the operating room environment and contribute to surgical site contamination is debated. The direction and speed of forced air warming airflow and the influence of laminar airflow in the operating room have not been reported. METHODS: In one institutional operating room, we examined changes in airflow speed and direction from a lower-body forced air warming device with sterile drapes mimicking abdominal surgery or total knee arthroplasty, and effects of laminar airflow, using a three-dimensional ultrasonic anemometer...
January 2018: Anesthesiology
Isao Saito, Kyoji Okada, Masahiko Wakasa, Hidekazu Abe, Akira Saito
This survey clarified foot pressure patterns and hindfoot deformities in individuals with advanced knee osteoarthritis (OA) and analyzed their associations with foot pain. Sixty-four individuals with unilateral knee OA who underwent total knee arthroplasty (TKA) were divided into the following groups: no foot pain (n=26; men:women, 4:22; mean age, 73.7 years), foot pain resolved after TKA (12; 2:10; 75.8), and foot pain remaining after TKA (26; 4:22; 74.7). Elderly individuals without pain or deformity in either knee (54; 10:44; 74...
January 2018: Gait & Posture
Ettore Vulcano, Andy L Chang, David Solomon, Mark Myerson
BACKGROUND: Capsular interposition arthroplasty is a joint- and motion-sparing procedure that has been shown as an effective alternative to fusion. This study aimed to evaluate patient function and satisfaction after long-term follow-up. METHODS: Sixty-four patients were treated with capsular interposition arthroplasty for hallux rigidus by the senior author performed between February 1998 and July 2011. Twenty-two patients could not be reached for follow-up and were thus excluded from the analysis...
January 2018: Foot & Ankle International
A Notarnicola, G Maccagnano, A Fiore, A Spinarelli, L Montenegro, M Paoloni, F Pastore, S Tafuri, B Moretti
PURPOSE: It is well known that total knee replacement surgery decreases pain and improves function, but the effect on postural assessment needs to be studied better with the use of new technological devices. Total knee arthroplasty (TKA) improves motor coordination and stability of the knee. On the other hand, changing joint functionality can modify the balance. The aim of this trial is to record and analyze the static and dynamic baropodometric data of patients in the first few months following joint replacement...
October 3, 2017: Musculoskeletal Surgery
S-D Joo, K-B Lee
AIMS: The purpose of this study was to compare the clinical and radiographic outcomes of total ankle arthroplasty (TAA) in patients with pre-operatively moderate and severe arthritic varus ankles to those achieved for patients with neutral ankles. PATIENTS AND METHODS: A total of 105 patients (105 ankles), matched for age, gender, body mass index, and follow-up duration, were divided into three groups by pre-operative coronal plane tibiotalar angle; neutral (< 5°), moderate (5° to 15°) and severe (> 15°) varus deformity...
October 2017: Bone & Joint Journal
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