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https://www.readbyqxmd.com/read/28549406/supramalleolar-osteotomy-for-tibial-component-malposition-in-total-ankle-replacement
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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)...
April 22, 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
#7
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
#8
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
https://www.readbyqxmd.com/read/28399635/safety-and-efficacy-of-intra-articular-injection-of-platelet-rich-plasma-in-patients-with-ankle-osteoarthritis
#9
Taisuke Fukawa, Satoshi Yamaguchi, Yorikazu Akatsu, Yohei Yamamoto, Ryuichiro Akagi, Takahisa Sasho
BACKGROUND: An intra-articular injection of platelet-rich plasma (PRP) may be an effective treatment for osteoarthritis (OA). However, its efficacy in ankle OA has not been investigated yet. The purpose of this study was to assess the safety and efficacy of an intra-articular injection of PRP in patients with ankle OA during a 24-week period. METHODS: Twenty ankles of 20 patients with varus-type ankle OA who received intra-articular injections of PRP were evaluated...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28361015/development-of-an-internally-braced-prosthesis-for-total-talus-replacement
#10
Markus Regauer, Mirjam Lange, Kevin Soldan, Steffen Peyerl, Sebastian Baumbach, Wolfgang Böcker, Hans Polzer
Total loss of talus due to trauma or avascular necrosis, for example, still remains to be a major challenge in foot and ankle surgery with severely limited treatment options. Implantation of a custom made total talar prosthesis has shown promising results so far. Most important factors for long time success are degree of congruence of articular surfaces and ligamentous stability of the ankle. Therefore, our aim was to develop an optimized custom made prosthesis for total talus replacement providing a high level of primary stability...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28342545/distal-tibial-nonunion-using-a-contralateral-anterior-l-shaped-locking-compression-plate-through-a-posterior-lateral-approach-a-retrospective-case-series
#11
Chuanlu Lin, Lixiang Lin, Lutchooman Vinesh, Xiwen Shao, Xiaolang Lu, Jianjun Hong
BACKGROUND: Distal tibial nonunion is usually due to severe open distal tibial fractures with high energy injury. The best surgical treatment is not well established because of the poor soft tissue condition. We retrospectively analyzed a series of patients with distal tibial nonunion after severe open distal tibial fractures; our purpose was to introduce a treatment using a contralateral anterior L-shaped locking compression plate through a posterior-lateral approach with Iliac crest bone graft and evaluate the outcomes of patients...
March 19, 2017: Injury
https://www.readbyqxmd.com/read/28337656/what-factors-are-associated-with-femoral-component-internal-rotation-in-tka-using-the-gap-balancing-technique
#12
Seung-Yup Lee, Hong-Chul Lim, Ki-Mo Jang, Ji-Hoon Bae
BACKGROUND: When using the gap-balancing technique for TKA, excessive medial release and varus proximal tibial resection can be associated with internal rotation of the femoral component. Previous studies have evaluated the causes of femoral component rotational alignment with a separate factor analysis using unadjusted statistical methods, which might result in treatment effects being attributed to confounding variables. QUESTIONS/PURPOSES: (1) What pre- and intraoperative factors are associated with internal rotation of the femoral component in TKA using the gap balancing technique? (2) To what degree does femoral component rotation as defined by the navigation system differ from rotation as measured by postoperative CT? METHODS: Three hundred seventy-seven knees that underwent computer-assisted primary TKA attributable to degenerative osteoarthritis with varus or mild valgus alignment in which medial soft tissue release was performed, and those with preoperative radiographs including preoperative CT between October 2007 and June 2014 were included in the study...
March 23, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28336190/clinical-and-radiological-outcomes-of-midfoot-derotational-osteotomy-for-midfoot-forefoot-varus-deformity
#13
Hong-Geun Jung, Dong-Oh Lee, Sang-Hun Lee, Joon-Sang Eom
BACKGROUND: Moderate to severe midfoot-forefoot varus deformities are commonly found in several conditions. However, few techniques are available to correct these deformities. So, we evaluated the clinical and radiological outcomes of patients who underwent midfoot derotational osteotomy to achieve plantigrade foot. METHODS: From 2006 to 2014, 6 patients (7 feet) underwent midfoot derotational osteotomy. A visual analog scale (VAS) pain and the American Orthopedic Foot & Ankle Society (AOFAS) functional score were evaluated...
March 20, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28330757/does-new-instrumentation-improve-radiologic-alignment-of-the-oxford%C3%A2-medial-unicompartmental-knee-arthroplasty
#14
Ki-Mo Jang, Hong Chul Lim, Seung-Beom Han, Chandong Jeong, Seul-Gi Kim, Ji-Hoon Bae
BACKGROUND: A new instrument system has been introduced to improve the accuracy and reproducibility of implant positioning in Oxford® unicompartmental knee arthroplasty (UKA). This study aimed to determine if the new instrumentation could improve postoperative implant positioning and limb alignment, and reduce the occurrence of outliers in Oxford® UKA. METHODS: A total of 77 cases of Oxford® UKA with the new instrumentation were included. Individual matching for the conventional instrument group was performed according to age, sex, and body mass index...
