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https://www.readbyqxmd.com/read/28721473/biomechanics-of-the-classic-metaphyseal-lesion-finite-element-analysis
#1
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...
July 18, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28704304/arterial-tree-anomalies-in-patients-with-clubfoot-an-investigation-carried-out-at-soba-university-hospital
#2
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
#3
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...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28657562/patient-specific-instrumentation-in-total-knee-arthroplasty
#4
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
https://www.readbyqxmd.com/read/28656162/evaluation-of-changes-in-the-tibiotalar-joint-after-high-tibial-osteotomy
#5
Seyed Morteza Kazemi, Mohamad Qoreishi, Ehsan Behboudi, Alireza Manafi, Seyed Kamyar Kazemi
BACKGROUND: There are limited studies regarding the effects of high tibial osteotomy (HTO) on other areas of lower extremity. In current study, we investigated the changes of tibiotalar joint following HTO. METHODS: A total of 39 patients with genu varum requiring HTO were enrolled in this before and after study. The genu varus, joint diversion (JDA), lateral distal tibial (LDTA) and lateral distal tibial-ground surface (LDT-GSA) angles were measured before the operation and compared with 6 months after the surgery...
May 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28634785/-imaging-and-preoperative-planning-for-osteotomies-around-the-knee
#6
REVIEW
D Pape, A Hoffmann, R Seil
Physiologic alignment of the human lower leg is well defined. The etiology for malalignment comprises constitutional, degenerative and posttraumatic conditions. Osteotomies around the knee can correct the malalignment, provided that the origin of deviation is in proximity of the knee center. Crucial factors for the evaluation of axis deviation are the weight-bearing line, the mechanical axes of femur and tibia, the joint line angles and the center of the hip, knee and upper ankle joint. Careful preoperative planning is mandatory for reproducible clinical results...
June 20, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28633795/valgus-ankle-degenerative-arthritis-with-an-isolated-deltoid-insufficiency-and-tibial-varus-a-case-report
#7
Joo-Yul Bae, Hee-Jae Won, Dong-Kyo Seo
We report a case of valgus ankle degenerative arthritis due to chronic isolated deltoid insufficiency combined with tibial varus that was treated successfully with ankle joint preserving surgery. A 63-year-old male complained of right lateral ankle pain with 10 minutes of maximal pain-free walking time. The assessed American Orthopaedic Foot and Ankle ankle-hindfoot scale score was 33 points. The ankle joint showed 18° of valgus deformity with 6° of tibia varus. Medial displacement calcaneal osteotomy, supramalleolar open wedge osteotomy, and deltoid ligament imbrication were performed...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28632776/dynamic-knee-valgus-alignment-influences-impact-attenuation-in-the-lower-extremity-during-the-deceleration-phase-of-a-single-leg-landing
#8
Akihiro Tamura, Kiyokazu Akasaka, Takahiro Otsudo, Jyunya Shiozawa, Yuka Toda, Kaori Yamada
Dynamic knee valgus during landings is associated with an increased risk of non-contact anterior cruciate ligament (ACL) injury. In addition, the impact on the body during landings must be attenuated in the lower extremity joints. The purpose of this study was to investigate landing biomechanics during landing with dynamic knee valgus by measuring the vertical ground reaction force (vGRF) and angular impulses in the lower extremity during a single-leg landing. The study included 34 female college students, who performed the single-leg drop vertical jump...
2017: PloS One
https://www.readbyqxmd.com/read/28578795/heterotopic-ossification-after-total-ankle-replacement-the-role-of-prosthesis-alignment
#9
Sebastian Manegold, Alexander Springer, Kristin Landvoigt, Serafim Tsitsilonis
BACKGROUND: The aetiology of heterotopic ossifications (HO) after total ankle arthroplasty (TAR) remains controversial. The aim of the study was to evaluate the prevalence and localisation of HO and the effect of alignment. METHODS: 88 TARs with a series of radiological controls and follow-up of 36 months were evaluated. Frontal and sagittal alignment parameters (alfa and beta angle defined by Hintermann) and tibial coverage were evaluated. RESULTS: The prevalence and grading of HO increased over time, mostly in the posterior gutter...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28566397/mediolateral-force-distribution-at-the-knee-joint-shifts-across-activities-and-is-driven-by-tibiofemoral-alignment
#10
I Kutzner, A Bender, J Dymke, G Duda, P von Roth, G Bergmann
AIMS: Tibiofemoral alignment is important to determine the rate of progression of osteoarthritis and implant survival after total knee arthroplasty (TKA). Normally, surgeons aim for neutral tibiofemoral alignment following TKA, but this has been questioned in recent years. The aim of this study was to evaluate whether varus or valgus alignment indeed leads to increased medial or lateral tibiofemoral forces during static and dynamic weight-bearing activities. PATIENTS AND METHODS: Tibiofemoral contact forces and moments were measured in nine patients with instrumented knee implants...
