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https://www.readbyqxmd.com/read/28103870/osteochondral-autograft-transplantation-with-biplanar-distal-tibial-osteotomy-for-patients-with-concomitant-large-osteochondral-lesion-of-the-talus-and-varus-ankle-malalignment
#1
Xingchen Li, Yuan Zhu, Yang Xu, Bibo Wang, Jinhao Liu, Xiangyang Xu
BACKGROUND: Osteochondral lesions of the talus (OLTs) are amongst the most common foot and ankle disorders. Varus ankle malalignment causes stress concentration on medial side of the joint, resulting in OLTs and osteoarthritis. For large symptomatic OLTs (>10 mm), Osteochondral autograft transplantation is usually recommended. This article highlights biplanar distal tibial osteotomy as an approach and management for patients with concomitant large OLTs and varus ankle malalignment...
January 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28053258/ankle-joint-pressure-changes-in-high-tibial-and-distal-femoral-osteotomies-a-cadaver-study
#2
F Krause, A Barandun, G Klammer, I Zderic, B Gueorguiev, T Schmid
AIMS: To assess the effect of high tibial and distal femoral osteotomies (HTO and DFO) on the pressure characteristics of the ankle joint. MATERIALS AND METHODS: Varus and valgus malalignment of the knee was simulated in human cadaver full-length legs. Testing included four measurements: baseline malalignment, 5° and 10° re-aligning osteotomy, and control baseline malalignment. For HTO, testing was rerun with the subtalar joint fixed. In order to represent half body weight, a 300 N force was applied onto the femoral head...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28017574/correcting-severe-varus-deformity-using-trial-components-during-total-knee-arthroplasty
#3
Man S Kim, In J Koh, Young J Choi, Yong D Kim, Yong In
BACKGROUND: Extensive medial soft tissue release may be necessary to correct severe varus deformity during total knee arthroplasty (TKA). However, this procedure may result in instability. Here, we describe a novel soft tissue balancing technique, which can minimize medial release in severe varus deformity during TKA. METHODS: Fifty knees (40 patients) with hip-knee-ankle angle of more than 20° of varus were corrected using this technique (group 1). After achieving flexion gap balancing by needle puncturing and spreading of the superficial medial collateral ligament, extension gap balancing was obtained by gradual extension with the trial components in place...
December 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27995304/patient-specific-instrumentation-versus-conventional-knee-arthroplasty-comparative-study
#4
Vlad Predescu, Catalin Prescura, Razvan Olaru, Liliana Savin, Paul Botez, Bogdan Deleanu
BACKGROUND: The key to a successful knee replacement is restoring normal kinematics with a neutral alignment, thus a hip-knee-ankle (HKA) angle of 180° (within 3° limits). Conventional TKR is proven to have excellent results but relies in extensive visual referencing of bony landmarks. Customised cutting blocks provide accurate bone cuts, also lowering the risk of fat embolism, blood loss and operating time. METHOD: We share our experience comparing two different TKA techniques using patient specific instrumentation (PSI) with the Visionaire knee and conventional instrumentation (CVI) from the same system (Genesis II Smith&Nephew)...
December 19, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27942740/primary-ankle-arthrodesis-for-severely-comminuted-tibial-pilon-fractures
#5
Mohamed E Al-Ashhab
Management of severely comminuted, complete articular tibial pilon fractures (Rüedi and Allgöwer type III) remains a challenge, with few treatment options providing good clinical outcomes. Twenty patients with severely comminuted tibial pilon fractures underwent primary ankle arthrodesis with a retrograde calcaneal nail and autogenous fibular bone graft. The fusion rate was 100% and the varus malunion rate was 10%. Fracture union occurred at a mean of 16 weeks (range, 13-18 weeks) postoperatively. Primary ankle arthrodesis is a successful method for treating highly comminuted tibial pilon fractures, having a low complication rate and a high satisfaction score...
