Jensen K Henry, Carson Rider, Elizabeth Cody, Scott J Ellis, Constantine Demetracopoulos
The number of total ankle replacements (TARs) performed in the United States has dramatically increased in the past 2 decades due to improvements in implant design and surgical technique. Yet as the prevalence of TAR increases, so does the likelihood of encountering complications and the need for further surgery. Patients with new-onset or persistent pain after TAR should be approached systematically to identify the cause: infection, fracture, loosening/subsidence, cysts/osteolysis, impingement, and nerve injury...
July 27, 2021: Foot & Ankle International
Maolin Sun, Liu Yang, Lin Guo, Rui He
Objective: To investigate the improvement of femoral rotation alignment in total knee arthroplasty (TKA) by robotic-arm assisted positioning and osteotomy and its short-term effectiveness. Methods: Between June 2020 and November 2020, 60 patients (60 knees) with advanced osteoarthritis of the knee, who met the selection criteria, were selected as the study subjects. Patients were randomly divided into two groups according to the random number table method, with 30 patients in each group...
July 15, 2021: Chinese Journal of Reparative and Reconstructive Surgery
Masahiro Horita, Keiichiro Nishida, Daisuke Kaneda, Kenzo Hashizume, Yoshihisa Nasu, Ryuichi Nakahara, Kenta Saiga, Hideki Ohashi, Masahito Watanabe, Toshifumi Ozaki
We investigated the clinical outcomes of surgical procedures for the treatment of forefoot deformities in patients with rheumatoid arthritis. Twenty feet in 16 women (mean age 62.1 years) underwent corrective osteotomy of the first metatarsal bone with shortening oblique osteotomy of the lesser metatarsophalangeal joints (joint-preservation group), while 13 feet in 12 women (mean age 67.4 years) underwent arthrodesis of the first metatarsophalangeal joint with resection arthroplasty of the lesser metatarsophalangeal joints (joint-sacrifice group); mean follow-up for each group was 25...
June 19, 2021: Journal of Foot and Ankle Surgery
Hong-Jie Wen, Shou-Yan Zhu, Hong-Bo Tan, Yong-Qing Xu
The aim of this meta-analysis was to compare the efficacy and safety between the microfracture (MFx) and augmented microfracture (MFx+) techniques for articular cartilage defects of the talus (OLTs). PubMed and EMBASE were searched from January 1950 to October 2020. Only randomized controlled trials, quasi-randomized controlled trials, and observational studies (retrospective and prospective) applying MFx and MFx+ techniques to treat talar cartilage defects were selected. Ten trials with 492 patients were included...
June 30, 2021: Journal of Foot and Ankle Surgery
David B Johnson, Kojo A Marfo, Christopher G Zochowski, Keith R Berend, Adolph V Lombardi
Common peroneal nerve palsy (CPNP) after total knee arthroplasty has a reported incidence of 0.3% to 4% and can lead to foot drop, equinovarus deformity, and marked disability if not resolved. Patients typically present in the early postoperative period with weakness or inability to dorsiflex the ankle and decreased sensation of the dorsum of the foot. The authors report their experience, technique, and outcomes of acute peroneal decompression within the first 90 days postoperatively for 5 patients with this unique complication...
July 2021: Orthopedics
Elliot Sappey-Marinier, Cécile Batailler, John Swan, Axel Schmidt, Laurence Cheze, Samuel J MacDessi, Elvire Servien, Sébastien Lustig
PURPOSE: In total knee arthroplasty (TKA), knee phenotypes including joint line obliquity are of interest regarding surgical realignment strategies. The hypothesis of this study is that better clinical results, including decreased postoperative knee pain, will be observed for patients with a restored knee phenotype. METHODS: A retrospective analysis was performed on prospective data, including 1078 primary osteoarthritic knees in 936 patients. The male:female ratio was 780:298, mean age at surgery was 71...
July 22, 2021: Knee Surgery, Sports Traumatology, Arthroscopy
Gustavo Eiji Nodu Sato, Rodrigo Gonçalves Pagnano, Marianyi Paola Martinez Duarte, Mauro Cesar Mattos E Dinato
Objective: This study aimed to identify the most used scales in the assessment of the clinical outcomes for the treatment of osteochondral lesions of the talus. Methods: We performed a systematic review of the PubMed/MEDLINE databases from September 1999 to September 2019, based on the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The research strategy was: osteochondral [All Fields], AND ("talus" [MeSH Terms] OR "talus" [All Fields]) AND lesion [All Fields]...