June 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28558996/supramalleolar-osteotomy-with-distraction-arthroplasty-in-treatment-of-varus-ankle-osteoarthritis-with-large-talar-tilt-angle-a-case-report-and-literature-review
#11
Hong-Mou Zhao, Xiao-Jun Liang, Yi Li, Ning Ning, Jun Lu
We treated a 57-year-old female with modified Takakura stage 3B varus ankle osteoarthritis. Her preoperative talar tilt angle was 21.3°. The patient wished to avoid ankle joint arthrodesis or replacement. Therefore, medial opening wedge supramalleolar osteotomy with fibular osteotomy was used for her varus ankle osteoarthritis. Also, fixed medial distraction arthroplasty was performed to improve her talar tilt. After 3 months, the external device was removed, and the patient was allowed partial weightbearing and began full weightbearing 4 months postoperatively after the osteotomy site had reached bony union radiographically...
May 27, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28557815/use-of-paley-classification-and-superankle-procedure-in-the-management-of-fibular-hemimelia
#12
Ruta M Kulkarni, Nitish Arora, Sagar Saxena, Sujay M Kulkarni, Yadwinder Saini, Rajiv Negandhi
BACKGROUND: Fibular hemimelia is the most common deficiency involving the long bones. Paley classification is based on the ankle joint morphology, identifies the basic pathology, and helps in planning the surgical management. Reconstruction surgery encompasses foot deformity correction and limb length equalization. The SUPERankle procedure is a combination of bone and soft tissue procedures that stabilizes the foot and addresses all deformities. METHODS: We retrospectively reviewed 29 consecutive patients (29 limb segments), surgically treated between December 2000 and December 2014...
May 26, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28549406/supramalleolar-osteotomy-for-tibial-component-malposition-in-total-ankle-replacement
#13
Manja Deforth, Nicola Krähenbühl, Lukas Zwicky, Markus Knupp, Beat Hintermann
BACKGROUND: Persistent pain despite a total ankle replacement is not uncommon. A main source of pain may be an insufficiently balanced ankle. An alternative to the revision of the existing arthroplasty is the use of a corrective osteotomy of the distal tibia, above the stable implant. This strictly extraarticular procedure preserves the integrity of the replaced joint. The aim of this study was to review a series of patients in whom a corrective supramalleolar osteotomy was performed to realign a varus misaligned tibial component in total ankle replacement...
May 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28527700/failure-of-hightibialvarus-osteotomy-for-lateral-tibio-femoral-osteoarthritis-with-10%C3%A2-of-valgus-outcomes-in-19-patients
#14
G Mirouse, A Dubory, F Roubineau, A Poignard, P Hernigou, J Allain, C H Flouzat Lachaniette
BACKGROUND: Osteotomy is a rational approach to slowing knee osteoarthritis progression by modifying loads, thereby avoiding joint replacement in younger individuals. Varus femoral osteotomy is recommended only in patients with more than 10° of valgus. The objective here was to assess outcomes of tibialvarus osteotomy in patients with lateral compartment tibio-femoral osteoarthritis and less than 10° of valgus. MATERIAL AND METHODS: A single-centre retrospective study was conducted in 19 consecutive patients managed by high tibialvarus osteotomy between January 2005 and May 2012...
