scholarly journals The INFINITY Total Ankle Prosthesis: Outcomes at Short Term Follow-up

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0042
Author(s):  
Calvin J. Rushing ◽  
Christopher F. Hyer ◽  
Gregory C. Berlet
Keyword(s):  
Medical Records ◽  
Sagittal Alignment ◽  
The United States ◽  
Ankle Arthritis ◽  
Single Institution ◽  
Short Term ◽  
Ankle Prosthesis ◽  
Grade 3 ◽  
Component Revision

Category: Ankle Arthritis; Ankle; Other Introduction/Purpose: The INFINITY total ankle prosthesis remains the most widely used 4th generation total ankle arthroplasty (TAA) system in the United States. The purpose of the present study was to assess outcomes for the INFINITY prosthesis at short-term follow-up. Methods: All patients who underwent primary TAA with INFINITY between August 2015 and June 2018 at a single institution and who were at least 1 year postoperative were included. A total of 55 ankles with a mean follow up 22 (range, 12-43) months met the criteria. Weightbearing radiographs were assessed using coronal and sagittal alignment parameters preoperatively, at 6- 8 weeks postoperatively, and at the most recent follow-up. Medical records and charts were reviewed and revisions, reoperations, and complications were classified according to the criteria established by Vander Griend et al. and Glazebrook at el., respectively. Results: Overall survivorship for the INFINITY prosthesis was 98.2%. Coronal and sagittal tibiotalar alignment improved after surgery (p<.001, p=0.09), and was maintained during the latest follow-up (p=0.62, p=0.47). One ankle (1.8%) required early component revision; while 5 (9.1%) required non-implant related revision. Postoperative periprosthetic lucency’s were observed in nineteen ankles (34.5%); most of which were non-progressive (17 ankles, 89.5%). Thirteen complications (3 high grade, 3 intermediate, and 7 low) in 11 ankles (20%) were recorded according to the Glazebrook classification system. Conclusion: INFINITY survivorship was 98.2% at a mean of 1.8 years of follow-up, with only 1 ankle requiring prosthetic revision. Additional studies with longer follow-up are warranted for 4th generation TAA prostheses.

scholarly journals Early Outcomes with the CADENCE Total Ankle Prosthesis

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0041
Author(s):  
Calvin J. Rushing ◽  
Gregory C. Berlet ◽  
Christopher F. Hyer
Keyword(s):  
Medical Records ◽  
Low Grade ◽  
Ankle Arthritis ◽  
Single Institution ◽  
Short Term ◽  
Malleolar Fracture ◽  
Ankle Prosthesis ◽  
The Past ◽  
Early Revision

Category: Ankle Arthritis; Ankle; Other Introduction/Purpose: A number of two-component, 4th generation total ankle arthroplasty (TAA) prostheses have been introduced to the market within the past few years. The purpose of the present study was to assess early outcomes for the CADENCE total ankle prosthesis. Methods: All patients who underwent primary TAA with CADENCE between August 2016 and June 2018 at a single institution and who were at least 1 year postoperative were included. A total of 32 ankles with a mean follow up of 19 (range, 12-33) months met the criteria. Weightbearing radiographs were assessed using coronal and sagittal alignment parameters preoperatively, at 6 weeks postoperative, and at the most recent follow-up. Medical records and charts were reviewed and revisions, reoperations, and complications were classified according to the criteria established by Vander Griend et al. and Glazebrook at el., respectively. Results: Survivorship for the CADENCE prosthesis was 93.7%. Coronal and sagittal tibiotalar alignment significantly improved after surgery (p< 0.001, p< 0.005), and was maintained at the latest follow-up (p=0.44, p=0.30). Overall, two ankles (6.3%) underwent early revision for aseptic loosening; while 6 (18.8%) underwent a non-revisional reoperation. Nine ankles (28.1%) presented a total of 13 complications (4 high grade, 2 intermediate, and 7 low) according to the Glazebrook classification system. The most common was intraoperative periprosthetic medial malleolar fracture (5 ankles, 15.6%), a low-grade complication. Conclusion: Satisfactory outcomes were observed at short-term follow-up for the CADENCE prosthesis. Additional studies with longer follow-up are warranted.

