Midterm Outcome of the Agility Total Ankle Arthroplasty

2017 ◽  
Vol 38 (6) ◽  
pp. 662-670 ◽  
Author(s):  
Steven M. Raikin ◽  
Kristin Sandrowski ◽  
Justin M. Kane ◽  
David Beck ◽  
Brian S. Winters
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Short Form ◽  
Linear Regression Analysis ◽  
Total Ankle Arthroplasty ◽  
Radiographic Appearance ◽  
Ankle Arthroplasty ◽  
Time Of Surgery ◽  
Kaplan Meier

Background: Ankle arthritis is a debilitating condition that causes severe functional impairment. While arthrodesis has been the gold standard of surgical treatment for this condition, significant improvements in total ankle arthroplasty have made it a viable alternative. The purpose of this study was to look at the midterm follow-up of the Agility total ankle. Methods: A retrospective review of prospectively collected data was conducted on 127 consecutive Agility total ankles implanted between 2002 and 2009. Charts were reviewed to collect patient demographics. In addition, coronal alignment, overall arc of motion, tibiotalar component motion, syndesmotic fusion, zones of osteolysis, and subsidence were determined. A Kaplan-Meier survival and linear regression analysis were used to predict implant failure. A multivariate regression analysis was used to assess whether radiographic measures were predictive of patient satisfaction. Results: Ninety (78.2%) of 115 patients retained their primary implant, of which 105 were available for evaluation, with an average follow-up of 9.1 years. Twenty-five had their implant removed. The average score for the Foot and Ankle Ability Measure (FAAM) activities of daily living subscale was 82.4, FAAM sport subscale 55.3, postoperative visual analog scale (VAS) for pain 12.7, and Short Form-12 (SF-12) Health Survey physical component 45.8 and SF-12 mental component 56.1. Average arc of motion across the implant was 22.3 and 6.3 degrees in adjacent joints. Osteolysis most commonly occurred in zones 1 and 6. No statistical differences were found in the rate or location of subsidence. Linear regression analysis demonstrated that age at the time of surgery was predictive of failure ( P = .036). Inflammatory and atraumatic arthritis demonstrated higher likelihoods of revision. No correlation was detected between radiographic parameters and outcomes scores ( P > .05; rho >0.2). A significant reduction in mean VAS pain scores by 67.6% was maintained at an average of 8 years. Discussion: Our results were improved over the nondesigner outcomes published in the current literature. Survivorship approached 80% at 9 years, with Kaplan-Meier 14-year survival calculated at 70.4%. Patients with their original implant were functioning with a high level of satisfaction based on statistically validated outcome scores, which was independent of the radiographic appearance of their implant. Age at the time of surgery and inflammatory/atraumatic arthritis were predictive of failure. Level of Evidence: Level IV, case series.

Ankle Arthrodesis Through a Fibular-Sparing Anterior Approach

2020 ◽  
Vol 41 (12) ◽  
pp. 1480-1486
Author(s):  
Ryan G. Rogero ◽  
Daniel J. Fuchs ◽  
Daniel Corr ◽  
Rachel J. Shakked ◽  
Steven M. Raikin
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Anterior Approach ◽  
Short Form ◽  
Linear Regression Analysis ◽  
Ankle Arthrodesis ◽  
Foot And Ankle ◽  
Composite Scale ◽  
Patient Reported

