scholarly journals One-stage tibial deformity correction and ankle arthrodesis for ankle osteoarthritis and tibial malalignment after low tibial osteotomy

2021 ◽  
pp. 106624
Author(s):  
Ichiro Tonogai ◽  
Koichi Sairyo
Keyword(s):  
Deformity Correction ◽  
Ankle Arthrodesis ◽  
Tibial Osteotomy ◽  
Ankle Osteoarthritis ◽  
One Stage

scholarly journals Arthroscopic Ankle Arthrodesis for Treating Osteoarthritis in a Patient with Kashin-Beck Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kenjiro Iwasa ◽  
Noriyuki Kanzaki ◽  
Takaaki Fujishiro ◽  
Shinya Hayashi ◽  
Shingo Hashimoto ◽  
...  
Keyword(s):  
Humic Acid ◽  
Growth Plate ◽  
Preventive Treatment ◽  
Ankle Arthrodesis ◽  
Ankle Osteoarthritis ◽  
Pathologic Feature ◽  
Skeletal Deformity ◽  
Degenerative Osteoarthritis ◽  
Beck Disease

Kashin-Beck disease (KBD) is an endemic degenerative osteoarthritis. Death of cartilage and growth plate is the pathologic feature; therefore, KBD involves skeletal deformity and often results in osteoarthritis. Deficiency of selenium, high humic acid levels in water, and fungi on storage gains are considered the cause of KBD. The most frequently involved joints are ankles, knees, wrists, and elbows and symptoms are pain and limited motions of those joints. The main treatments for KBD are rehabilitation and osteotomy to correct the deformities because preventive treatment has not been established. In this report, we present a case of ankle osteoarthritis due to KBD and first describe arthroscopic ankle arthrodesis for treating osteoarthritis of KBD.

scholarly journals Bilateral Tibial Proximal Fractures Caused by Secondary Osteomalacia due to Autoimmune Polyendocrine Syndrome Type 2: A Case Report

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Daisuke Nakagawa ◽  
Keisuke Oe ◽  
Tomoaki Fukui ◽  
Ryosuke Kuroda ◽  
Takahiro Niikura
Keyword(s):  
Case Report ◽  
Pharmacological Treatment ◽  
Plate Osteosynthesis ◽  
Deformity Correction ◽  
Serum Phosphate ◽  
Tibial Osteotomy ◽  
Syndrome Type ◽  
Radiographic Findings ◽  
Autoimmune Polyendocrine Syndrome

Introduction: Hypophosphatemic osteomalacia can be overlooked or confused with other musculoskeletal disorders due to the variety of associated clinical, laboratory, and radiographic findings. If osteomalacia is diagnosed early and the fractures are not displaced, they often heal with nutritional supplements, but, if they progress to displaced fractures, they may require surgical intervention. Case Report: We present a case of secondary osteomalacia due to autoimmune polyendocrine syndrome Type 2 due to this condition, the patient developed bilateral tibial proximal fractures and her varus deformity had progressed. No clear indication of the timing for surgery for adults with osteomalacia has been reported. However, medical treatment improves the symptoms of osteomalacia and it is reported that in children, appropriate level of the serum phosphate (P) should be attained and maintained for the successful bone healing after osteotomy. Therefore, we prioritized pharmacological treatment and prescribed surgery after confirming that the value of serum phosphate P had been improved to recommended levels (2.5-3.5 mg/dl). We performed high tibial osteotomy for the right side and gradual correction by an external fixation for the left tibia, because of more severe deformation, and converted to an internal fixation to shorten the treatment period. During conversion, we performed the operation with a locking plate by the minimal invasive plate osteosynthesis method (MIPO). Conclusion: We conclude that the use of different deformity correction methods, depending on the degree of deformity, and the pharmacological treatment of osteomalacia may lead to favorable results. Keywords: Osteomalacia, autoimmune polyendocrine syndrome type 2, deformity correction method.

scholarly journals Realignment Surgery for Anterior Translation of Talus after Malunited Ankle Fracture

2019 ◽  
Author(s):  
Xingchen Li ◽  
Kai Rong ◽  
Yang Xu ◽  
Yuan Zhu ◽  
Xiangyang Xu
Keyword(s):  
Soft Tissue ◽  
Ankle Joint ◽  
Ankle Fracture ◽  
Sagittal Plane ◽  
Tibial Osteotomy ◽  
Ankle Osteoarthritis ◽  
Anterior Translation ◽  
Functional Scores ◽  
Weber Type ◽  
The Mean

