scholarly journals Extrinsic Muscle Forces Affect Ankle Loading Before and After Total Ankle Arthroplasty

2015 ◽  
Vol 473 (9) ◽  
pp. 3028-3037 ◽  
Author(s):  
Tassos Natsakis ◽  
Josefien Burg ◽  
Greta Dereymaeker ◽  
Jos Vander Sloten ◽  
Ilse Jonkers
Keyword(s):  
Total Ankle Arthroplasty ◽  
Muscle Forces ◽  
Ankle Arthroplasty ◽  
Extrinsic Muscle ◽  
Before And After

Midfoot Function Before and After Total Ankle Arthroplasty

2021 ◽  
pp. 107110072199578
Author(s):  
Frank E. DiLiberto ◽  
Steven L. Haddad ◽  
Steven A. Miller ◽  
Anand M. Vora
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Peak Power ◽  
Nonparametric Tests ◽  
Total Ankle Arthroplasty ◽  
Control Group ◽  
Ankle Arthroplasty ◽  
First Metatarsal ◽  
Before And After

Background: Information regarding the effect of total ankle arthroplasty (TAA) on midfoot function is extremely limited. The purpose of this study was to characterize midfoot region motion and power during walking in people before and after TAA. Methods: This was a prospective cohort study of 19 patients with end-stage ankle arthritis who received a TAA and 19 healthy control group participants. A motion capture and force plate system was used to record sagittal and transverse plane first metatarsal and lateral forefoot with respect to hindfoot motion, as well as sagittal plane midfoot region positive and negative peak power during walking. Parametric or nonparametric tests to examine differences and equivalence across time were conducted. Comparisons to examine differences between postoperative TAA group and control group foot function were also performed. Results: Involved-limb midfoot function was not different between the preoperative and 6-month postoperative time point in the TAA group (all P ≥ .17). Equivalence testing revealed similarity in all midfoot function variables across time (all P < .05). Decreased first metatarsal and lateral forefoot motion, as well as positive peak power generation, were noted in the TAA group postoperative involved limb in comparison to the control group (all P ≤ .01). Conclusion: The similarity of midfoot function across time, along with differences in midfoot function in comparison to controls, suggests that TAA does not change midfoot deficits by 6 months postoperation. Level of Evidence: Level II, prospective cohort study.

Step activity monitoring to assess ambulation before and after total ankle arthroplasty

2011 ◽  
Vol 17 (3) ◽  
pp. 136-139 ◽  
Author(s):  
Mathieu Assal ◽  
Amin Che Ahmad ◽  
Alain Lacraz ◽  
Delphine S. Courvoisier ◽  
Richard Stern ◽  
...  
Keyword(s):  
Activity Monitoring ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthroplasty ◽  
Before And After

scholarly journals Patient-Reported Outcomes Before and After Primary and Revision Total Ankle Arthroplasty

2018 ◽  
Vol 40 (1) ◽  
pp. 34-41 ◽  
Author(s):  
James R. Lachman ◽  
Jania A. Ramos ◽  
Samuel B. Adams ◽  
James A. Nunley ◽  
Mark E. Easley ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
High Volume ◽  
Clinical Results ◽  
Patient Reported Outcome ◽  
Total Ankle Arthroplasty ◽  
Study Patient ◽  
Ankle Arthroplasty ◽  
Patient Reported ◽  
Before And After

Background: Studies examining the clinical outcomes of revision total ankle arthroplasty (TAA) are sparse. Revision TAA surgery has become more common with availability of revision implants and refinement of bone-conserving primary implants. In this study, patient-reported results and clinical outcomes were analyzed for a cohort of patients who underwent both primary and revision TAA at a single high-volume institution. Methods: We retrospectively reviewed prospectively collected data on 29 patients with failed primary total ankle arthroplasty. Cases of isolated polyethylene exchange, infection, or extra-articular realignment procedures were excluded. Patient-reported outcome (PRO) measures and clinical results were reviewed in this longitudinal study. Results: Fifteen patients (51.7%) underwent revision of just the talar and polyethylene components while 13 patients (44.8%) underwent revision of all components. The most common cause was talar subsidence (51.7%). The average time to revision was 3.9 years with a follow-up of 3.2 years after revision, and 3 (10.3%) revision arthroplasties required further surgery; 2 required conversion to arthrodesis and 1 required second revision TAA. Improvements in PROs were better after primary than revision TAA. Conclusions: Clinical and patient-reported results of revision ankle arthroplasty after metal component failure improved significantly but never reached the improvements seen after primary ankle arthroplasty. In our series, 10.3% of revision TAAs required a second revision TAA or arthrodesis surgery. Levels of Evidence: Therapeutic Level III, comparative series.