Background: The open anterior approach to ankle arthrodesis offers a technique that provides several advantages for surgeons, such as easier visualization of the joint for deformity correction and preservation of the malleoli for potential future conversion to total ankle arthroplasty. The purpose of this study was to evaluate clinical, radiographic, and functional outcomes in a large series of patients undergoing open ankle arthrodesis via a fibular-sparing anterior approach. Methods: A retrospective review was performed of patients undergoing primary ankle arthrodesis with a single fellowship-trained foot and ankle orthopedic surgeon between 2009 and 2017. Patients were excluded if an approach other than anterior was performed. Patient-reported outcome measures (Foot and Ankle Ability Measure–Activities of Daily Living [FAAM-ADL], Short-Form 12 [SF-12], and visual analog scale [VAS] pain) were subsequently collected at a minimum of 24 months (2 years) following index surgery, along with outcome satisfaction and likelihood to repeat surgery. Fusion of the tibiotalar joint at the time of last radiographic follow-up was also assessed. Paired t tests were performed to assess change in pre- to postoperative outcomes, while linear regression analysis was performed to identify any patient factors associated with outcomes. Eighty-one patients, including 31 women and 50 men, with a mean age of 51.5 years and a mean follow-up of 58.9 (range, 24-104) months, were included. Results: Sixty-two patients reported significant improvement in mean FAAM-ADL ( P < .0001), SF-12 Physical Composite Scale ( P < .0001), and VAS pain ( P < .0001), while the SF-12 Mental Composite Scale also improved, though not significantly ( P = .2854). Twelve patients (14.8%) experienced complications following their arthrodesis procedure. Seventy-nine patients (97.5%) achieved fusion at their last radiographic follow-up. Multiple linear regression analysis revealed age ( B = 0.071 [0.004, 0.128]; P = .0373) to have a positive association with postoperative VAS pain. Conclusion: Ankle arthrodesis utilizing a fibular-sparing anterior approach combined with the transarticular screw fixation technique offers surgeons several advantages, along with a low postoperative complication rate, high rate of radiographic evidence of joint fusion, and substantially large improvement in pain and functional levels. Level of Evidence: Level IV, retrospective case series.

Comparison of Intermediate-term Outcomes of Total Ankle Arthroplasty in Primary and Ligamentous Post-traumatic Osteoarthritis

2019 ◽  
Vol 40 (11) ◽  
pp. 1273-1281 ◽  
Author(s):  
Gun-Woo Lee ◽  
Asep Santoso ◽  
Keun-Bae Lee
Keyword(s):  
Short Form ◽  
Total Ankle Arthroplasty ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Radiographic Outcomes ◽  
Primary Osteoarthritis ◽  
Post Traumatic ◽  
American Orthopaedic ◽  
End Stage

Background: Ankle ligamentous injuries without fracture can result in end-stage ligamentous post-traumatic osteoarthritis, which may cause ligamentous imbalance after total ankle arthroplasty (TAA). However, outcomes of TAA in these patients are not well known. The purpose of this study was to evaluate intermediate-term clinical and radiographic outcomes of TAA in patients with ligamentous post-traumatic osteoarthritis and compare them with results of TAA for patients with primary osteoarthritis. Methods: We enrolled 114 patients (119 ankles) with consecutive primary TAA using HINTEGRA prosthesis at a mean follow-up duration of 6.0 years (range, 3-13). We divided all patients into 2 groups according to the etiology of osteoarthritis: (1) primary osteoarthritis group (69 ankles) and (2) ligamentous post-traumatic osteoarthritis group (50 ankles). Results: There was no significant intergroup difference in mean Ankle Osteoarthritis Scale (AOS), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, Short Form-36 Physical Component Summary, visual analog scale pain score, ankle range of motion, or complications at the final follow-up. However, the final tibiotalar angle was less corrected to 4.2 degrees in the ligamentous post-traumatic osteoarthritis group compared to 2.7 degrees in the primary osteoarthritis group ( P = .001). More concomitant procedures were required at the index surgery for the ligamentous post-traumatic osteoarthritis group ( P = .001). The estimated 5-year survivorship was 93.4% (primary osteoarthritis group: 91.3%; ligamentous post-traumatic osteoarthritis group: 95.8%). Conclusions: Clinical outcomes, complication rate, and 5-year survivorship of TAA in ankles with primary and ligamentous post-traumatic osteoarthritis were comparable with intermediate-term follow-up. Our results suggest that TAA would be a reliable treatment in ankles with ligamentous post-traumatic osteoarthritis when neutrally aligned stable ankles are achieved postoperatively. Level of Evidence: Level III, retrospective cohort study.

