Total ankle replacement and simultaneous subtalar arthrodesis: CT scan evaluation of fusion rate

2016 ◽  
Vol 22 (2) ◽  
pp. 84
Author(s):  
F.G. Usuelli ◽  
C. Maccario ◽  
L. Manzi
Keyword(s):  
Ct Scan ◽  
Fusion Rate ◽  
Total Ankle Replacement ◽  
Subtalar Arthrodesis ◽  
Ankle Replacement

scholarly journals Total ankle replacement and simultaneous subtalar arthrodesis

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Luigi Manzi ◽  
Cristian Indino ◽  
Camilla Maccario ◽  
Claudia Di Silvestri ◽  
Riccardo D’Ambrosi ◽  
...  
Keyword(s):  
Subtalar Joint ◽  
Surgical Techniques ◽  
Fusion Rate ◽  
Total Ankle Replacement ◽  
Ct Scans ◽  
Talonavicular Joint ◽  
Joint Fusion ◽  
Subtalar Fusion ◽  
Ankle Replacement ◽  
Functional Scores

Category: Ankle, Ankle Arthritis, Hindfoot, Midfoot/Forefoot Introduction/Purpose: Patients with arthritis or severe dysfunction involving both the ankle and the subtalar joints can benefit tibiotalocalcaneal (TTC) arthrodesis or total ankle replacement and subtalar fusion. With the evolution of prosthetic design and surgical techniques, total ankle replacement (TAR) has become a reasonable alternative to arthrodesis. The aim of this study was to investigate the fusion rate of the subtalar joint and talonavicular joint in patients simultaneously treated with total ankle replacement (TAR) and subtalar joint fusion. Methods: This study includes 11 patients who underwent primary TAR and simultaneous subtalar and talonavicular fusion from May 2011 to January 2015. Six males and five females were enrolled with a mean age of 61 years (41-75). Patients were clinically assessed preoperatively and at 6 and 12 months postoperatively. Total follow-up time was 24.2±11.6 months. Radiographic examination included a postoperative CT scan obtained 12 months after surgery. Three surgeons independently reviewed the CT scans and interobserver reliability was calculated. Functional scores were also assessed. Results: At 12 months postoperatively, the subtalar fusion rate in patients treated with TAR and simultaneous subtalar fusion was 92% and the talonavicular fusion rate was 88%. There was a statistically significant increase in American Orthopedic Foot & Ankle Society ankle/hindfoot score from 25.9 to 74.1 at 12 months post-operatively. Ankle range of motion significantly increased from 10.2° to 30.8 degrees. Additionally, there was a statistically significant decrease in visual analog scale (VAS) pain score from 8.8 to 1.9. Conclusion: TAR and simultaneous subtalar and talonavicular joint fusion are reliable procedures for the treatment of ankle and subtalar joint arthritis. Furthermore, CT scans showed an excellent reliability among orthopaedic surgeons in determining the degree of successful fusion of subtalar and talonavicular arthrodesis.

Reply to the letter to the editor: Periprosthetic osteolysis after AES total ankle replacement: Conventional radiography versus CT scan

2016 ◽  
Vol 22 (2) ◽  
pp. 143
Author(s):  
Anthony Viste ◽  
Nader A.L. Zahrani ◽  
Nuno Brito ◽  
Christophe Lienhart ◽  
Michel Henri Fessy ◽  
...  
Keyword(s):  
Ct Scan ◽  
Conventional Radiography ◽  
Total Ankle Replacement ◽  
Periprosthetic Osteolysis ◽  
Letter To The Editor ◽  
Ankle Replacement

Secondary Subtalar Joint Osteoarthritis Following Total Ankle Replacement

2019 ◽  
Vol 40 (10) ◽  
pp. 1122-1128 ◽  
Author(s):  
Marc Sokolowski ◽  
Nicola Krähenbühl ◽  
Chen Wang ◽  
Lukas Zwicky ◽  
Christine Schweizer ◽  
...  
Keyword(s):  
Subtalar Joint ◽  
Case Series ◽  
Fusion Rate ◽  
Total Ankle Replacement ◽  
Time Interval ◽  
Level Of Evidence ◽  
Joint Fusion ◽  
Ankle Replacement ◽  
Cystic Changes

Background:An advantage of total ankle replacement (TAR) compared to ankle fusion is that by maintaining motion, the occurrence of hypermobility of adjacent joints may be prevented. This could affect the development of symptomatic subtalar joint osteoarthritis (OA). The aim of the study was to determine the incidence of subtalar joint fusion and the progression of subtalar joint OA following TAR.Methods:Secondary subtalar joint fusion rate was determined from a cohort of 941 patients receiving primary TAR between 2000 and 2016. The indication for fusion, the time interval from primary TAR to fusion, and the union rate were evaluated. To assess the progression of subtalar joint OA, degenerative changes of the subtalar joint were classified in 671 patients using the Kellgren-Lawrence score (KLS) prior to TAR and at latest follow-up.Results:In 4% (37) of the patients, a secondary subtalar joint fusion was necessary. The indication for fusion was symptomatic OA in 51% (19), hindfoot instability in 27% (10), osteonecrosis of the talus in 19% (7), and cystic changes of the talus in 3% (1) of the patients. Time from primary TAR to subtalar joint fusion due to progressive OA was 5.0 (range, 0.3-10) years and for other reasons 1.6 (range, 0.2-11.6) years ( P = .3). In 68% (456) of the patients, no progression of subtalar joint OA was observed.Conclusion:The incidence of secondary subtalar joint fusion was low. The most common reason for subtalar joint fusion following TAR was symptomatic OA.Level of Evidence:Level IV, case series.

