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Varus ankle

William Colyn, Rintje Agricola, Nele Arnout, Jan A N Verhaar, Johan Bellemans
PURPOSE: The influence of type and intensity of sports during growth on knee alignment was investigated. The second aim was to ascertain whether the distal femur or proximal tibia contribute most to knee alignment. Also, the influence of field position and leg dominancy on knee alignment in soccer players was audited. METHODS: Standardized full-leg standing digital radiographs were obtained from 100 males and 100 females on which 8 different alignment parameters were measured...
October 14, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Marie Laberge-Malo, Xavier Rodrigue, Céline Goyette, Annie Pouliot-Laforte, Audrey Parent, Isabelle Marcoux, Laurent Ballaz
OBJECTIVE: Fibula hemimelia is a congenital malformation of the lower limbs that is associated to aplasia or hypoplasia of the fibula. This condition is characterized by knee valgus which tends to increase over years in children walking with a below knee prosthesis. However, few recommendations are available regarding the optimal prosthesis alignment for amputated children with fibula hemimelia. The aim of this case study was to compare different prosthesis alignments and to assess their impact on knee joint moment in the frontal plane during walking...
September 2016: Annals of Physical and Rehabilitation Medicine
Ki-Mo Jang, Jong-Hee Lee, Il Youp Cho, Bong-Kyung Park, Seung-Beom Han
BACKGROUND: The purpose of this study was to assess the reliability of pre-, intra operative, and postoperative limb alignment measurements and investigate the correlation between the measurements in biplanar medial opening-wedge high tibial osteotomy. METHODS: This study enrolled 59 knees undergoing biplanar opening-wedge high tibial osteotomy for primary medial osteoarthritis with varus deformity. Preoperative and postoperative standing lower leg radiographs and intraoperative fluoroscopic images were taken...
August 27, 2016: Journal of Arthroplasty
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
Joon Ho Wang, Jung Min Shin, Hyun Ho Kim, Seung-Hoon Kang, Byung Hoon Lee
PURPOSE: To evaluate the differences in the amount of varus malalignment and valgus (over) correction in relation to three different weight bearing conditions from whole leg AP radiographs (single-limb (SL) stance, double-limb (DL) stance, supine position (S)) before and after high tibial osteotomy (HTO), and to evaluate which alignment parameters affect the changes for patients in three different weight bearing conditions. METHODS: A total of 40 consecutive patients (43 knees) with varus osteoarthritis underwent navigation assisted open wedge HTO...
August 18, 2016: International Orthopaedics
H J T A M Huijbregts, R J K Khan, D P Fick, M J Hall, S A Punwar, E Sorensen, M J Reid, S Dalle Vedove, S Haebich
AIMS: We conducted a randomised controlled trial to assess the accuracy of positioning and alignment of the components in total knee arthroplasty (TKA), comparing those undertaken using standard intramedullary cutting jigs and those with patient-specific instruments (PSI). PATIENTS AND METHODS: There were 64 TKAs in the standard group and 69 in the PSI group. The post-operative hip-knee-ankle (HKA) angle and positioning was investigated using CT scans. Deviation of > 3° from the planned position was regarded as an outlier...
August 2016: Bone & Joint Journal
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
Julia Evers, Martin Schulze, Dominic Gehweiler, Martin Lakemeier, Michael J Raschke, Dirk Wähnert, Sabine Ochman
BACKGROUND: Tibiotalocalcaneal arthrodesis (TTCA) using intramedullary nails is a salvage procedure for many diseases in the ankle and subtalar joint. Despite "newly described intramedullary nails" with specific anatomical shapes there still remain major complications regarding this procedure. The following study presents a modified biomechanical test setup for investigations of the hindfoot. METHODS: Nine fresh-frozen specimens from below the human knee were anaysed using the Hindfoot Arthrodesis Nail (Synthes) instrument...