Outcomes of Total Ankle Arthroplasty in Moderate and Severe Valgus Deformity

2018 ◽  
Vol 12 (3) ◽  
pp. 238-245 ◽  
Author(s):  
Constantine A. Demetracopoulos ◽  
Elizabeth A. Cody ◽  
Samuel B. Adams ◽  
James K. DeOrio ◽  
James A. Nunley ◽  
...  
Keyword(s):  
Short Form ◽  
Valgus Deformity ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthroplasty ◽  
Short Musculoskeletal Function Assessment ◽  
Sf 36 ◽  
Patient Reported ◽  
Musculoskeletal Function ◽  
American Orthopaedic

Introduction. Failure to correct coronal deformity at the time of total ankle arthroplasty (TAA) can lead to early implant failure. We aimed to determine clinical, radiographic, and patient-reported outcomes of patients with moderate to severe valgus deformity who underwent TAA for end-stage ankle arthritis. Methods. Patients with a valgus deformity of at least 10° who underwent TAA were retrospectively reviewed. The coronal tibiotalar angle was assessed on radiographs preoperatively, at 1 year, and at final follow-up. The visual analog scale (VAS) for pain, Short Form-36 (SF-36), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle scale, and Short Musculoskeletal Function Assessment (SMFA) scores were assessed preoperatively and at final follow-up. Results. Mean preoperative valgus deformity was 15.5 ± 5.0°, and was corrected to a mean of 1.2 ± 2.6° of valgus postoperatively. VAS, SF-36, AOFAS, and SMFA scores improved significantly ( P < .001 for all). There was no significant change in tibiotalar angle between 1 year and final follow-up in either group. Reoperation and revision rates did not differ between groups. Conclusion. Correction of coronal alignment was achieved and maintained in patients with both moderate and severe preoperative valgus malalignment. Outcome scores significantly improved for all patients. Levels of Evidence: Therapeutic, Level IV

scholarly journals Revision Surgery for Metal Component Failure in Total Ankle Arthroplasty

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0007
Author(s):  
James Lachman ◽  
Jania A. Ramos ◽  
Samuel Adams ◽  
Mark Easley ◽  
James DeOrio
Keyword(s):  
Revision Surgery ◽  
Short Form ◽  
Total Ankle Arthroplasty ◽  
Study Patient ◽  
Foot And Ankle ◽  
Metal Component ◽  
Component Failure ◽  
Ankle Arthroplasty ◽  
Patient Reported

Category: Ankle Arthritis Introduction/Purpose: Metal component failure in total ankle arthroplasty(TAA) is difficult to treat. Traditionally, to an arthrodesis has been advocated. Revision TAA surgery has become more and more common with availability of revision implants and refinement of bone conserving primary implants. It this study, patient reported results and clinical outcomes are analyzed for patients undergoing revision total ankle arthroplasty. Methods: We retrospectively reviewed prospectively collected data on 45 patients (cases) with a mean age of 63.7 +/-10.2 years who developed loosening or collapse of either major metal component in the primary total ankle arthroplasty. Cases of isolated polyethylene exchange, infection, or extra-articular realignment procedures were excluded. Prospectively collected patient reported outcomes measures including the American Orthopaedic Foot and Ankle Society(AOFAS) hindfoot score, Visual Analog Scale (VAS), Short Form 36 (SF-36), Short Musculoskeletal Function Assessment (SMFA), and the Foot and Ankle Outcomes Score (FAOS) questionnaires were collected. Clinical data was collected through thorough review of the electronic medical record to identify clinical failure defined as explant and second revision or conversion to arthrodesis or amputation. Results: The causes of failure of primary TAA in this study were aseptic loosening of both components (40%), talar component subsidence/loosening (37.7%), tibial loosening (8.8%), coronal talar subluxation (8.8%) and talar malrotation (2.2%). Twenty-four patients (53.3%) underwent revision of all components, nineteen (42.2%) just the talar and polyethylene components, and two (4.4%) the tibial and polyethylene components. The average time to revision was 5.56 years +/- 5.71 with a follow-up of 3.02 years +/- 1.25 after revision. Ten (22.2%) revision arthroplasties required further surgery; five required conversion to arthrodesis and five required second revision TAA. VAS scores, SF36 scores, SMFA scores, AOFAS Hindfoot scores, and FAOS all improved after revision surgery but took 2 years to reach scores comparable to 1 year after primary TAA. Conclusion: Clinical and patient reported results of revision ankle arthroplasty after metal component failure were comparable to those after primary ankle arthroplasty. In our series, 22.2% of revision TAAs required a second revision TAA or arthrodesis surgery. Various prosthesis performed similarly when used in revision scenarios. Patients recovered faster from primary ankle arthroplasty when compared to revision ankle arthroplasty but all scores were comparable by the two-year follow-up visit after revision arthroplasty surgery.