Imaging of Bone Perfusion and Metabolism in Subjects Undergoing Total Ankle Arthroplasty Using 18F-Fluoride Positron Emission Tomography

2019 ◽  
Vol 40 (12) ◽  
pp. 1351-1357
Author(s):  
Jonathan P. Dyke ◽  
Jonathan H. Garfinkel ◽  
Lauren Volpert ◽  
Austin Sanders ◽  
Meghan Newcomer ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
The Body ◽  
Total Ankle Arthroplasty ◽  
Emission Tomography ◽  
Bone Blood Flow ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Positron Emission ◽  
Pet Ct ◽  
Before And After

Background: Total ankle arthroplasty (TAA) continues to exhibit a relatively high incidence of complications and need for revision surgery compared to knee and hip arthroplasty. One common mode of failure in TAA is talar component subsidence. This may be caused by disruption in the talar blood supply related to the operative technique. The purpose of this study was to quantify changes in talar bone perfusion and turnover before and after TAA with the INBONE II system using 18F-fluoride positron emission tomography / computed tomography (PET/CT). Methods: Nine subjects (5 M/4 F) aged 68.9 ± 8.2 years were enrolled for 18F-fluoride PET/CT imaging before and 3 months after TAA. Regions of interest (ROI) were placed on the postoperative CT images in the body of the talus beneath the talar component and overlaid on the fused static PET images. Standard uptake values (SUVs) along with dynamic K1 (bone blood flow) and ki (bone metabolism or osteoblastic turnover) were calculated. Results: The SUV underneath the talar component compared to that measured at baseline before surgery was 1.93 ± 0.29 preoperatively vs 2.47 ± 0.37 postoperatively ( P > .05). K1 was 0.84 ± 0.16 mL/min/mL preoperatively vs 1.51 ± 0.23 mL/min/mL postoperatively ( P = .026). ki was constant at 0.09 ± 0.03 mL/min/mL preoperatively vs 0.12 ± 0.03 mL/min/mL postoperatively ( P > .05). Conclusion: Our study was the first to link 18F-fluoride PET/CT with pre-post evaluation of total ankle replacements. The study quantified perfusion within the talus beneath the TAA implant supporting the hypothesis that perfusion of the talus remained intact after surgery. Level of Evidence: Level II, prospective cohort study with development of diagnostic criteria.

scholarly journals The risk factors of subsidence of the talar component in the 3 rd generation TNK ankle

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0036
Author(s):  
Shigeki Morita ◽  
Akira Taniguchi ◽  
Yasuhito Tanaka ◽  
Yoshinori Takakura
Keyword(s):  
Risk Factors ◽  
Cox Model ◽  
Articular Surface ◽  
Weight Bearing ◽  
Varus Deformity ◽  
Total Ankle Arthroplasty ◽  
Patient Specific ◽  
Ankle Arthroplasty ◽  
Tilting Angle ◽  
Before And After

Category: Ankle Arthritis Introduction/Purpose: One of the major reasons for revision surgeries after total ankle arthroplasty (TAA) was subsidence of the talar component. The purpose of this study was to evaluate mid-term outcomes after total ankle arthroplasty(TAA) using the 3 rd generation TNK ankle and investigate risk factors leading to subsidence of the talar component. Methods: Fifty consecutive patients who received the 3 rd generation TNK prosthesis between October 2007 and December 2014 were investigated in this study. Weight-bearing foot and ankle radiographies were taken and evaluated before and after surgery. At least 1 mm sinking of the talar component was defined as the subsidence. BMI, age at the surgery, complications were investigated as patient specific parameter and talar tilting angle(TTA) and inclination of the articular surface of the distal end of tibia were investigated as preoperative radiographic parameters. Position and angle of replaced implant were also investigated using postoperative radiography. Results: Preoperative TTA had positive correlation (p=0.049, Cox model), and the angle between the talar and the 1st metatarsal axis (Meary angle) had negative correlation with subsidence (p=0.042, Cox model). Conclusion: The larger TTA shows varus deformity of the ankle and indicates the potential instability of the ankle, that leads to frequent incidence of ankle sprain postoperatively. Repeated micro trauma causes the loosening and subsidence of the talar component. The smaller Meary angle shows the cavus deformity, that prevents the favorable load distribution to the navicular and calcaneus, and leads to higher pressure concentration to the implant. The larger TTA and smaller Meary angle were risk factors of subsidence of the talar component in the TAA.