2016: BMC Musculoskeletal Disorders
Hiroyasu Ogawa, Kazu Matsumoto, Takahiro Ogawa, Kentaro Takeuchi, Haruhiko Akiyama
PURPOSE: Medial opening wedge high tibial osteotomy (HTO) is a realignment of the lower limb. Despite accurate preoperative planning and careful surgical techniques, many HTOs result in alignment correction errors. These alignment correction errors may be due to soft tissue laxity around the knee such as varus or valgus laxity. The purpose of this study was to examine the relationship of varus and valgus laxity of the knee and alignment correction errors, and to have a formula to predict the subsequent degree of these correction errors...
October 2016: Archives of Orthopaedic and Trauma Surgery
J Dallinga, A Benjaminse, A Gokeler, N Cortes, E Otten, K Lemmink
Video feedback may be a powerful tool to change biomechanical landing patterns associated with anterior cruciate ligament (ACL) injury risk. This study investigated the effect of video feedback on drop vertical jump (DVJ) landing strategies in team sport athletes. 59 athletes were assigned to a video feedback (VI) or control (CTRL) group. A pretest, 2 training sessions and a posttest were conducted. In both training sessions, video feedback, consisting of a video of the athlete's contour superimposed onto an expert's contour performing the DVJ landing task, was provided to the VI group; the CTRL group did not receive feedback...
July 18, 2016: International Journal of Sports Medicine
M Walther, S Kriegelstein, S Altenberger, A Röser
OBJECTIVES: Correction of calcaneal malalignment as part of a hindfoot correction procedure. INDICATIONS: Varus and valgus malalignment of the calcaneus, increased calcaneal pitch. CONTRAINDICATIONS: Osteoarthritis of the subtalar joint. Fixed and symptomatic deformities of the subtalar joint. SURGICAL TECHNIQUE: After having identified and marked the desired planes of the osteotomy under image intensifier, a percutaneous v‑shaped calcaneal osteotomy is performed...
August 2016: Operative Orthopädie und Traumatologie
Björn Menger, Andreas Kannenberg, Wolf Petersen, Thore Zantop, Ingo Rembitzki, Hartmut Stinus
INTRODUCTION: Unloader braces are non-surgical treatment options for patients with unicompartmental knee osteoarthritis (OA). However, many patients do not adhere to brace treatment because of complications related to discomfort and poor fit. An alternative to knee bracing is an ankle-foot orthosis (AFO) with a lever arm that presses the lower leg into valgus or varus. The aim of this study is to evaluate the clinical benefits of this AFO for patients with unicompartmental knee OA. MATERIALS AND METHODS: Twenty-three patients with knee OA were enrolled in this observational study...
September 2016: Archives of Orthopaedic and Trauma Surgery
Vincenzo Franceschini, Scott R Nodzo, Alejandro Gonzalez Della Valle
BACKGROUND: Proper rotational alignment of the femoral component is critical for a successful total knee arthroplasty (TKA). Controversy remains regarding the optimal intraoperative reference to determine femoral component rotation. METHODS: Thirty-one patients who underwent magnetic resonance imaging of a TKA between April 2008 and November 2015 were retrospectively reviewed. A single surgeon performed the TKA using a posterior condylar angle of 3° (PCA group) or surgical transepicondylar axis (TEA group) to determine femoral component rotation...
May 27, 2016: Journal of Arthroplasty
Teruyuki Miyasaka, Daisaburo Kurosaka, Mitsuru Saito, Toshiyuki Omori, Ryo Ikeda, Keishi Marumo
BACKGROUND: Achieving neutral limb alignment during total knee arthroplasty (TKA) has been identified as a potential factor in long-term prosthesis survival. This study aimed to analyze the accuracy of component orientation and postoperative alignment of the leg after computed tomography (CT)-based navigation-assisted TKA, compare these parameters with those of a conventional technique, and analyze differences in the data of outliers. METHODS: We retrospectively compared the alignment of 130 TKAs performed with a CT-based navigation system with that of 67 arthroplasties done with a conventional system...