scholarly journals Clinical and Radiological Outcomes of Transfibular Total Ankle Arthroplasty

2018 ◽  
Vol 40 (1) ◽  
pp. 24-33 ◽  
Author(s):  
Federico G. Usuelli ◽  
Camilla Maccario ◽  
Francesco Granata ◽  
Cristian Indino ◽  
Venus Vakhshori ◽  
...  
Keyword(s):  
Short Form ◽  
Case Series ◽  
Total Ankle Replacement ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthritis ◽  
Plate Removal ◽  
Ankle Arthroplasty ◽  
Ankle Replacement ◽  
Patient Reported

Background: Ankle arthritis is a highly limiting pathology that causes pain and functional limitation with subsequent deterioration of quality of life. With recent advances in surgical instrumentation and techniques, prosthetic replacement of the ankle has proven to be a valid alternative to arthrodesis with comparable outcomes. The purpose of this study was to evaluate clinical and radiological findings in a transfibular total ankle replacement with follow-up of at least 2 years. Methods: This prospective study included 89 patients who underwent transfibular total ankle arthroplasty from May 2013 to February 2016. The mean age was 53.2 ± 13.5 years. All patients were followed for at least 24 months postoperatively with an average follow-up of 42.0 ± 23.5 months. Patients were assessed clinically and radiographically preoperatively and at 6, 12, and 24 months postoperatively. Results: At 24 months postoperatively, patients demonstrated statistically significant improvement in the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle Hindfoot Score from 33.8 ± 14.3 to 88.5 ± 6.6 ( P < .001), visual analog scale (VAS) from 80.5 ± 17.0 to 14.1 ± 9.2 ( P < .001), and Short Form-12 Physical and Mental Composite Scores from 29.9 ± 6.7 and 43.3 ± 8.6 to 47.0 ± 7.6 and 53.3 ± 8.1, respectively ( P < .001). In addition, ankle dorsiflexion and plantarflexion improved from 6.2 ± 5.5 and 9.6 ± 5.8 degrees to 24.2 ± 7.9 and 18.1 ± 7.6 degrees, respectively ( P < .001). Radiographically, patients demonstrated maintained neutral alignment of the ankle at 24 months. No patient demonstrated any radiographic evidence of tibial or talar lucency at final follow-up. Seven patients underwent reoperation for removal of symptomatic hardware (6 fibular plates, 1 syndesmotic screw); 2 patients experienced delayed wound healing. The first one was treated with plate removal and flap coverage. The second one required fibular plate removal. One patient developed a postoperative prosthetic infection requiring operative debridement, removal of implants, and placement of an antibiotic spacer. Conclusion: This study found that transfibular total ankle replacement was a safe and effective option for patients with ankle arthritis resulting in improvements in patient-reported outcomes, range of motion, and radiographic parameters. However, further studies are required to determine the mid- and long-term performance of these implants. Level of Evidence: Level IV, case series.

scholarly journals Mid-Term (4-10 year) Outcomes of INBONE I Total Ankle Arthroplasty with Deformity Analysis