scholarly journals Total Ankle Replacement and Simultaneous Subtalar Arthrodesis

2016 ◽  
Vol 1 (1) ◽  
pp. 2473011416S0003
Author(s):  
Federico G. Usuelli ◽  
Luigi Manzi ◽  
Camilla Maccario
Keyword(s):  
Total Ankle Replacement ◽  
Subtalar Arthrodesis ◽  
Ankle Replacement

scholarly journals The CT gap sign, a case of failure to seat the polythene component in total ankle replacement (infinity)

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Anoop Anugraha ◽  
Zak Ferguson ◽  
Anand Pillai
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Revision Surgery ◽  
Inflammatory Markers ◽  
The Body ◽  
Total Ankle Replacement ◽  
Full Recovery ◽  
Polyethylene Liner ◽  
X Ray ◽  
Ankle Replacement

Abstract We present a case of incorrect seating of the polyethylene liner in an INFINITY total ankle replacement causing discomfort and eventually leading to a revision ankle replacement. This malposition of the implant was observed on a computed tomography (CT) scan as a ‘gap’ between the liner and the body of the replacement. The patient complained of discomfort on walking postoperatively, which limited activity. All investigations were normal including X-Ray, inflammatory markers, ultrasound, and it was only the subtle CT changes along with history that confirmed the diagnosis. This case demonstrates a complication of the design of the INFINITY prosthesis and the approach taken to the ankle when inserting. The patient fortunately made a full recovery after revision surgery, returning to normal activities with minimal pain.

scholarly journals The Demographics of Total Ankle Replacement in the USA: A Study of 21,222 Cases Undergoing Pre- Operative CT Scan-Based Planning

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0038
Author(s):  
Murray J. Penner ◽  
Gregory C. Berlet ◽  
Ricardo Calvo ◽  
Eric Molina ◽  
David Reynolds ◽  
...  
Keyword(s):  
Ct Scan ◽  
Demographic Data ◽  
Total Ankle Replacement ◽  
Patient Specific ◽  
Clear Understanding ◽  
Ankle Arthritis ◽  
Ankle Replacement ◽  
The Usa ◽  
The Mean ◽  
Over Time

Category: Ankle; Ankle Arthritis Introduction/Purpose: To understand the role of total ankle replacement (TAR) in treating the spectrum of arthritis of the ankle, a clear understanding of the epidemiology of ankle arthritis is required. The largest pools of epidemiologic data available to date come from international registries. In the USA, the largest market for TAR, where an estimated 10,000 TARs are implanted per year, the largest pool of demographic data on patients undergoing TAR is comprised of just 805 cases collected over 6 years. With the advent of patient-specific instrumentation (PSI), detailed demographic and CT scan data can now be collected. These data on 21,222 cases undergoing CT scan-based PSI planning were reviewed to define the demographics of a very large cohort of TAR patients. Methods: The cohort contained 21,222 patients from the USA and Canada, with surgery dates from 2012 - 2019. Data analysed included deformity measures, presence of existing hardware and joint fusion status. To date, a subset sample of 4800 cases was available for analysis. Extraction is ongoing and data for the full cohort will soon be available. This subset described cases with surgery dates ranging from November 2015 through May 2019. Summary statistics to describe age, gender, ankle size, and tibio- talar deformity were calculated. Of the 4800 patients analyzed, 53% were male. Mean age 63.6 years (SD 10.4) (Age distribution in Figure 1a). The deformity distribution is shown in Figure 1b, with varus more common than valgus. The mean degree of deformity increased with every decade of patient age from 6.1° (age 30-39) to 9.2° (age 80-89), and over time from 9.3°(2016) to 11.8° (2019) [in stemmed- implant cases]. Results: Tibia size varied with gender. Females ranged between 34-38mm in 85% of cases; males from 41-48mm in 79%. Of 21,222 cases, 5964 (28%) had adjacent hardware (screws, etc) in situ and pre-existing ankle fusions were present in 517 (2.4%), increasing from 1.2% in 2013 to 2.9% in 2019.The mean age of TAR patients is similar to that reported in smaller series. Tibia size was significantly greater in males than females, a finding not previously reported in demographic literature. In contrast to knee arthritis, intra-articular deformity >5° is common, present in > 51% of cases (varus > valgus). This is the first series to show the degree of deformity increases with age. Over time, TAR is being used in cases with greater deformity. Conclusion: Hardware is seen to be commonly present in TAR, increasing complexity. Conversion of fusion to TAR, while rare, is more common than existing literature suggests, with the rate increasing each year, suggesting this may be an increasingly important role for TAR in the future. This study presents the largest set of demographic data on TAR patients in the literature. The demographics of USA patients undergoing TAR are similar to those seen in non-USA registries. Deformity is common, increasing with age. The severity of deformity treated with TAR and conversion of fusion to TAR are increasing over time.

Total Ankle Replacement With Subtalar Arthrodesis

2010 ◽  
Vol 9 (4) ◽  
pp. 182-189 ◽  
Author(s):  
James K. DeOrio
Keyword(s):  
Total Ankle Replacement ◽  
Subtalar Arthrodesis ◽  
Ankle Replacement

Periprosthetic osteolysis after AES total ankle replacement: Conventional radiography versus CT-scan

2015 ◽  
Vol 21 (3) ◽  
pp. 164-170 ◽  
Author(s):  
Anthony Viste ◽  
Nader AL Zahrani ◽  
Nuno Brito ◽  
Christophe Lienhart ◽  
Michel Henri Fessy ◽  
...  
Keyword(s):  
Ct Scan ◽  
Conventional Radiography ◽  
Total Ankle Replacement ◽  
Periprosthetic Osteolysis ◽  
Ankle Replacement
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