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Varus ankle

Chong Meng Lee, Malkit K Dhillon, Mohd Amin Sulaiman
Background: The use of navigation for total knee arthroplasty (TKA) improves limb alignment in the coronal and sagittal planes. However, similar improvements in femoral and tibial component rotation have not yet been realized using currently available systems. Methods: We developed a modified navigated TKA technique in which femoral rotation was set using the resected tibial plane as the reference with the aim of achieving a rectangular flexion gap. Limb alignment was assessed in a cohort of 30 knees using the navigation system...
March 2018: Arthroplasty Today
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
Kristina Stanković, Brian G Booth, Femke Danckaers, Fien Burg, Philippe Vermaelen, Saartje Duerinck, Jan Sijbers, Toon Huysmans
Background: Foot morphology has received increasing attention from both biomechanics researches and footwear manufacturers. Usually, the morphology of the foot is quantified by 2D footprints. However, footprint quantification ignores the foot's vertical dimension and hence, does not allow accurate quantification of complex 3D foot shape. Methods: The shape variation of healthy 3D feet in a population of 31 adult women and 31 adult men who live in Belgium was studied using geometric morphometric methods...
2018: Journal of Foot and Ankle Research
Mohammad Kia, Timothy M Wright, Michael B Cross, David J Mayman, Andrew D Pearle, Peter K Sculco, Geoffrey H Westrich, Carl W Imhauser
BACKGROUND: The correct amount of external rotation of the femoral component during TKA is controversial because the resulting changes in biomechanical knee function associated with varying degrees of femoral component rotation are not well understood. We addressed this question using a computational model, which allowed us to isolate the biomechanical impact of geometric factors including bony shapes, location of ligament insertions, and implant size across three different knees after posterior-stabilized (PS) TKA...
January 2018: Clinical Orthopaedics and related Research
Jasmin Diallo, Joe Wagener, Christine Schweizer, Tamara Horn Lang, Roxa Ruiz, Beat Hintermann
BACKGROUND: An acute ankle sprain can result in a bony avulsion of the lateral ankle ligaments. The extent of concomitant lesions and subsequent instability patterns are not clearly understood. The high incidence of old avulsion fractures found in symptomatic chronic ankle instability may indicate the need for primary fixation. METHODS: Ten patients (5 male, 5 female; mean age, 34 years; range, 15-64 years) with bony avulsion fractures of the fibula after acute ankle sprains were included...
March 1, 2018: Foot & Ankle International
Zhendong Zhang, Hong Zhang, Dianzhong Luo, Hui Cheng, Kai Xiao, Shuxun Hou
PURPOSE: We aimed to identify the coronal plane alignment of lower limbs in patients with unilateral developmental hip dislocation (UDHD) and observe the difference between Hartofilakidis type II and III. PATIENTS AND METHODS: The radiographic data of 76 patients who met the inclusion criteria were retrospectively reviewed, including the hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), anatomical lateral distal femoral angle (aLDFA), mechanical proximal tibial angle (MPTA), and lateral distal tibial angle (LDTA)...
March 3, 2018: International Orthopaedics
Myung-Rae Cho, Young Sik Lee, Won-Kee Choi
Purpose: The objective was to evaluate the relationship between side-to-side differences of lateral femoral bowing and varus knee deformity based on two-dimensional (2D) assessment in unilateral total knee arthroplasty (TKA). Materials and Methods: A total of 143 patients with varus knee osteoarthritis who underwent unilateral TKA were enrolled. We evaluated the side-to-side differences of the frontal lower limb alignment by assessing lateral femoral bowing, anatomical medial distal femoral angle, and anatomical medial proximal tibial angle (aMPTA)...
March 1, 2018: Knee Surgery & related Research
Amir Ali Jafarnezhadgero, Mahdi Majlesi, Hojat Etemadi, D G E Robertson
BACKGROUND: Previous studies have demonstrated increased medial stresses in knee varus alignment. Selecting a suitable treatment strategy for individuals with knee malalignment should be a priority. OBJECTIVES: We aimed to investigate the effects of a 16-week corrective exercise continuum (CEC) program on 3-D joint angles of the dominant and non-dominant lower limbs in children with genu varus during walking. METHODS: Overall, 28 male children with genu varus (age range 9-14 years) volunteered to participate in this study...