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Andrew Harston ◽  
James Nunley ◽  
Mark Easley ◽  
James DeOrio ◽  
Samuel Adams ◽  
...  
Keyword(s):  
Short Form ◽  
Total Ankle Arthroplasty ◽  
Coronal Plane ◽  
Consecutive Series ◽  
Ankle Arthroplasty ◽  
Sf 36 ◽  
Significant Difference ◽  
Patient Reported ◽  
Plane Deformity

Category: Ankle, Ankle Arthritis Introduction/Purpose: Concerns for limited coronal plane stability prompted the manufacturer and designers of the INBONE total ankle arthroplasty system to replace the original saddle-shaped talar component (INBONE I) with a sulcus-shaped talar component (INBONE II). Prior to the availability of the INBONE II talar component, numerous INBONE I total ankle replacements were performed. To our knowledge mid-term outcomes of INBONE I total ankle arthroplasty have not been reported. This study compares the mid-term outcomes of patients with and without preoperative coronal plane deformity who underwent total ankle replacement with the INBONE I prosthesis. In our opinion, the longer-term outcomes of the INBONE I prosthesis are important for patient and surgeon education. Methods: A consecutive series of patients, from May, 2007 to September, 2011, at a single institution who underwent total ankle arthroplasty with the INBONE I Total Ankle Arthroplasty (Wright Medical) were prospectively enrolled. Pain and patient- reported function were assessed preoperatively and at yearly follow-ups with use of a visual analog scale (VAS) for pain, the American Orthopaedic Foot & Ankle Society (AOFAS) ankle- hindfoot score, the Short Musculoskeletal Function Assessment (SMFA), and the Short Form-36 (SF-36) Health Survey. We analyzed the data for complications, reoperations, and failures (defined as undergoing revision for exchange or removal of the metallic components for any reason). Patients were grouped according to coronal plane tibiotalar alignment (preoperative coronal plane malalignment of >10 degrees and <10 degrees deformity) and outcomes compared. Results: One-hundred fifty-five INBONE I prostheses were implanted in 151 patients, with minimum 4 year clinical and radiographic follow-up. Follow-up ranged from 48-113 months with an average of 67 months. There was significant (p<0.05) improvement in the VAS, AOFAS, SMFA, and SF-36 scores at most recent follow-up. Forty-five patients (29%) had 49 additional surgeries for impingement, loosening/subsidence, malalignment, ligament instability, polyethylene exchange, and/or infection. There were 14 implant failures with overall survivorship of 90.3%. There was no statistically significant difference in outcomes between patients with coronal plane deformity >10 degrees (47.7%) and <10 degrees (52.3%). Patients with >10 degrees had fewer reoperations (19 vs. 30) and fewer revisions (5 vs. 9) when compared to patients with <10 degrees deformity. Conclusion: Patients who underwent INBONE I total ankle arthroplasty demonstrated significant improvement in pain and patient-reported outcomes at a mean of 5.7 years post-operatively. The patients with preoperative coronal plane tibiotalar deformity had similar pain relief, function, and need for additional surgeries and revisions. Despite the presumed shortcomings of the INBONE I’s saddle-shaped talar design, this operation shows promising results, with or without deformity, at mid-term follow- up with survivorship of 90.3%.

Factors Influencing the Changes in Masticatory Performance: The Suita Study

2018 ◽  
Vol 3 (4) ◽  
pp. 405-412 ◽  
Author(s):  
T. Kosaka ◽  
M. Kida ◽  
M. Kikui ◽  
S. Hashimoto ◽  
K. Fujii ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Bite Force ◽  
Masticatory Performance ◽  
Longitudinal Changes ◽  
Independent Variables