May 17, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28502350/current-update-in-total-ankle-arthroplasty-salvage-of-the-failed-total-ankle-arthroplasty-with%C3%A2-anterior-translation-of-the-talus
#15
REVIEW
Alastair Younger, Andrea Veljkovic
Ankle replacement results may be compromised by malposition of the components. An anterior displacement can be measured on a lateral standing radiograph. The ankle may appear anteriorly translated because the ankle is overstuffed, the heel cord is tight, or the posterior capsule is tight. In ankle instability with degenerative arthritis, the talus may be anteriorly translated, internally rotated, and in varus. In an ankle replacement, this deformity may persist and will require correction. On occasion, the talus is inserted too anterior; revision to a flat cut talar component and posterior translation of the talar component will result in correction...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502349/total-ankle-replacement-in-the-presence-of-talar-varus-or-valgus-deformities
#16
REVIEW
Andrew Dodd, Timothy R Daniels
Patients presenting with end-stage ankle arthritis with coronal plane talar deformities have a variety of complex multidirectional deformities that require careful preoperative assessment and a clear understanding of the pathophysiology. Surgeons managing these patients with total ankle arthroplasty need to be familiar with extra-articular and intra-articular surgical methods to correct pes planus and pes cavus deformities, including bony procedures and soft tissue procedures. Performing these procedures in 1 or 2 stages depends on surgeon preference and the severity of the deformities...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28433387/how-do-rocker-soled-shoes-influence-the-knee-adduction-moment-in-people-with-knee-osteoarthritis-an-analysis-of-biomechanical-mechanisms
#17
Elizabeth G Madden, Crystal O Kean, Tim V Wrigley, Kim L Bennell, Rana S Hinman
The primary objective was to examine mechanisms behind previously observed changes in the knee adduction moment (KAM) with rocker-soled shoes, in participants sub-grouped according to whether they experienced an immediate decrease, or increase, in peak KAM. In subgroups where frontal plane knee ground reaction force (GRF) lever-arm emerged as a significant predictor, a secondary aim was to examine biomechanical factors that contributed to change in this parameter. Thirty individuals with symptomatic, radiographic knee osteoarthritis (OA) underwent 3D gait analysis in unstable rocker-soled shoes and non-rocker-soled shoes...
April 9, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28432396/weight-bearing-computed-tomography-findings-in-varus-ankle-osteoarthritis-abnormal-internal-rotation-of-the-talus-in-the-axial-plane
#18
Ji-Beom Kim, Young Yi, Jae-Young Kim, Jae-Ho Cho, Min-Soo Kwon, Seung-Hyuk Choi, Woo-Chun Lee
OBJECTIVES: To assess the incidence of abnormal internal rotation of the talus in the axial plane in patients with varus ankle osteoarthritis, and to determine whether this incidence differs from the severity of varus ankle osteoarthritis (moderate versus severe). MATERIALS AND METHODS: We retrospectively evaluated weight-bearing computed tomography (CT) and plain radiographs of 52 ankles with no abnormalities (control group) and 96 ankles with varus osteoarthritis (varus-OA group), which were further stratified into a moderate-OA subgroup (50 ankles) and a severe-OA subgroup (46 ankles)...
August 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28419804/simultaneous-reconstruction-of-the-medial-and-lateral-collateral-ligaments-for-chronic-combined-ligament-injuries-of-the-ankle
#19
Toshito Yasuda, Hiroaki Shima, Katsunori Mori, Seiya Tsujinaka, Masashi Neo
BACKGROUND: Objective data on chronic injuries of the medial collateral ligament (MCL) of the ankle are scarce. Chronic MCL injuries are frequently associated with lateral collateral ligament (LCL) injuries. For patients with chronic combined MCL and LCL injuries, the authors have performed simultaneous surgery of the 2 ligaments. HYPOTHESIS: Simultaneous surgery of the 2 ligaments may be effectively used to treat chronic combined MCL and LCL injuries. STUDY DESIGN: Case series; Level of evidence, 4...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28405708/-supramalleolar-osteotomy-in-asymmetric-ankle-osteoarthritis-short-term-clinical-and-radiographic-results
#20
A Barg, M Wiewiorski, J Paul, M Wurm, M Jacxsens, K Nykytina, V Valderrabano
BACKGROUND: The main indication for the supramalleolar osteotomy is asymmetric ankle osteoarthritis with concomitant supramalleolar valgus or varus deformity. The aim of this prospective study was to analyze short-term clinical and radiographic outcomes in patients with asymmetric ankle osteoarthritis. METHODS: A total of 16 patients with asymmetric ankle osteoarthritis and concomitant supramalleolar deformity - 7 patients with valgus deformity, 9 patients with varus deformity - were treated...
April 12, 2017: Der Orthopäde
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