Does Intra-articular Injection of the Ankle With Corticosteroids Increase the Risk of Subsequent Periprosthetic Joint Infection (PJI) Following Total Ankle Arthroplasty (TAA)? If So, How Long After a Prior Intra-articular Injection Can TAA Be Safely Performed?

2019 ◽  
Vol 40 (1_suppl) ◽  
pp. 3S-4S
Author(s):  
Ilker Uçkay ◽  
Christopher B. Hirose ◽  
Mathieu Assal
Keyword(s):  
Periprosthetic Joint Infection ◽  
Corticosteroid Injection ◽  
Joint Infection ◽  
Invasive Procedure ◽  
Total Ankle Arthroplasty ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Strong Consensus ◽  
Healthcare Associated ◽  
The Ideal

Recommendation: Every intra-articular injection of the ankle is an invasive procedure associated with potential healthcare-associated infections, including periprosthetic joint infection (PJI) following total ankle arthroplasty (TAA). Based on the limited current literature, the ideal timing for elective TAA after corticosteroid injection for the symptomatic native ankle joint is unknown. The consensus workgroup recommends that at least 3 months pass after corticosteroid injection and prior to performing TAA. Level of Evidence: Limited. Delegate Vote: Agree: 92%, Disagree: 8%, Abstain: 0% (Super Majority, Strong Consensus)

The Effect of Patient Characteristics on 1 to 2-Year and Minimum 5-Year Outcomes After Total Ankle Arthroplasty

2019 ◽  
Vol 101 (3) ◽  
pp. 199-208 ◽  
Author(s):  
Daniel J. Cunningham ◽  
James K. DeOrio ◽  
James A. Nunley ◽  
Mark E. Easley ◽  
Samuel B. Adams
Keyword(s):  
Patient Characteristics ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthroplasty

30-Day Outcomes for Total Ankle Arthroplasty in Patients With Anemia

2021 ◽  
pp. 107110072110175
Author(s):  
Jordan R. Pollock ◽  
Matt K. Doan ◽  
M. Lane Moore ◽  
Jeffrey D. Hassebrock ◽  
Justin L. Makovicka ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Univariate Analysis ◽  
Hospital Length ◽  
Total Ankle Arthroplasty ◽  
Hospital Length Of Stay ◽  
Preoperative Anemia ◽  
Improvement Project ◽  
Average Hospital ◽  
Ankle Arthroplasty ◽  
Reoperation Rates

Background: While anemia has been associated with poor surgical outcomes in total knee arthroplasty and total hip arthroplasty, the effects of anemia on total ankle arthroplasty remain unknown. This study examines how preoperative anemia affects postoperative outcomes in total ankle arthroplasty. Methods: A retrospective analysis was performed using the American College of Surgeons National Surgery Quality Improvement Project database from 2011 to 2018 for total ankle arthroplasty procedures. Hematocrit (HCT) levels were used to determine preoperative anemia. Results: Of the 1028 patients included in this study, 114 patients were found to be anemic. Univariate analysis demonstrated anemia was significantly associated with an increased average hospital length of stay (2.2 vs 1.8 days, P < .008), increased rate of 30-day readmission (3.5% vs 1.1%, P = .036), increased 30-day reoperation (2.6% vs 0.4%, P = .007), extended length of stay (64% vs 49.9%, P = .004), wound complication (1.75% vs 0.11%, P = .002), and surgical site infection (2.6% vs 0.6%, P = .017). Multivariate logistic regression analysis found anemia to be significantly associated with extended hospital length of stay (odds ratio [OR], 1.62; 95% CI, 1.07-2.45; P = .023) and increased reoperation rates (OR, 5.47; 95% CI, 1.15-26.00; P = .033). Anemia was not found to be a predictor of increased readmission rates (OR, 3.13; 95% CI, 0.93-10.56; P = .066) or postoperative complications (OR, 1.27; 95% CI, 0.35-4.56; P = .71). Conclusion: This study found increasing severity of anemia to be associated with extended hospital length of stay and increased reoperation rates. Providers and patients should be aware of the increased risks of total ankle arthroplasty with preoperative anemia. Level of Evidence: Level III, retrospective comparative study.

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