May 2021: Acta Ortopedica Brasileira
Hannes Vermue, Philip Winnock de Grave, Alexander Ryckaert, Thomas Luyckx
PURPOSE: Joint imbalance has become one of the main reasons for early revision after total knee arthroplasty (TKA) and it is directly related to the surgical technique. Therefore, a better understanding of how much bone has to be removed to obtain a balanced flexion/extension gap could improve current practice. The primary objective of this study was to analyse the amount of bone that needed to be removed from the distal and posterior femoral joint surfaces to obtain an equal flexion/extension gap in robot-assisted TKA...
July 21, 2021: Knee Surgery, Sports Traumatology, Arthroscopy
Arun Mullaji, Rahul Shah, Ritesh Bhoskar, Abhimanyu Singh, Murtaza Haidermota, Harshad Thakur
PURPOSE: Recommendations for resecting distal femur and proximal tibia in mechanical and anatomical alignment techniques are standardized. Kinematic alignment propagates individualizing resection planes. Whether significant variation exists, to warrant departure from standardized resection planes, has not been shown thus far in a large cohort of knees and with a wide range of varus deformity. The null hypothesis of this study was that there was no phenotypic variation in varus osteoarthritic knees...
July 20, 2021: Knee Surgery, Sports Traumatology, Arthroscopy
Na-Kyoung Lee, Tae Woo Kim, Sanghoon Lee, Yun Seong Choi, Seung-Baik Kang, Chong Bum Chang
PURPOSE: Although knee joint line orientation (KJLO) after total knee arthroplasty (TKA) has been emphasized as an important factor that can affect postoperative knee kinematics, the effect of foot position on KJLO has not been fully understood. This study aimed to (1) identify the anatomical and positional factors that determine KJLO after TKA, and (2) determine the effect of foot position on KJLO after TKA. The hypothesis of this study was that the post-TKA KJLO would change depending on the distance between the feet, as well as the coronal implant positions...
July 16, 2021: Knee Surgery, Sports Traumatology, Arthroscopy
Peter Savov, Lars-Rene Tuecking, Henning Windhagen, Jonathan Ehmig, Max Ettinger
INTRODUCTION: Robotic-assisted surgery techniques are increasing in total knee arthroplasty (TKA). One crucial point is the prolonged time of surgery. The primary objective of this study was to determine the learning curve necessary to minimize the time of surgery. The secondary objective was to evaluate the accuracy of the implant alignment when using an imageless robotic system for TKA. MATERIALS AND METHODS: In a case-control study, the first 70 consecutive robotic-assisted TKA procedures performed by a single senior surgeon were analyzed with regard to surgery time and implant alignment by comparing the intraoperative plan with the postoperative alignment...
July 14, 2021: Archives of Orthopaedic and Trauma Surgery
Yun Seong Choi, Tae Woo Kim, Seung Cheol Song, Sang Yoon Kim, Moon Jong Chang, Seung-Baik Kang
PURPOSE: Studies regarding the best strategy to determine appropriate femoral component rotation during bilateral total knee arthroplasty (TKA) in wind swept deformities (WSD) are very limited. The purpose of this study was (1) to evaluate whether femoral rotational profiles differ between varus and valgus osteoarthritic knees in WSD and (2) to analyze the correlation between femoral rotational profiles and coronal radiologic parameters. METHODS: A total of 40 patients who were diagnosed with bilateral knee osteoarthritis with WSD between January 2010 and December 2020 at a single institution were retrospectively reviewed...
July 14, 2021: Knee Surgery, Sports Traumatology, Arthroscopy
Ian M Foran, Emily C Vafek, Daniel D Bohl, Simon Lee, Kamran S Hamid
Research demonstrating improved outcomes with third-generation ankle replacement implants has resulted in increasing utilization of total ankle arthroplasty over the past 3 decades. The purpose of this study was to examine the quality and trends of clinical outcomes research being published on third-generation total ankle arthroplasty implants. Two fellowship-trained foot and ankle surgeons reviewed all peer-reviewed, Medline-indexed English-language clinical outcomes studies evaluating total ankle arthroplasty published between 2006 and 2019...
June 10, 2021: Journal of Foot and Ankle Surgery
Harin Kim, Chul-Ho Kim
BACKGROUND: To date, no meta-analysis of the relationship between hospital readmission after total joint arthroplasty (TJA) and preoperative depression has been conducted. Hence, this systematic review and meta-analysis aimed to evaluate the association of preoperative depression with the readmission rate following TJA. METHODS: We systematically searched MEDLINE, EMBASE, and Cochrane Library for studies published before March 28, 2021, which compared readmission rates in patients with or without preoperative depression who underwent TJA...