February 21, 2018: Annals of Physical and Rehabilitation Medicine
Prasanna Sritharan, Yi-Chung Lin, Sara E Richardson, Kay M Crossley, Trevor B Birmingham, Marcus G Pandy
This study quantified the contributions by muscular, gravitational and inertial forces to the ground reaction force (GRF) and external knee adduction moment (EKAM) for knee osteoarthritis (OA) patients and controls walking at similar speeds. Gait data for 39 varus mal-aligned medial knee OA patients and 15 controls were input into musculoskeletal models to calculate the contributions of individual muscles and gravity to the fore-aft (progression), vertical (support), and mediolateral (balance) GRF, and the EKAM...
February 23, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Xue-Xun Bao, Chen-Jie Xia, Bi-Yun Zhao, De-Jun Shi, Guan-Hua Lan, Guo-Lin Ren, Zu-Hong Xie, Wen-Xi Du
OBJECTIVE: To study the feasibility and clinical efficacy of a minimally invasive sinus tarsi approach in the treatment of Sanders II calcaneus fractures. METHODS: From August of 2015 to July of 2016, 13 patients(totally 13 feet) with Sanders II intra-articular calcaneus fractures were treated via the minimally invasive sinus tarsi approach. The Böhler angle, Gissane angle and the length, width and height of calcaneus were compared between pre-operation and post-operation...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Yong Nie, Jun Ma, ZeYu Huang, Bin Xu, Shuo Tang, Bin Shen, Virginia Byers Kraus, FuXing Pei
To investigate the change in clinical outcomes and biomechanical properties of the knee in response to upper partial fibulectomy. Sixteen patients with medial compartment knee osteoarthritis (KOA) underwent upper partial fibulectomy. Visual analog scale (VAS) pain, the hospital for special surgery knee score (HSS), hip-knee-ankle (HKA) angle (measured in the frontal plane), and flexion/extension range of motion of the knee were assessed before and up to 6 months after surgery. Patients were evaluated for gait parameters and overall peak knee adduction moment (KAM)...
December 13, 2017: Journal of Biomechanics
Christopher E Gross, William Barfield, Christine Schweizer, Helmut Rasch, Michael T Hirschmann, Beat Hintermann, Markus Knupp
Combined single-photon emission computed tomography and conventional computed tomography (SPECT/CT) is a hybrid imaging modality that shows a combination of metabolic and structural information about the ankle, including arthritis. We hypothesize that uptake in specific locations within the ankle joint can be associated with both clinical outcomes and may help predict which patients will have a successful SMO. Eighty-five pre-operative SMO patients with varus (37), valgus (41), or neutral (7) alignment of the hindfoot were assessed using SPECT/CT...
February 10, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Yong Nie, ZeYu Huang, Bin Xu, Bin Shen, Virginia Byers Kraus, FuXing Pei
To investigate the change in short-term clinical outcomes and biomechanical properties of the knee in response to upper partial fibulectomy and to probe into the biomechanical mechanism underlying the clinical benefits of upper partial fibulectomy for medial compartment knee osteoarthritis (KOA). 29 patients with medial compartment KOA underwent upper partial fibulectomy. Visual analog scale (VAS) pain, the hospital for special surgery knee score (HSS), hip-knee-ankle (HKA) angle (measured in the frontal plane), and flexion/extension range of motion of the knee were assessed before and up to 6 months after surgery...
February 9, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Zhong-Yu Hao, Ping Pei, Lin Liu, Yu-Xin Song
OBJECTIVE: To explore clinical outcomes of retrograde interlocked intramedullary nailing with tibia bone graft fusion in treating end-stage ankle arthritis. METHODS: From November 2014 to April 2016, 22 patients with end-stage ankle arthritis were treated with retrograde interlocked intramedullary nailing with tibia bone graft fusion, including 9 males and 13 females aged from 30 to 65 years old with an average of 48.5 years old. Seven patients had obvious varus deformity, and other 15 patients' appearance were normal...
June 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Alessio Bernasconi, Nazim Mehdi, François Lintz
Ankle arthrodesis is still considered the gold standard in the treatment of advanced painful ankle osteoarthritis. More than 3 decades ago, it was performed under arthroscopy; thereafter, many authors have reported excellent results and a low complication rate. Despite the significant improvements in surgical techniques, nonunion remains a problematic and relatively frequent event. This is one of the reasons the research is constantly active in this field. Ten years ago, a fibular resection during ankle arthrodesis was, for the first time, described in the literature as a means to correct malalignment in varus cases...
