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https://www.readbyqxmd.com/read/29074324/does-calipered-kinematically-aligned-tka-restore-native-left-to-right-symmetry-of-the-lower-limb-and-improve-function
#1
Alexander J Nedopil, Avreeta K Singh, Stephen M Howell, Maury L Hull
BACKGROUND: Kinematically aligned total knee arthroplasty (KA TKA) strives to restore the native left to right symmetry of the lower limb; however, the reproducibility of achieving this target is unknown. The present study determined the proportion of patients with left to right symmetry and the improvement in patient-reported function after calipered KA TKA. METHODS: A review of 562 postoperative scanograms identified 102 patients (53 women) with a KA TKA in one limb, no other skeletal abnormalities in either limb, and symmetrical rotation between limbs on the scanogram...
September 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29074321/predicting-the-feasibility-of-correcting-mechanical-axis-in-large-varus-deformities-with-unicompartmental-knee-arthroplasty
#2
Laura J Kleeblad, Jelle P van der List, Andrew D Pearle, Austin T Fragomen, S Robert Rozbruch
BACKGROUND: Due to disappointing historical outcomes of unicompartmental knee arthroplasty (UKA), Kozinn and Scott proposed strict selection criteria, including preoperative varus alignment of ≤15°, to improve the outcomes of UKA. No studies to date, however, have assessed the feasibility of correcting large preoperative varus deformities with UKA surgery. The study goals were therefore to (1) assess to what extent patients with large varus deformities could be corrected and (2) determine radiographic parameters to predict sufficient correction...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29071434/does-alignment-of-the-limb-and-tibial-width-determine-relative-narrowing-between-compartments-when-planning-mechanically-aligned-tka
#3
Avreeta K Singh, Alexander J Nedopil, Stephen M Howell, Maury L Hull
INTRODUCTION: We determined (1) the range of the hip-knee-ankle (HKA) angle in the native or pre-arthritic limbs of patients with a contralateral total knee arthroplasty (TKA); and when mechanical alignment is planned (2) the relationships between the HKA angle and the tibial width, and the relative narrowing between the medial and lateral compartments and (3) the effect of tibial width on the range of narrowing. METHODS: The HKA angle, distal lateral femoral angle (DLFA), and proximal medial tibial angle (PMTA) were measured on the native limb of 102 subjects (53 female) treated with contralateral TKA...
October 25, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28963155/comparison-of-the-outcome-of-total-ankle-arthroplasty-for-osteoarthritis-with-moderate-and-severe-varus-malalignment-and-that-with-neutral-alignment
#4
COMPARATIVE STUDY
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
https://www.readbyqxmd.com/read/28963153/do-varus-or-valgus-outliers-have-higher-forces-in-the-medial-or-lateral-compartments-than-those-which-are-in-range-after-a-kinematically-aligned-total-knee-arthroplasty-limb-and-joint-line-alignment-after-kinematically-aligned-total-knee-arthroplasty
#5
T J Shelton, A J Nedopil, S M Howell, M L Hull
AIMS: The aims of this study were to determine the proportion of patients with outlier varus or valgus alignment in kinematically aligned total knee arthroplasty (TKA), whether those with outlier varus or valgus alignment have higher forces in the medial or lateral compartments of the knee than those with in-range alignment and whether measurements of the alignment of the limb, knee and components predict compartment forces. PATIENTS AND METHODS: The intra-operative forces in the medial and lateral compartments were measured with an instrumented tibial insert in 67 patients who underwent a kinematically aligned TKA during passive movement...
October 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28953661/comparison-of-kinematic-and-mechanical-alignment-techniques-in-primary-total-knee-arthroplasty-a-meta-analysis
#6
Jung-Ro Yoon, Seung-Beom Han, Min-Kyo Jee, Young-Soo Shin
BACKGROUND: This meta-analysis compared clinical and radiographic outcomes and complications of kinematic alignment (KA) and mechanical alignment (MA) techniques in primary total knee arthroplasty (TKA). METHODS: All studies comparing the operation time, change in hemoglobin, length of hospital stay, postoperative complications, and clinical and radiographic outcomes as assessed with various measurement tools, from direct interview to imaging methods, in patients who underwent primary TKA through the KA or MA technique were included...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28953163/the-effect-of-plantar-flexor-lengthening-on-foot-pressure-in-ambulatory-children-with-cerebral-palsy
#7
Oussama Abousamra, Joshua Schwartz, Chris Church, Nancy Lennon, John Henley, Tim Niiler, Freeman Miller
This study aimed to assess the effects of plantar flexor lengthening (PFL) on dynamic foot pressures of children with cerebral palsy using pedobarographs. Of 97 enrolled, 13 children with 18 legs had PFL. Age at surgery was 4.7 (2.8-8.8) years. A significant increase in ankle dorsiflexion and heel impulse was achieved postoperatively and was maintained at 5 years. The coronal plane pressure index increased postoperatively, but reverted to preoperative levels at the 5-year follow-up. Children tend to have more valgus after PFL...