December 8, 2016: Orthopedics
https://www.readbyqxmd.com/read/27939181/chronic-ankle-instability-arthroscopic-anatomical-repair
#6
M Arroyo-Hernández, M Mellado-Romero, P Páramo-Díaz, L García-Lamas, J Vilà-Rico
INTRODUCTION: Ankle sprains are one of the most common injuries. Despite appropriate conservative treatment, approximately 20-40% of patients continue to have chronic ankle instability and pain. In 75-80% of cases there is an isolated rupture of the anterior talofibular ligament. MATERIAL AND METHOD: A retrospective observational study was conducted on 21 patients surgically treated for chronic ankle instability by means of an arthroscopic anatomical repair, between May 2012 and January 2013...
December 8, 2016: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/27935562/current-conservative-management-and-classification-of-club-foot-a-review
#7
Ganesan Balasankar, Ameersing Luximon, Adel Al-Jumaily
Clubfoot, known as congenital talipes equinovarus, is one of the complex paediatric foot deformity with the incidence of 1 in every 1000 live births. It consists of four complex foot abnormalities such as forefoot adductus, midfoot cavus, and hindfoot varus and ankle equinus. There are a number of surgical techniques (soft tissue releases, arthrodesis) used to correct clubfoot. However currently the conservative management (manipulation, serial casting, and braces) of clubfoot is considered as the best choice and it is widely accepted among orthopaedists...
November 30, 2016: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/27920333/accuracy-and-reproducibility-using-patient-specific-instrumentation-in-total-ankle-arthroplasty
#8
Justin Daigre, Gregory Berlet, Bryan Van Dyke, Kyle S Peterson, Robert Santrock
BACKGROUND: Implant survivorship is dependent on accuracy of implantation and successful soft tissue balancing. System instrumentation for total ankle arthroplasty implantation has a key influence on surgeon accuracy and reproducibility. The purpose of this study was to determine the accuracy and reproducibility of implant position with patient-specific guides for total ankle arthroplasty across multiple surgeons at multiple facilities. METHODS: This retrospective, multicenter study included 44 patients who received a total ankle implant (INBONE II Total Ankle System; Wright Medical Technology, Memphis, TN) using PROPHECY patient-specific guides from January 2012 to December 2014...
December 5, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27902166/is-intramedullary-nailing-applicable-for-distal-tibial-fractures-with-ankle-joint-extension
#9
Ozan Beytemür, Cem Albay, Oktay Adanır, Serdar Yüksel, Mehmet Akif Güleç
OBJECTIVES: This study aims to evaluate the functional and radiographic results and treatment complications of AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association) type 43C1 and C2 fractures treated with intramedullary nailing. PATIENTS AND METHODS: We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%)...
December 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/27896394/the-orientation-of-the-surgical-epicondylar-axis-varies-in-varus-and-non-varus-knees-in-the-coronal-plane
#10
Yunjie Zhang, Xiaofeng Wang, Yunchao Shao, Qing Xia
PURPOSE: To investigate the orientations of the surgical epicondylar axis (SEA) of varus and non-varus knees in the coronal plane. METHODS: One-hundred and sixty-two knees from 81 Chinese patients undergoing total knee arthroplasty (TKA) were retrospectively investigated. The angle between the medial side of the femoral mechanical axis and the SEA (MA-SEA), as well as the physiological valgus angle, was measured in the coronal plane using three-dimensional reconstruction...
November 28, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27894173/open-wedge-high-tibial-osteotomy-and-combined-arthroscopic-surgery-in-severe-medial-osteoarthritis-and-varus-malalignment-minimum-5-year-results
#11
Moon-Jib Yoo, Yong-Eun Shin
Purpose: To evaluate the radiologic and functional outcomes of medial open wedge high tibial osteotomy (HTO) combined with arthroscopic procedure in patients with medial osteoarthritis. Materials and Methods: From June 1996 to March 2010, 26 patients (32 knees) who underwent medial open wedge osteotomy and arthroscopic operation for medial osteoarthritis were retrospectively reviewed. Measurements included hip-knee-ankle (HKA) angle, femorotibial angle, medial proximal tibial angle, posterior tibial slope angle, and Kellgren-Lawrence grade...