Abstract Background: It is challenging for the clinical management of malunited ankle fracture. The aim of this study is to evaluate the clinical outcome of realignment surgery for anterior translation of talus after malunited ankle fracture and to analyze its. Methods: A total of 11 patients with anterior translation of talus after malunited ankle fractures underwent corrective osteotomy in our institute were retrospectively reviewed. All patients were evaluated with radiological parameters and clinical functional scores. There were 4 patients with Weber type A fracture, 4 patients with Pilon type B fracture and 3 patients with Weber type C fracture. 8/11 patients had impaction on the anterior distal tibial plafond, intra-articular distal tibial osteotomy was performed in these patients, additional bony correction and soft tissue surgery were also performed to achieve congruent ankle joint. Results: The mean age at surgery was 32.8 ± 10.8 (range,16-48) years. The mean follow-up time was 50.5 ± 23.6 (range, 16-80) months. The mean AOFAS-AH score increased from 28.2 ± 19.1preoperatively to 72.5 ± 8.1 points postoperatively(p<0.05), the mean lateral talar station(LTS) improved from 9.2 ± 3.7 preoperatively to 1.5 ± 1.4 mm postoperatively(p<0.05). 10/11 patients had improvement or no worsening ankle osteoarthritis on sagittal plane, while 1 patient had advanced ankle osteoarthritis. Conclusion: A congruent ankle joint in sagittal plane could be achieved by corrective osteotomies with additional soft tissue procedures. The realignment surgery was a valuable treatment option for the salvage of anterior translation of talus after malunited ankle fracture.

Validation of the Ankle Osteoarthritis Scale Instrument for Preoperative Evaluation of End-Stage Ankle Arthritis Patients Using Item Response Theory

2019 ◽  
Vol 40 (4) ◽  
pp. 422-429 ◽  
Author(s):  
Guiping Liu ◽  
Alexander C. Peterson ◽  
Kevin Wing ◽  
Trafford Crump ◽  
Alastair Younger ◽  
...  
Keyword(s):  
Item Response Theory ◽  
Item Response ◽  
Ankle Arthrodesis ◽  
Ankle Arthritis ◽  
Response Theory ◽  
Ankle Osteoarthritis ◽  
Differential Item Function ◽  
Ankle Replacement ◽  
End Stage ◽  
Pain Domain

Background: Significant ankle arthritis results in functional limitations and patient morbidity. There is a need to measure symptoms and the impact of interventions on patient’s quality of life using valid and reliable patient-reported measurement instruments. The objective of this research was to validate the Ankle Osteoarthritis Scale instrument in the preoperative setting using factor analysis, item response theory, and differential item function methods. Methods: This research is based on secondary analysis of patients scheduled for ankle arthrodesis or total ankle replacement in Vancouver, Canada. Participants completed the instrument between September 2014 and August 2017. Item response theory was used to estimate item difficulty and discrimination parameters, controlling for study participants’ underlying level of ankle function. Differential item function was examined for sex, age group, and surgery. There were 88 participants. Results: Modification indices suggested that item 10, “walking around the house,” would better fit the pain domain rather than the disability domain. Items in the pain domain displayed a range of discrimination and difficulty. Items in the disability domain exhibited a range of discrimination, though the disability domain had low difficulty. Differential item functioning for sex, age group, and ankle arthrodesis or total ankle replacement appeared to be ignorable. Conclusion: This evaluation of the Ankle Osteoarthritis Scale found the instrument to be a strong measure of the effect of pain and dysfunction among patients with end-stage ankle arthritis, even when removing items 7 and 8, supporting its prior use in numerous clinical studies. Level of Evidence: Level II, prospective comparative study.

scholarly journals The comparison of one stage and two stage high tibial osteotomy.