Introduction: Although previous studies have identified various factors related to masticatory performance, which factors affect longitudinal changes in masticatory performance have not been clarified. Objectives: We aimed to clarify factors involved in changes to masticatory performance and construct models from factors related to masticatory performance in a longitudinal study of a general urban population in Japan. Methods: A total of 1,005 Japanese subjects (411 men, 594 women; mean age at baseline, 65.7 ± 7.7 years; mean follow-up period, 5.0 ± 0.9 years) were included in the Suita study. These subjects participated in dental checkups both at baseline (June 2008–December 2011) and at follow-up (June 2013–January 2017). The number of functional teeth and occlusal support areas was recorded and the latter assessed using the Eichner index. Subjects’ periodontal status was evaluated based on the Community Periodontal Index. Masticatory performance was determined using test gummy jelly. Factors affecting masticatory performance at follow-up and the degree of their effect were investigated by multiple linear regression analysis. Results: In multiple linear regression analysis with masticatory performance at follow-up as the dependent variable, baseline age, masticatory performance, number of functional teeth, and maximum bite force were significant independent variables. The results of multiple linear regression analyses by occlusal support at baseline identified only maximum bite force at baseline in subjects who were Eichner A and baseline age, masticatory performance, and number of functional teeth in subjects who were Eichner B as significant independent variables concerning masticatory performance at follow-up. Conclusion: Our study showed a relationship between longitudinal changes in masticatory performance and age, number of functional teeth, and maximum bite force and furthermore showed that the effects of these factors vary according to the residual number of occlusal support areas. Knowledge Transfer Statement: Patients and clinicians should recognize the importance of objective and quantitative assessment for chewing efficiency and understand that various factors are related to longitudinal changes in masticatory performance. The results of this study can provide basic data for preventing or improving the decline in masticatory performance for elderly people with varying numbers of occlusal support areas.

scholarly journals Optimized Surgical Strategy for Adult Spinal Deformity: Quantitative Lordosis Correction versus Lordosis Morphology

2021 ◽  
Vol 10 (9) ◽  
pp. 1867
Author(s):  
Sang-Kyu Im ◽  
Ki Young Lee ◽  
Hae Seong Lim ◽  
Dong Uk Suh ◽  
Jung-Hee Lee
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Correlation Analysis ◽  
Sagittal Alignment ◽  
Adult Spinal Deformity ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Optimal Alignment ◽  
Stepwise Multiple Linear Regression

Background: In surgical correction of adult spinal deformity (ASD), pelvic incidence (PI)-lumbar lordosis (LL) plays a key role to restore normal sagittal alignment. Recently, it has been found that postoperative lordosis morphology act as an important factor in preventing mechanical complications. However, there have been no studies on the effect of postoperative lordosis morphology on the restoration of sagittal alignment. The primary objective of this study was to evaluate the effect of postoperative lordosis morphology on achievement of optimal sagittal alignment. The secondary objective was to find out which radiographic or morphologic parameter affects sagittal alignment in surgical correction of ASD. Methods: 228 consecutive patients with lumbar degenerative kyphosis who underwent deformity correction and long-segment fixation from T10 to S1 with sacropelvic fixation and follow-up over 2 years were enrolled. Patients were divided according to whether optimal alignment was achieved (balanced group) or not (non-balanced group) at last follow-up. We analyzed the differences of postoperative radiographic parameters and morphologic parameters between two groups. Correlation analysis and stepwise multiple linear regression analysis was performed to predict the effect of PI-LL and morphologic parameters on the sagittal vertical axis (SVA). Results: Of 228 patients, 195 (85.5%) achieved optimal alignment at last follow-up. Two groups significantly differed in postoperative and last follow-up LL (p < 0.001 and p = 0.028, respectively) and postoperative and last follow-up PI-LL (p < 0.001 and p = 0.001, respectively). Morphologic parameters did not significantly differ between the two groups except lower lordosis arc angle (=postoperative sacral slope). In correlation analysis and stepwise multiple linear regression analysis, postoperative PI-LL was the only parameter which had significant association with last follow-up SVA (R2 = 0.134, p < 0.001). Morphologic parameters did not have any association with last follow-up SVA. Conclusions: When planning spine reconstruction surgery, although considering postoperative lordosis morphology is necessary, it is still very important considering proportional lordosis correction based on individual spinopelvic alignment (PI-LL) to achieve optimal sagittal alignment.