December 1, 2016: Knee Surgery & related Research
https://www.readbyqxmd.com/read/27856802/optimization-of-hindfoot-alignment-radiography
#12
Chonglin Yang, Xiangyang Xu, Mu Hu, Bibo Wang, Yuan Zhu, Jinhao Liu
BACKGROUND: Cobey and Buck described methods to evaluate hindfoot alignment, but it is still unclear which method is better and easier to perform in clinical practice. PURPOSE: To evaluate the optimal method for radiography of hindfoot alignment. MATERIAL AND METHODS: We randomly selected 50 patients visiting the foot and ankle surgery outpatient department who underwent hindfoot alignment radiography between 1 July and 31 August 2015. Radiographs were taken using both Cobey's and Buck's methods...
November 17, 2016: Acta Radiologica
https://www.readbyqxmd.com/read/27856127/radiographic-assessment-of-knee-ankle-alignment-after-total-knee-arthroplasty-for-varus-and-valgus-knee-osteoarthritis
#13
Fuqiang Gao, Jinhui Ma, Wei Sun, Wanshou Guo, Zirong Li, Weiguo Wang
BACKGROUND: There are unanswered questions about knee-ankle alignment after total knee arthroplasty (TKA) for varus and valgus osteoarthritis (OA) of the knee. The aim of this retrospective study was to assess knee-ankle alignment after TKA. METHODS: The study consisted of 149 patients who had undergone TKA due to varus and valgus knee OA. The alignment and angles in the selected knees and ankles were measured on full-length standing anteroposterior radiographs, both pre-operatively and post-operatively...
November 14, 2016: Knee
https://www.readbyqxmd.com/read/27844117/are-advanced-three-dimensional-imaging-studies-always-needed-to-measure-the-coronal-knee-alignment-of-the-lower-extremity
#14
Jean Yves Lazennec, Quentin Chometon, Dominique Folinais, Christopher B Robbins, Aidin Eslam Pour
BACKGROUND: Coronal malalignment of the lower extremity is closely related to the onset and progression of osteoarthritis. Restoring satisfactory alignment after tibial osteotomy improves the long-term success of this conservative surgery. The purpose of our study was to determine (1) if there is a difference between two-dimensional (2D) and 3D measurements of the hip-knee-ankle (HKA) angle between the mechanical axes of the femur and the tibia, (2) which parameter most affects 2D-3D HKA measurement, and (3) the percentage of patients who are at risk of error in HKA measurement...
November 14, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27843798/chronic-ankle-instability-current-perspectives
#15
REVIEW
Omar A Al-Mohrej, Nader S Al-Kenani
Ankle sprain is reported to be among the most common recurrent injuries. About 20% of acute ankle sprain patients develop chronic ankle instability. The failure of functional rehabilitation after acute ankle sprain leads to the development of chronic ankle instability. Differentiation between functional and anatomical ankle instability is very essential to guide the proper treatment. Stability testing by varus stress test and anterior drawer test should be carried out. Subtalar instability is an important pathology that is commonly by passed during the assessment of chronic ankle instability...