September 25, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28948831/midterm-outcomes-of-a-fixed-bearing-total-ankle-arthroplasty-with-deformity-analysis
#8
Andrew Harston, Alexander L Lazarides, Samuel Adams, James DeOrio, Mark Easley, James Nunley
BACKGROUND: We present our results with an INBONE I (Wright Medical, Memphis, TN) prosthesis who have a minimum of 4 to 10 years of follow-up and include a preoperative deformity analysis on outcomes. METHODS: A consecutive series of 149 patients, from 2007 to 2011, at a single institution were enrolled. Pain and patient-reported function were assessed preoperatively and at yearly follow-ups. We analyzed the data for complications, reoperations, and failures (defined as undergoing revision for exchange or removal of one or both metallic components for any reason)...
September 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28940779/knee-alignment-is-quantitatively-related-to-periarticular-bone-morphometry-and-density-especially-in-those-with-osteoarthritis
#9
Grace H Lo, Mehveen Merchant, Jeffrey B Driban, Jeffrey Duryea, Lori Lyn Price, Charles B Eaton, Timothy E McAlindon
OBJECTIVE: Static alignment influences knee loading and predicts osteoarthritis (OA) progression. Periarticular bone is important in dispersing forces across the knee. And there is substantial evidence for molecular crosstalk between cartilage and subchondral bone. Our objective was to evaluate the relationship of periarticular trabecular morphology and bone mineral density (BMD) with knee alignment. METHODS: This was a cross-sectional analysis of Osteoarthritis Initiative (OAI) Bone Ancillary Study participants...
September 21, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28854764/extramedullary-tibial-bone-cutting-using-medial-cortical-line-in-total-knee-arthroplasty
#10
Ju-Hyung Yoo, Chang-Dong Han, Hyun-Cheol Oh, Sang-Hoon Park, Se-Han Jung, Yun-Jae Lee
Purpose: This study aims to identify the effectiveness of the medial cortical line for attaining a more accurate tibial component alignment in proximal tibial resection using an extramedullary alignment rod. Materials and Methods: The study examined 100 cases of total knee arthroplasty performed from December 2013 to February 2014 in a retrospective manner. On a preoperative anteroposterior (AP) radiograph of the entire tibia, we identified the medial cortical line that runs parallel to the tibial anatomical axis and passes the medial tibial spine, and measured the point where the medial cortical line crosses between the medial malleolus and the lateral malleolus in the ankle joint...
September 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28828747/patient-reported-outcomes-correlate-with-functional-scores-after-opening-wedge-high-tibial-osteotomy-a-clinical-study
#11
Seung-Beom Han, Jong-Hee Lee, Seul-Gi Kim, Chun-Guang Cui, Dong-Won Suh, Seung-Yup Lee, Ki-Mo Jang
PURPOSE: The purpose of this study was to assess post-operative patient subjective satisfaction and to analyze associated peri-operative factors following biplanar medial open wedge high tibial osteotomy (OWHTO). METHODS: The study cohort consisted of 88 patients with a minimum of two years of follow-up. Patient satisfaction was evaluated with a questionnaire that assessed (1) overall satisfaction, (2) pain relief, (3) daily living functions, and (4) cosmesis. Patients were categorized into two groups (satisfied or unsatisfied) based on overall satisfaction questionnaire...
August 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28826786/surgical-treatment-of-chronic-lateral-ankle-instability-using-an-inferior-extensor-retinaculum-flap-a-retrospective-study
#12
Faycal Trichine, Toufik Friha, Azzedine Boukabou, Lamine Belaid, Terek Bouzidi, Mahdjoub Bouzitouna
Chronic lateral ankle instability causes significant problems with physical activity. The purpose of the present study was to evaluate the results of ligamentous retensioning combined with reinforcement using an extensor retinaculum flap. A consecutive series of 38 patients were included with a minimum follow-up duration of 2 years. The functional results were assessed using the Karlsson and American Orthopaedic Foot and Ankle Society scale scores. The pre- and postoperative radiologic assessment was performed using stress radiographs to measure varus tilt and anterior drawer tests...
August 17, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28819603/bilateral-ankle-fusion-in-leak-syndrome-induced-deformity-a-case-report
#13
Luis Sobral, Ana C Ângelo, Afonso Caetano, Joaquim Rodeia, Isabel Rosa
INTRODUCTION: Systemic capillary leak syndrome (SCLS) is a rare condition of unknown etiology defined by sudden episode of hypotension, high hematocrit, and low serum protein concentration due to capillary hyperpermeability. Several treatments have been published for this pathology and eventual compartment syndrome but not for the disabling consequences. This clinical case highlights the negative orthopedic consequences of a severe systemic attack and reports a subsequent deformity treatment option that resulted in the patient quality of life improvement...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28800855/radiographic-analysis-of-the-lower-limbs-using-the-hip-calcaneus-line-in-healthy-individuals-and-in-patients-with-varus-knee-osteoarthritis
#14
Toshikazu Tanaka, Koji Takayama, Shingo Hashimoto, Noriyuki Kanzaki, Shinya Hayashi, Ryosuke Kuroda, Tomoyuki Matsumoto
BACKGROUND: Several recent reports define the line from the centre of the femoral head to the lowest point of the calcaneus. The purpose of this study was to comparatively examine the usefulness of the hip-calcaneus (HC) line and hip-ankle (HA) line for the evaluation of lower-limb alignment in healthy individuals and in patients with osteoarthritis (OA). METHODS: Participants included 34 healthy individuals (mean age, 26.4years) and 34 patients with OA (mean age, 74...
