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Ankle Replacement Procedures News
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All Recent Ankle Replacement Procedures News |
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Influences of anti-tumour necrosis factor agents on postoperative recovery in patients with rheumatoid arthritis
Abstract The aim of this study is to investigate the influences of the anti-tumour necrosis factor (TNF) agents infliximab and etanercept
on the postoperative recovery of patients with rheumatoid arthritis (RA). We also investigated the effects of biologics on
wound healing. Patients with RA were split into a TNF group (n = 39) that underwent 39 operations and were treated with anti-TNF agents, and a non-TNF group (n = 74) that underwent 74 operations and were treated only with conventional disease-modifying antirheumatic drugs. Operations
included ankle arthrodesis and total arthroplasty of the hip, knee, elbow, shoulder and ankle. Adverse events (AEs) of surgical
wounds, time for complete wound healing, febrile period after operation and recovery parameters after o......
POSTED 01/13/2010 at 12:43 AM --
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Total ankle replacement by the Ankle Evolution System: MEDIUM-TERM OUTCOME.
We present the outcomes in 38 consecutive patients who had total ankle replacement using the Ankle Evolution System with a minimum follow-up of four years. Pain and function were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score and regular standardised anteroposterior and lateral weight-bearing radiographs were obtained. Patient satisfaction and complications were recorded and the survival of the implants was demonstrated by the Kaplan-Meier method. The mean follow-up was for 57.8 months (48 to 80). The cumulative survival rate at six years was 94.7% (95% confidence interval 80.3 to 98.7). The mean total AOFAS score was 88.1 (53 to 100). The mean score for pain was 35.8 (20 to 40). Ten patients presented with edge-loading of whom nine had corrective surgery. Two......
POSTED 12/31/2009 at 06:00 PM --
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Moje First Metatarsophalangeal Replacement—A Case Series with Functional Outcomes Using the AOFAS-HMI Score
We report the functional results of a case series of Moje first metatarsophalangeal total joint replacements carried out between February 2001 and November 2006. All patients who underwent Moje arthroplasty under the care of a single surgeon were included; outcome scores and complications were recorded annually. A total of 32 joints in 29 consecutive patients were followed for a mean duration of 34 (range 6 to 74) months, and the mean patient age at the time of operation was 56 (range 38 to 79) years. Hallux rigidus was the primary diagnosis in 28 (87.5%) of the cases. The mean American Orthopaedic Foot & Ankle Society Hallux-Metatarsophalangeal-Interphalangeal score at final follow-up was 74/100 (range 9 to 100), with 13 (40.63%) joints rated good to excellent. Two (6.25%) joints were rev......
POSTED 12/26/2009 at 08:45 AM --
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[Peripheral arterial disease in women.]
Authors: Aboyans V, Salazar J, Lacroix P
The widespread use of the ankle-brachial index (ABI) enabled to reveal the high prevalence of lower extremities peripheral arterial disease (PAD) in women, even higher than in men in several series. Nonetheless, the use of a same ABI threshold for men and women may overestimate the prevalence of subclinical PAD in women. Conversely, the clinical manifestations of PAD are more often atypical in women, with as a result, a delayed diagnosis and management. The level of association between cardiovascular disease risk factors and PAD is similar in both genders. To date, there is no evidence for any association between PAD and different hormonal events in women. Despite an inverse association between hormonal replacement therapy (HRT) after menopause ......
POSTED 12/13/2009 at 06:00 PM --
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Human Immunodeficiency Virus Disclosure and Patient Confidentiality in Orthopaedic Procedures
A thirty-two-year-old man with hemophilia whose chief complaint was knee pain was referred by his hematologist for consideration of a total knee arthroplasty. On his initial visit, the patient was seen and evaluated with his pregnant wife and their infant child present in the examination room at his request. During the review of systems and past medical history, the treating surgeon inquired into the status of his human immunodeficiency virus (HIV) viral load and CD4 count. At that point, the patient denied ever testing positive for HIV. Later, in a private discussion, the patient confirmed his HIV-positive status. He admitted that his wife was unaware of his history, and he stated that he did not wish her to know. The surgeon explained to the patient that his HIV history posed a major hea......