March 19, 2017: Knee
https://www.readbyqxmd.com/read/28302462/the-impact-of-mechanical-and-restricted-kinematic-alignment-on-knee-anatomy-in-total-knee-arthroplasty
#15
Abdulaziz M Almaawi, Jonathan R B Hutt, Vincent Masse, Martin Lavigne, Pascal-Andre Vendittoli
BACKGROUND: Total knee arthroplasty (TKA), aiming at neutral mechanical alignment (MA), inevitably modifies the patient's native knee anatomy. Another option is kinematic alignment (KA), which aims to restore the original anatomy of the knee. The aim of this study was to evaluate the variations in lower limb anatomy of a patient population scheduled for TKA, and to assess the use of a restricted KA TKA protocol and compare the resulting anatomic modifications with the standard MA technique...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28299385/no-impact-of-under-correction-and-joint-line-obliquity-on-clinical-outcomes-of-total-knee-arthroplasty-for-the-varus-knee
#16
Richard D Rames, Michael Mathison, Zachary Meyer, Robert L Barrack, Denis Nam
PURPOSE: It has been hypothesized that under-correction of a preoperative varus deformity may be more natural and improve outcomes after total knee arthroplasty (TKA). This study's purpose was to assess the impact of hip-knee-ankle (HKA) alignment and joint line obliquity on TKA outcomes for the varus knee. METHODS: All patients with a preoperative varus deformity received both preoperative and postoperative standing, full-length radiographs from which two independent observers performed radiographic measurements including the HKA axis and mechanical medial proximal tibial angle (mMPTA)...
March 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28276647/clinical-comparison-of-extensile-lateral-approach-and-sinus-tarsi-approach-combined-with-medial-distraction-technique-for-intra-articular-calcaneal-fractures
#17
Hai-Chao Zhou, Tao Yu, Hao-Yang Ren, Bing Li, Kai Chen, You-Guang Zhao, Yun-Feng Yang
OBJECTIVE: To study and compare the clinical outcomes of open reduction and internal fixation via extensile L-shape incision and limited open reduction via the sinus tarsi approach using the medial distraction technique for intra-articular calcaneal fractures. METHODS: We performed a retrospective review of 65 intra-articular calcaneal fractures treated operatively between March 2012 and February 2015. Patients were divided into two groups: 28 were in the sinus tarsi approach group and 37 were in the extensile lateral approach group...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28253941/arthrodesis-of-the-ankle
#18
H Zwipp
About 90 % of all cases of painful posttraumatic ankle arthritis can be very successfully treated with a minor invasive ankle arthrodesis technique by using a small anterior approach and a fixation with four 6. 5 mm screws of which the posteromedial and transfibular one are inserted percutaneously. The results with this standardized procedure have been reported previously as excellent and good in a mid-term run of 6 years (34). This technique leads to a high union rate of 99% (92 of 93) with rapid bone healing within 8 ± 2 weeks, it causes a low minor complication rate of 8 % and enables a significant increase of the AOFAS ankle/hindfoot score (17) from 36 preoperatively to 85 postoperatively as well as a midtarsal movement of 24° ± 16°...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28231959/obtaining-correct-ankle-alignment-using-intraoperative-external-fixation-for-ankle-arthrodesis
#19
Reza Firoozabadi, Daniel Thuillier, Stephen Benirschke
Ankle arthrodesis remains an important treatment option for patients with ankle arthritis. Many methods have been described; however, no consensus has been reached regarding the best technique to achieve both successful fusion and a good position for optimal foot mechanics. Furthermore, as arthroplasty has become more popular, preservation of the fibula to allow for future arthroplasty has become critical. The present report describes an innovative technique in which temporary external fixation at operative fixation is used, along with internal fixation, to achieve both an optimal foot position and high fusion rates, while maintaining the integrity of the fibula...
March 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28209345/multiobjective-optimization-of-cartilage-stress-for-non-invasive-patient-specific-recommendations-of-high-tibial-osteotomy-correction-angle-a-novel-method-to-investigate-alignment-correction
#20
Keke Zheng, Corey J Scholes, Junning Chen, David Parker, Qing Li
Medial opening wedge high tibial osteotomy (MOWHTO) is a surgical procedure to treat knee osteoarthritis associated with varus deformity. However, the ideal final alignment of the Hip-Knee-Ankle (HKA) angle in the frontal plane, that maximizes procedural success and post-operative knee function, remains controversial. Therefore, the purpose of this study was to introduce a subject-specific modeling procedure in determining the biomechanical effects of MOWHTO alignment on tibiofemoral cartilage stress distribution...
February 13, 2017: Medical Engineering & Physics
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