1986 ◽  
Vol 35 (2) ◽  
pp. 641-643
Author(s):  
Takeshi Arizono ◽  
Kosuke Ogata ◽  
Hisashi Sakamoto ◽  
Yoichi Sugioka
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Osteotomy ◽  
Two Stage ◽  
One Stage

scholarly journals 20 Degree Post Traumatic Ankle Valgus and Distal Lateral Tibial Osteonecrosis Treated with Staged Deformity Correction and Total Ankle Arthroplasty

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Lawrence DiDomenico ◽  
Danielle Butto
Keyword(s):  
Ankle Joint ◽  
Deformity Correction ◽  
Total Ankle Arthroplasty ◽  
Wedge Osteotomy ◽  
Tibial Osteotomy ◽  
Opening Wedge ◽  
Ankle Arthroplasty ◽  
Initial Surgery ◽  
Post Traumatic ◽  
Ankle Valgus

Category: Ankle, Ankle Arthritis Introduction/Purpose: The purpose of this review is to present a case of post-traumatic ankle valgus and distal lateral tibial osteonecrosis successfully treated with staged deltoid repair, opening wedge tibial osteotomy, fibular lengthening, syndesmotic fusion and total ankle arthroplasty. Methods: Initial surgery consisted of ankle joint arthrotomy and deltoid imbrication. The second surgery consisted of a tibial opening wedge osteotomy with autogenous cortical fibular bone graft superior to the area of osteonecrosis to correct the 20 degree ankle valgus. Fibular lengthening osteotomy and fusion of the distal syndesmosis were also performed. CT scan confirmed bony consolidation at the distal tibiofibular syndesmosis as well as union of the allograft opening wedge. The final surgery was total ankle joint replacement with bone grafting of the area of osteonecrosis. Results: After 5 years of follow up the patient has progressed out of his AFO to full weightbearing. He reports no ankle pain, improved function and range of motion and is ambulating independently with no assistive devices. Conclusion: We successfully treated a case of distal lateral tibial osteonecrosis, and a 20 degree ankle valgus with staged deformity correction and ankle replacement. Radiographs demonstrate a well seated and positioned implant. We believe that with proper alignment that total ankle arthroplasty is a safe treatment option in the face of bone infarction.

scholarly journals Long-Term Results Of Low Tibial Osteotomy For Ankle Osteoarthritis

2016 ◽  
Vol 1 (1) ◽  
pp. 2473011416S0021
Author(s):  
Naohiro Hio ◽  
Atsushi Hasegawa ◽  
Satoshi Monden ◽  
Hideo Noguchi ◽  
Masanori Taki ◽  
...  
Keyword(s):  
Long Term Results ◽  
Tibial Osteotomy ◽  
Ankle Osteoarthritis

Arthroscopic Ankle Arthrodesis

2007 ◽  
Vol 28 (6) ◽  
pp. 695-706 ◽  
Author(s):  
Nikolaos E. Gougoulias ◽  
Filon G. Agathangelidis ◽  
Stephen W. Parsons
Keyword(s):  
Sagittal Plane ◽  
Deformity Correction ◽  
Frontal Plane ◽  
Ankle Arthrodesis ◽  
Valgus Deformity ◽  
Postoperative Treatment ◽  
Average Hospital ◽  
Superficial Wound ◽  
Group A ◽  
Group B

Background: Arthroscopic arthrodesis has been used mainly for in situ fusion of arthritic ankles without deformity. This paper presents the application of arthroscopic arthrodesis of ankles with marked deformity. Methods: The results of 78 consecutive cases of arthroscopic ankle arthrodeses, performed in 74 patients, were retrospectively evaluated. Forty-eight ankles had minor deformity (group A), whereas 30 ankles had a varus or valgus deformity of more than 15 degrees (maximum 45 degrees) (group B). The average hospital stay was 3.8 and 3.4 days in groups A and B, respectively ( p = 0.74). Postoperative treatment included ankle immobilization for 3 months. Progressive weightbearing was initiated at 2 weeks. Mean followup was 21.1 months. Results: Fusion occurred in 47 of 48 (97.9%) ankles in group A at an average time of 13.1 ± 5.8 weeks and in 29 of 30 (96.7%) ankles at 11.6 ± 2.4 weeks in group B ( p = 0.19). Unplanned operative procedures were required in 11 ankles (14.1%). One superficial wound infection occurred. Symptomatic arthritis from the adjacent joints developed in six ankles (7.7%). Postoperative ankle alignment in the frontal plane averaged 0.7 and 0.4 degrees of valgus ( p = 0.41), whereas the sagittal plane angle averaged 106 ± 4 degrees and 104.5 ± 7 degrees in groups A and B, respectively ( p = 0.22). The outcome was graded as very good in 79.2% (38 feet) in group A and 80% (24 feet) in group B, fair in 18.8% (9 feet) in group A and 16.7% (5 feet) in group B and poor in one ankle in each group ( p = 0.68). Conclusions: The arthroscopic technique offered high fusion rates and low morbidity. Deformity correction was achieved with good results.

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