June 7, 2016: Journal of Arthroplasty
Thomas Gicquel, Jean Christophe Lambotte, Jean Louis Polard, Mickael Ropars, Denis Huten
PURPOSE: Our purpose was to assess medial unicompartmental knee arthroplasty with navigation alone for the tibial cut and limb alignment. We hypothesised that this technique could be used routinely in practice. METHODS: Outcome measures were tibial cut orientation and residual varus. Six-month post-operative radiographs of 59 knees were assessed. RESULTS: Tibial cut orientation was within 2° of planned in 70.2 and 76.3 % of knees in the coronal and sagittal planes, respectively (49...
June 30, 2016: International Orthopaedics
Tomoharu Mochizuki, Osamu Tanifuji, Yoshio Koga, Takashi Sato, Koichi Kobayashi, Katsutoshi Nishino, Satoshi Watanabe, Akihiro Ariumi, Toshihide Fujii, Hiroshi Yamagiwa, Go Omori, Naoto Endo
PURPOSE: To characterize femoral deformities and determine sex differences in varus knee osteoarthritis (OA), femoral morphology and limb alignment were evaluated by using three-dimensional (3D) assessment, comparing healthy, elderly volunteers with osteoarthritic knees. METHODS: A total of 178 lower limbs of 169 subjects with knee osteoarthritis (136 women, 33 men; mean age 74.9 ± 5.2 years) and 80 lower limbs of 45 healthy, elderly subjects (24 women, 21 men; mean age 65 ± 4...
June 4, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Yuan Zhu, Xiang-Yang Xu, Bi-Bo Wang
Foot and ankle physicians in China encounter quite a large amount of severe and complex deformities. The main cause of severe ankle and foot deformity is trauma, while the other causes may be neuromuscular diseases, improper reduction and fixation and so on. Staged procedure may sometimes be a safer way to correct deformities in the presence of severe soft tissue contracture. Periarticular osteotomy combined with soft tissue balancing can be used in treating severe varus ankle arthritis, including stage IIIb cases and patients with talar tilt of more than 10 degrees...
June 2016: Foot and Ankle Clinics
Hao Sun, Lin Zhou, Fengsheng Li, Jun Duan
Young active patients with medial knee osteoarthritis (OA) combined with varus leg alignment can be treated with high tibial osteotomy (HTO) to stop the progression of OA and avoid or postpone total knee arthroplasty (TKA). Closing-wedge osteotomy (CWO) and opening-wedge osteotomy (OWO) are the most commonly used osteotomy techniques. The purpose of this study was to compare the clinical and radiologic outcomes and complications between OWO and CWO. We retrospectively evaluated 23 studies including 17 clinical trials from published databases from their inception to May 2015...
May 24, 2016: Journal of Knee Surgery
Yong Sang Kim, Moses Lee, Yong Gon Koh
BACKGROUND: Supramalleolar osteotomy (SMO) is reported to be an effective treatment for varus ankle osteoarthritis by redistributing the load line within the ankle joint. Mesenchymal stem cells (MSCs) have been proposed as a new treatment option for osteoarthritis on the basis of their cartilage regeneration ability. The purpose of this study was to compare the clinical, radiological, and second-look arthroscopic outcomes between MSC injection with marrow stimulation and marrow stimulation alone in patients with varus ankle osteoarthritis who have undergone SMO...
December 2016: Journal of Experimental Orthopaedics
Albert d'Heurle, James McCarthy, David Klimaski, Keith Stringer
BACKGROUND: Guided growth has long been used in the lower extremities but has not been applied to varus or valgus deformity in the hip, as may occur in children with cerebral palsy or developmental dysplasia of the hip. The purpose of this study was to determine if screw, plate, or drilling techniques decreased the femoral neck-shaft angle (NSA) and articular trochanteric disease (ATD), as well as describe growth plate structural changes with each method. METHODS: Twelve 8-week-old lambs underwent proximal femoral hemiepiphysiodesis (IACUC approved) using either a screw (n=4), plate (n=4), or drilling procedure (n=4)...
May 19, 2016: Journal of Pediatric Orthopedics
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