October 2016: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/27830485/lateral-compartment-osteophytes-are-not-associated-with-lateral-compartment-cartilage-degeneration-in-arthritic-varus-knees
#16
Wenzel Waldstein, Maximilian F Kasparek, Martin Faschingbauer, Reinhard Windhager, Friedrich Boettner
BACKGROUND: Progression of arthritis in the lateral compartment is one of the main failure modes of unicompartmental knee arthroplasty (UKA). The decision regarding whether to perform a medial UKA sometimes is made based on whether lateral-compartment osteophytes are visible on plain radiographs obtained before surgery, but it is not clear whether the presence of lateral-compartment osteophytes signifies that the cartilage in the lateral compartment is arthritic. QUESTIONS/PURPOSES: (1) Is the presence of lateral compartment osteophytes associated with biomechanical properties of lateral-compartment cartilage, and (2) are osteophytes in the lateral compartment associated with particular histologic features of cartilage in the lateral compartment? METHODS: Between May 2010 and January 2012, we performed 201 TKAs for varus osteoarthritis confirmed on standardized AP hip-to-ankle standing radiographs...
November 9, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27829727/windswept-deformities-an-indication-to-individualise-valgus-correction-angle-during-total-knee-arthroplasty
#17
Gautam M Shetty, Arun Mullaji, Ahmed Adel Khalifa, Abhik Ray
PURPOSE: We aimed to determine variation in femoral valgus correction angle (VCA) between the two limbs in a patient with windswept deformity undergoing total knee arthroplasty (TKA). METHODS: Femoral VCA was measured on full-length, hip-to-ankle, standing radiographs and was compared between the varus and the valgus limbs in 66 patients with windswept deformities. RESULTS: The mean VCA in varus knees was significantly higher compared to mean VCA in valgus knees (p = 0...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27810026/does-osteoarthritis-of-the-ankle-joint-progress-after-triple-arthrodesis-a-midterm-prospective-outcome-study
#18
Chris A M Aarts, Petra J C Heesterbeek, Perry E M Jaspers, Mark Stegeman, Jan Willem K Louwerens
BACKGROUND: Debate exists regarding the effect of triple fusion on the development of osteoarthritis (OA) of the ankle joint. The midterm outcome after triple arthrodesis and the prevalence of OA following triple arthrodesis are reported in this study. The role of alignment in the development of OA was investigated. METHODS: Seventy five patients (87 feet) were evaluated in 2003 and of these, 48 patients (55 feet) were available for second evaluation in 2008. X-rays of the ankles and feet were made prior to surgery, in 2003 and in 2008, and the level of osteoarthritis (OA) was graded with the Kellgren and Lawrence score...
December 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27794622/mobile-bearing-medial-unicompartmental-knee-arthroplasty-restores-limb-alignment-comparable-to-that-of-the-unaffected-contralateral-limb
#19
Arun B Mullaji, Siddharth Shah, Gautam M Shetty
Background and purpose - Medial unicompartmental knee arthroplasty (UKA) is undertaken in patients with a passively correctable varus deformity. We investigated whether restoration of natural soft tissue tension would result in a lower limb alignment similar to that of the contralateral unaffected lower limb after mobile-bearing medial UKA. Patients and methods - In this retrospective study, hip-knee-ankle (HKA) angle, position of the weight-bearing axis (WBA), and knee joint line obliquity (KJLO) after mobile-bearing medial UKA was compared with that of the unaffected (clinically and radiologically) contralateral lower limb in 123 patients...
February 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/27776517/the-role-of-fibular-for-supramalleolar-osteotomy-in-treatment-of-varus-ankle-arthritis-a-biomechanical-and-clinical-study
#20
Hongmou Zhao, Xiaojun Liang, Yi Li, Guangrong Yu, Wenxin Niu, Yan Zhang
BACKGROUND: Supramalleolar osteotomy (SMOT) is a well-accepted treatment method for mid-stage varus ankle osteoarthritis (OA). However, few studies have examined the role of fibular osteotomy in SMOT. The objective of the current study was to compare the biomechanical and clinical outcomes of SMOT with and without fibular osteotomy. METHODS: Eight cadaveric lower legs with 10° varus/valgus SMOT models were tested using a Tekscan ankle sensor. Tibiotalar joint contact with and without fibular osteotomy conditions were compared...
October 24, 2016: Journal of Orthopaedic Surgery and Research
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