POSTED 12/01/2009 at 12:02 PM --
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Skin, muscle and joint disease from the 17th century: scurvy
We report three cases of scurvy, with differing musculoskeletal presentations, from a tertiary teaching hospital in Sydney, Australia. Case 1 was a man with cerebral palsy who presented with knee swelling following a minor injury. In Case 2, a patient with thalassaemia major presented with purpuric rash, difficulty walking and distal thigh swelling and ecchymosis. Case 3 was a man with Down's syndrome who presented with acute ankle arthritis. Scurvy in Cases 1 and 3 were related to abnormal dietary preferences, whereas in Case 2, scurvy was thought to be related to thalassaemia. All three cases responded rapidly to vitamin C replacement. The subjects did not appear malnourished as they had adequate carbohydrate and protein intake. (Source: APLAR Journal of Rheumatology)...
POSTED 11/22/2009 at 06:00 PM --
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Is the Wii Fit a new-generation tool for improving balance, health and well-being? A pilot study.
Conclusion Activity fostered by Wii Fit showed an immediate effect on balance and strength that needs confirmation by statistically powered studies.
PMID: 19905991 [PubMed - as supplied by publisher] (Source: Climacteric)...
POSTED 11/11/2009 at 06:00 PM --
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Oxygen tensiometry as a predictor of wound healing in total ankle arthroplasty.
CONCLUSION: Oxygen tensiometry is not thought to be useful for predicting patients at risk for postoperative wound healing complications after TAA, suggesting that, if adequate pulses are present before surgery, the trauma of using excessive superficial traction on the skin during surgery is more responsible for wound healing problems than the underlying blood supply.
PMID: 19881316 [PubMed - in process] (Source: Acta Orthopaedica et Traumatologica Turcica)...
POSTED 10/31/2009 at 07:00 PM --
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Long-term clinical results of the Oxford medial unicompartmental knee arthroplasty
Abstract The purposes of this study were to investigate the mode of failure and survivorship of an independently performed series of
medial Oxford unicompartmental knee arthroplasties. The study included 43 knees in 40 patients with a mean follow-up of 14.88 years:
13 knees (11 patients) had revision surgery (30%), and ten patients required conversion to total knee prosthesis. The mean
International Knee Society (IKS) scores at the time of the revision were 145.52 [standard deviation (SD): 39.90, range: 167–200].
The overall alignment of the knee was restored to neutral, with a hip-knee-ankle (HKA) angle average of 178° (SD: 3.21°, range:
170–186°). Survivorship, as defined by an endpoint of failure for any reason, showed that the survival rate at five year......
POSTED 10/16/2009 at 01:00 PM --
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Static progressive stretch improves range of motion in arthrofibrosis following total knee arthroplasty
This study evaluated a static progressive stretching device as a treatment method for patients
who had refractory knee stiffness after total knee arthroplasty. Twenty-five patients who had knee stiffness and no improvement
with conventional physical therapy modalities were treated with the device. After a median of 7 weeks (range, 3–16 weeks),
the median increase in range of motion was 25° (range, 8–82°). The median gain in knee active flexion was 19° (range, 5–80°).
Ninety-two percent of patients were satisfied with the results. The authors believe static progressive stretching devices
may be an effective method for increasing the ranges of motion and satisfaction levels of patients who develop arthrofibrosis
after total knee arthroplasty.
Content Type Journal......
POSTED 10/14/2009 at 12:58 AM --
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Managing Medical Errors
A patient with severe arthritis of the hip and shortening of the ipsilateral extremity undergoes hip replacement surgery with correction of the limb-length discrepancy. At the time of the postoperative examination, he is found to have a complete foot drop. (Source: JBJS [Am])...
POSTED 10/01/2009 at 12:01 PM --
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Endoprosthetic reconstruction of the distal tibia and ankle joint after resection of primary bone tumours.
We report the outcome of six patients treated between 1981 and 2007. There were four males and two females, with a mean age of 43.5 years (15 to 75), and a mean follow-up of 9.6 years (1 to 27). No patient developed a local recurrence or metastasis. Two of the six went on to have a below-knee amputation for persistent infection after a mean 16 months (1 to 31). The four patients who retained their endoprosthesis had a mean musculoskeletal tumour society score of 70% and a mean Toronto extremity salvage score of 71%. All were pain free and able to perform most activities of daily living in comfort. A custom-made endoprosthetic replacement of the distal tibia and ankle joint is a viable treatment option for carefully selected patients with a primary bone tumour. Patients should, however, be ......