October 2017: Knee
https://www.readbyqxmd.com/read/28799095/assessment-of-hindfoot-alignment-using-mri-and-standing-hindfoot-alignment-radiographs-saltzman-view
#15
Nydia Büber, Marco Zanetti, Arno Frigg, Nadja Saupe
OBJECTIVE: To compare the hindfoot alignment measured on standing HAV radiographs (Saltzman view) and on non-weight-bearing coronal MR images. MATERIALS AND METHODS: The apparent moment arm was measured on weight-bearing conventional radiographs (Saltzman views) and on MRIs of the ankle in 50 consecutive patients (mean age, 54 years; age range, 18-77 years). The evaluation was performed independently by three readers using analogous reference points for both methods...
August 10, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28765981/-anatomic-stabilization-of-chronic-lateral-instability-of-the-ankle-gold-technique
#16
REVIEW
T Diermeier, B Scheiderer, L Lacheta, A B Imhoff
OBJECTIVES: Anatomical reconstruction of the lateral ligament complex in the ankle. INDICATIONS: Chronic lateral ankle instability. CONTRAINDICATIONS: Severe osteoarthritis, obesity, hindfoot varus, general contraindications (infection, circulatory disorders, diabetic foot syndrome). SURGICAL TECHNIQUE: Anatomical V‑shaped reconstruction of the lateral ligament complex with half of the peroneus brevis tendon and additional retinaculum stabilization...
August 1, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28721473/biomechanics-of-the-classic-metaphyseal-lesion-finite-element-analysis
#17
Andy Tsai, Brittany Coats, Paul K Kleinman
BACKGROUND: The classic metaphyseal lesion (CML) is strongly associated with infant abuse, but the biomechanics responsible for this injury have not been rigorously studied. Radiologic and CT-pathological correlates show that the distal tibial CML always involves the cortex near the subperiosteal bone collar, with variable extension of the fracture into the medullary cavity. Therefore, it is reasonable to assume that the primary site of bone failure is cortical, rather than intramedullary...
November 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28704304/arterial-tree-anomalies-in-patients-with-clubfoot-an-investigation-carried-out-at-soba-university-hospital
#18
Samir Shaheen, Mustafa E H Bahar, Almigdad H A Mohammed, Sara F A Elbadri, Ashok Johari
Vascular deficiencies and reduced perfusion of the anterior tibial artery and the dorsalis pedis artery were suggested as causes of congenital talipes equino varus (CTEV). In this study, we assessed the prevalence of arterial abnormalities in patients with CTEV (50 patients; 74 feet) compared with a normal control group (16 patients; 32 feet) by Doppler ultrasound and Ankle Brachial Index. The flow was normal in the control group and was deficient in 39.19% of clubfoot patients. In severe clubfoot cases, the deficiency was found to an extent of 76...
July 12, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28670918/novel-double-osteotomy-technique-of-distal-tibia-for-correction-of-asymmetric-varus-osteoarthritic-ankle
#19
Beat Hintermann, Roxa Ruiz, Alexej Barg
BACKGROUND: A most challenging condition for balancing a varus arthritic ankle is the presence of a defect in the medial tibial plafond. After our initial results with a medial tibial plafondplasty did not fulfill our expectations of success, we hypothesized that adding a correcting supramalleolar osteotomy of the distal tibia would move the loading force to the tibiotalar joint more medially and move the center of rotation of the talus more laterally. In this study, we analyzed midterm clinical and radiographic outcomes in patients with double tibial osteotomy...
September 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28657562/patient-specific-instrumentation-in-total-knee-arthroplasty
#20
Andrea Colombelli, Alberto Belluati, Yousef Rizqallah, Giovanni Guerra, Carlo Busatto
BACKGROUND AND AIM OF THE WORK: The international literature and analysis of the prosthetic registers highlight a significant relationship between the alignment of the components and the survival of prosthetic implants of the knee. The patient specific instrumentation (PSI) technology exploits the data obtained with the MRN for the production of cutting blocks (CB) useful to a TKA. Revisiting the recent international literature, comparing the results of the conventional method and PSI, numerous studies confirm a statistically significant difference of inliers (± 3 degrees) for HKA...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
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