June 24, 2021: Journal of Arthroplasty
Nuno Oliveira, Pedro Pinho, Mário Baptista, Daniel Freitas, Pedro Varanda, Bruno S Pereira
Tillaux fractures are fractures of the lateral margin of the distal tibia, usually reported in children between 12 and 14 years old. As intraarticular fractures, they require anatomic reduction and fixation to avoid posttraumatic complications. Since the injury mechanism is external rotation of the foot on the leg, these injuries are commonly associated with other fractures or ligamentous lesions. Currently, arthroscopy is being increasingly used to assist and improve surgical treatment of ankle fractures. The authors describe a 12-month follow-up of a rare case of a missed Tillaux fracture associated with syndesmosis injury in a 76-year-old polytrauma patient, successfully treated by arthroscopically-assisted reduction and internal fixation...
June 2021: Revista Brasileira de Ortopedia
Christopher J Callaghan, John C McKinley
AIMS: Arthroplasty has become increasingly popular to treat end-stage ankle arthritis. Iatrogenic posterior neurovascular and tendinous injury have been described from saw cuts. However, it is hypothesized that posterior ankle structures could be damaged by inserting tibial guide pins too deeply and be a potential cause of residual hindfoot pain. METHODS: The preparation steps for ankle arthroplasty were performed using the Infinity total ankle system in five right-sided cadaveric ankles...
July 2021: Bone & joint open
Naicheng Diao, Fei Yu, Bo Yang, Lifeng Ma, Heyong Yin, Ai Guo
BACKGROUND: The change in hip-knee-ankle (HKA) angle after total knee arthroplasty (TKA) may cause an adjustment in hindfoot alignment (HFA). However, the relationship between the changes in HKA angle and HFA is still not well studied. This study aimed to investigate the association between HKA angle and hindfoot alignment changes after TKA for varus knee osteoarthritis. METHODS: A prospective study was carried out in which 108 patients with varus knee deformities were radiographically and clinically evaluated before and 3 months after TKA...
July 6, 2021: BMC Musculoskeletal Disorders
Paul Schadler, Birgit Lohberger, Bettina Thauerer, Martin Faschingbauer, Werner Kullich, Martin Helmut Stradner, Rusmir Husic, Andreas Leithner, Bibiane Steinecker-Frohnwieser
BACKGROUND: There is no single blood biomarker for the staging of knee osteoarthritis (KOA). The purpose of this study was to assess the relationship of obesity, serum biomarkers, the hip-knee-ankle angle (HKAA) with sonographic cartilage thickness. METHODS: We conducted a cross-sectional study of n = 33 patients undergoing knee arthroplasty. Body mass index (BMI) was recorded, and patients were grouped based on BMI. Serum blood samples were collected, and the following biomarkers were measured using the ELISA technique (subgroup of n = 23): oxidized low-density lipoprotein (oxLDL), soluble receptor for advanced glycation end-products (sRAGE), fatty acid-binding protein 4 (FABP4), membrane-bound phospholipase A2 (PLA2G2A)...
July 5, 2021: Cartilage
Felix Wunderlich, Maheen Azad, Ruben Westphal, Thomas Klonschinski, Patrick Belikan, Philipp Drees, Lukas Eckhard
Neutral coronal leg alignment is known to be important for postoperative outcome in total knee arthroplasty (TKA). Customized individually made implants (CIM) instrumented with patient-specific cutting guides are an innovation aiming to increase the precision and reliability of implant positioning and reconstruction of leg alignment. We aimed to compare reconstruction of the hip-knee-ankle angle (HKA) of the novel CIM system iTotal™ CR G2 (ConforMIS Inc.) to a matched cohort of the off-the-shelf (OTS) knee replacement system Vanguard™ CR (Zimmer Biomet)...
June 12, 2021: Journal of Personalized Medicine
Dahang Zhao, Gonghao Zhang, Dichao Huang, Jian Yu, Kan Wang, Xu Wang, Tiansong Zhang, Xin Ma
PURPOSE: This study was designed to investigate (1) the contour of the distal tibial cutting surface, and (2) the bone mineral density (BMD) of the distal tibial cutting surface used during total ankle arthroplasty (TAA). METHODS: Eight-four distal tibial models were created using foot and ankle computerized tomographic (CT) images taken from normal people. The distal tibial cutting surface for TAA was determined to be 10 mm proximal to the tibial plafond. The bony contour and BMD values were determined from the CT image at that level...
May 2021: Journal of Orthopaedic Surgery
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