scholarly journals 697Change of smoking habits by introducing and spreading heated tobacco products in Japan

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Sei Harada ◽  
Mizuki Sata ◽  
Minako Matsumoto ◽  
Ayano Takeuchi ◽  
Miho Iida ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cohort Study ◽  
Linear Regression ◽  
Prospective Cohort ◽  
Linear Regression Analysis ◽  
Tobacco Product ◽  
Smoking Habits ◽  
Tobacco Products ◽  
Never Smokers

Abstract Background Heated tobacco product (HTP) users are rapidly increasing in Japan since 2014. Controlling HTPs is now one of the most urgent issues. We aimed to clarify the change of smoking habits by introducing and spreading HTPs. Methods We conducted the survey of HTP use in the participants of the Tsuruoka Metabolomics Cohort Study, a prospective cohort including 11,002 participants aged 40-74 in Japan. All data were obtained in the follow-up (2018-2019) and baseline (2012-2013) survey. Smoking habits were categorized to five groups according to follow-up survey; never smokers (NS), past smokers (PS), cigarette only smokers (CS), HTP only smokers (HS) and dual smokers (DS). Linear regression analysis was performed to examine the association between smoking habits and change of number of smoking tobacco products during follow-up. Results Prevalence of HTP user was 12.4% in 40-59 years of age and 1.8% in 60-79 for male, and 1.7% in 40-59 and 0% in 60-79 for female. Dual smokers accounted for 34.9% of all HTP users. Change of smoking number during follow-up (5.7±0.8 years) was +3.11 (95%CI: 1.17, 5.07) in DS and -1.09 (-2.70, 0.53) in HS compared with CS, after adjusted for age, sex and smoking number at baseline. Conclusions HTPs smoking including dual smoking was getting popular in Japan. Shift to HTPs was unlikely to affect the number of smoking tobacco, but dual smokers tended to smoke more than at baseline. Key messages Dual smokers of cigarettes and HTPs tended to smoke more than before introducing and spreading HTPs.

The HINTEGRA total ankle arthroplasty

2019 ◽  
Vol 101-B (6) ◽  
pp. 695-701 ◽  
Author(s):  
H-Y Yang ◽  
S-H Wang ◽  
K-B Lee
Keyword(s):  
Functional Outcome ◽  
Short Form ◽  
Major Complication ◽  
Mobile Bearing ◽  
Total Ankle Arthroplasty ◽  
Range Of Movement ◽  
Ankle Arthroplasty ◽  
Implant Survivorship ◽  
American Orthopaedic

Aims The purpose of this study was to determine the functional outcome and implant survivorship of mobile-bearing total ankle arthroplasty (TAA) performed by a single surgeon. Patients and Methods We reviewed 205 consecutive patients (210 ankles) who had undergone mobile-bearing TAA (205 patients) for osteoarthritis of the ankle between January 2005 and December 2015. Their mean follow-up was 6.4 years (2.0 to 13.4). Functional outcome was assessed using the Ankle Osteoarthritis Scale, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, 36-Item Short-Form Health Survey (SF-36) score, visual analogue scale, and range of movement. Implant survivorship and complications were also evaluated. Results There were significant improvements in all functional outcome categories between the preoperative and final follow-up assessments (p < 0.001). Patients showed marked improvement in clinical outcomes in terms of pain, function, and quality of life. The overall implant survivorship was 91.7% at a mean follow-up of 6.4 years. In all, 33 major complications were identified with a 15.7% rate, resulting in 12 prosthesis failures (5.7%). Periprosthetic osteolysis (19 cases; 9.0%) was the most frequent complication. Conclusion Mobile-bearing TAA resulted in improved functional outcomes, a low major complication rate, and excellent implant survivorship at a mean follow-up of 6.4 years. Cite this article: Bone Joint J 2019;101-B:695–701.

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