October 2017: Arthroscopy Techniques
Nicola Krähenbühl, Lena Siegler, Manja Deforth, Lukas Zwicky, Beat Hintermann, Markus Knupp
BACKGROUND: Although it has been proposed that in mid-stage ankle osteoarthritis, the subtalar joint can compensate for deformities above the ankle joint, the evidence is weak. We thus investigated subtalar joint alignment in different stages of ankle osteoarthritis using weightbearing computed tomography (CT) scans. METHODS: The subtalar joint of 88 patients with osteoarthritis of the ankle joint and a control group of 27 healthy volunteers were assessed. Subgroups were performed according to the ankle deformity (varus and valgus) and stage of ankle joint osteoarthritis...
October 18, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Caio Nery, Lucas Fonseca, Fernando Raduan, Marcus Moreno, Daniel Baumfeld
BACKGROUND: Lateral ankle ligament injury is among the most common orthopedic injuries. The objective of this study is to present the preliminary prospective results of treatment using the "Inside-Out" variant of the fully arthroscopic Broström-Gould technique. METHODS: Twenty six patients were included: 20 male and 6 female, aged 19-60 years, mean 41 years. All patients had positive "anterior drawer" and "talar tilt" tests. When necessary, cartilage injuries were treated with microfracture and arthroscopic resection for anterior impingement; three patients had hindfoot varus, on whom Dwyer osteotomy was performed; one patient had peroneal tendinopathy and was treated with tendoscopic debridement and another one had partial injury of the deltoid ligament, which was treated by direct repair...
March 22, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Brian S Baum, Hiroaki Hobara, Kyung Koh, Hyun Joon Kwon, Ross H Miller, Jae Kun Shim
OBJECTIVE: The objective of this study was to investigate 3D lower extremity joint moment differences between limbs and speed influences on these differences in individuals with lower extremity amputations using running-specific prostheses. DESIGN: 8 individuals with unilateral transtibial amputations and 8 control subjects with no amputations ran overground at three constant velocities (2.5, 3.0, and 3.5 m/s). A 2x2x3 (group x leg x speed) repeated-measures ANOVA with Bonferroni adjustments determined statistical significance...
February 5, 2018: American Journal of Physical Medicine & Rehabilitation
Takaaki Ohmori, Tamon Kabata, Yoshitomo Kajino, Daisuke Inoue, Tadashi Taga, Takashi Yamamoto, Tomoharu Takagi, Junya Yoshitani, Takuro Ueno, Ken Ueoka, Hiroyuki Tsuchiya
OBJECTIVES: Limb lengthening after total knee arthroplasty (TKA) has been reported in some cases, all of which were evaluated using 2-dimensional images. To our knowledge, no case has been evaluated using 3-dimensional (3D) images. We investigated 3D limb lengthening after TKA. METHODS: We simulated 100 varus knees using 3D templating software. Virtual TKA was performed to maintain the original joint line by conducting a measured-resection technique. We examined the relationships of 3D distance between the femoral head center and ankle center before and after TKA, degree of hip-knee-ankle angle (HKA) improvement, and degree of flexion contracture angle improvement...
February 1, 2018: Modern Rheumatology
Tsukasa Teramoto, Shota Harada, Motoyuki Takaki, Tomohiko Asahara, Narutaka Kato, Nobuyuki Takenaka, Takasi Matsushita, Yosiaki Makino, Kouitiro Tasiro, Ootuka Kazutaka, Yukinobu Nishi, Kiyoto Kinugsa
We have devised a medial peri-articular osteotomy, the distal tibial oblique osteotomy (DTOO), and have used this technique since 1994 for ankle osteoarthritis of advanced and late stages associated with varus inclination. This report describes the surgical technique and its applicability. DTOO can be used for cases of varus ankle osteoarthritis with a range of the ankle joint movement of at least 10° or more. The osteotomy is obliquely directed cut across the distal tibia from proximal-medial to distal lateral and is of an opening-wedge type with the centre of rotation coincident with the centre of the tibiofibular joint...
January 29, 2018: Strategies in Trauma and Limb Reconstruction
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