POSTED 09/30/2009 at 06:00 PM --
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Bone Graft Substitutes and Allografts for Reconstruction of the Foot and Ankle
In reconstructive foot and ankle surgery, the use of bone graft is common. Whether for trauma, acquired or congenital deformities, arthrodeses, joint replacement, bone loss from infection, or bone tumor resection, the foot and ankle surgeon must be knowledgeable about current bone grafting options to make informed decisions. Innovation and technologic advances have produced an impressive and exciting array of options, advancing us closer to mimicking the gold standard: autograft. However, the sheer volume of available products makes it challenging for the foot and ankle surgeon to stay abreast of current bone graft technology. The purpose of this article is to simplify and classify current bone grafting options, discuss advantages and disadvantages, and provide relevant clinical examples. ......
POSTED 09/24/2009 at 12:56 PM --
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Biologic Resurfacing of the Ankle and First Metatarsophalangeal Joint: Case Studies with a 2-Year Follow-Up
The goal of biologic resurfacing is to provide a smooth joint surface with a low coefficient of friction, which allows the joint to function with near normal biomechanics, as well as provide intermittent pressure, to the subchondral and cancellous bone. This unique combination often results in the formation of a “neocartilage-like” structure that can reduce pain and restore biomechanics. As well as giving a brief history of cutis arthroplasty, this article describes cases in which the ankle and first metatarsophalangeal joint underwent biologic resurfacing, with a 2-year postoperative follow up. (Source: Clinics in Podiatric Medicine and Surgery)...
POSTED 09/24/2009 at 12:56 PM --
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Sports activities after lower limb osteotomy
Introduction
Active sports participation can be important in some patients with degenerative joint disease in the lower limb. We investigated whether this is possible after an osteotomy for osteoarthritis of the hip, knee and ankle joints.
Sources of data
We performed a literature search using Medline, Cochrane, CINAHL and Google Scholar with no restriction to time period or language using the keywords: ‘osteotomy and sports’. Eleven studies (all level IV evidence) satisfied our inclusion and exclusion criteria. Nine reported on high tibial osteotomies, one on periacetabular osteotomies and one on distal tibial osteotomies. The Coleman Methodology Score to assess the quality of studies showed much heterogeneity in terms of study design, patient characteristics, management meth......
POSTED 09/02/2009 at 06:00 PM --
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Total ankle replacement in moderate to severe varus deformity of the ankle.
Authors: Kim BS, Choi WJ, Kim YS, Lee JW
Our study describes the clinical outcome of total ankle replacement (TAR) performed in patients with moderate to severe varus deformity. Between September 2004 and September 2007, 23 ankles with a varus deformity > or = 10 degrees and 22 with neutral alignment received a TAR. Following specific algorithms according to joint congruency, the varus ankles were managed by various additional procedures simultaneously with TAR. After a mean follow-up of 27 months (12 to 47), the varus ankles improved significantly in all clinical measures (p < 0.0001 for visual analogue scale and American Orthopaedic Foot and Ankle Society score, p = 0.001 for range of movement). No significant differences were found between the varus and neutral groups regardin......
POSTED 08/31/2009 at 06:00 PM --
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Conversion of Painful Ankle Arthrodesis to Total Ankle Arthroplasty
(Source: JBJS [Am])...
POSTED 08/02/2009 at 06:00 PM --
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Conversion of Painful Ankle Arthrodesis to Total Ankle Arthroplasty
(Source: JBJS [Am])...
POSTED 08/02/2009 at 06:00 PM --
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Conversion of painful ankle arthrodesis to total ankle arthroplasty.
Authors: Kini SG
PMID: 19651973 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)...
POSTED 07/31/2009 at 06:00 PM --
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Wear behaviour in total ankle replacement: A comparison between an in vitro simulation and retrieved prostheses
Abstract: Background: To minimise wear of the meniscal component in total ankle replacement, a three-component artificial joint has recently been developed. This new prosthesis has convex spherical tibial and anticlastic talar metal components with non-anatomic but ligament-compatible shapes in the sagittal plane, and a fully conforming ultra-high-molecular-weight-polyethylene meniscal component inserted in between. The in vitro wear of meniscal components can be assessed using a four-station joint simulator. The study was aimed at comparing wear patterns obtained in vitro with those observed in implant retrievals with the same design.Methods: The wear tests were run in a joint wear simulator at a frequency of 1.1Hz for two million cycles. Three bearings within corresponding metal componen......
POSTED 07/29/2009 at 06:00 PM --
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