Intermediate-Term Outcomes of a Third-Generation, 2-Component Total Ankle Prosthesis

2021 ◽  
pp. 107110072098611
Author(s):  
Calvin J. Rushing ◽  
Bryon J. Mckenna ◽  
Emily A. Zulauf ◽  
Christopher F. Hyer ◽  
Gregory C. Berlet
Keyword(s):  
Medical Records ◽  
Case Series ◽  
Third Generation ◽  
Single Institution ◽  
Short Term ◽  
Level Of Evidence ◽  
Ankle Prosthesis ◽  
Low Incidence ◽  
Component Revision

Background: Short-term outcomes for the INBONE I and INBONE II tibial stems have been favorable. The INBONE-II talus has been shown to have lower reoperation and failure rates compared to its predecessor at short term follow-up. The purpose of the present study was to assess mid-term outcomes for the third generation, two component total ankle prosthesis at 5 to 9 years follow-up, evaluating both the tibial and talar components. Methods: All patients who underwent primary total ankle arthroplasty (TAA) with INBONE-II between July 2010 and July 2014 at a single institution and who were at least 5 years postoperative were included. A total of 15 ankles with a mean follow-up of 85 months (range, 61-113 months) met the criteria. Radiographs were assessed using coronal and sagittal alignment parameters preoperatively, at 6 weeks postoperatively, and at the most recent follow-up. Medical records were reviewed and revisions, reoperations, and complications were classified according to the criteria established by Vander Griend et al and Glazebrook et al, respectively. Results: The survivorship of the prosthesis at a mean of 85 months was 93.7%. The coronal and sagittal tibiotalar alignments 6 weeks after surgery were 2.1 degrees ( P = .081) and 36% ( P = .15), respectively. Maintenance of this alignment was observed during the latest follow-up ( P = .684 and P = .837, respectively). One ankle (6.7%) required early component revision, while 4 (26.7%) required a non–implant-related revision. Six complications (2 high grade, 1 intermediate, and 3 low) in 5 ankles (33.3%) were recorded according to the Glazebrook classification system. Conclusion: The present study is the first to report midterm follow-up after TAA with this third-generation, 2-component prothesis. High survivorship, maintenance of correction, and a low incidence of major complications were observed in this small case series. The most common complication overall was lateral gutter impingement, which accounted for the majority of the nonrevisional reoperations. Level of Evidence: Level IV, case series.

The INFINITY Total Ankle Prosthesis: Outcomes at Short-Term Follow-up

2020 ◽  
pp. 193864002094619 ◽  
Author(s):  
Calvin J. Rushing ◽  
Kurt Kibbler ◽  
Christopher F. Hyer ◽  
Gregory C. Berlet
Keyword(s):  
Case Series ◽  
The United States ◽  
Fourth Generation ◽  
Low Grade ◽  
Single Institution ◽  
Short Term ◽  
Radiographic Outcomes ◽  
Early Revision ◽  
Grade 3

Background The INFINITY total ankle prothesis remains the most widely used fourth-generation total ankle arthroplasty (TAA) system in the United States. The purpose of the present study was to assess radiographic outcomes for INFINITY at short-term follow-up. Methods All patients who underwent primary TAA with INFINITY between August 2015 and June 2018 at a single institution and who were at least 1 year postoperative were included. A total of 55 ankles with a mean follow up 22 months (range, 12-43 months) met the criteria. Weightbearing radiographs were assessed using coronal and sagittal alignment parameters preoperatively, at 6 to 8 weeks postoperatively, and at the most recent follow-up. Medical records and charts were reviewed and revisions, reoperations, and complications were classified according to the criteria established by Vander Griend et al and Glazebrook at el, respectively. Results Overall, INFINITY survivorship was 98.2%. Coronal and sagittal tibiotalar alignment improved after surgery ( P < .001, P = .09, respectively), and was maintained during the latest follow-up ( P = .62, P = .47, respectively). Only 1 ankle (1.8%) required early revision; while 5 (9.1%) indicated non-implant-related revision; 85.5% required no reoperation. In nineteen ankles (34.5%), postoperative periprosthetic lucency was observed; most were not progressive (17 ankles, 89.5%). Twelve complications (3 high grade, 3 intermediate, and 6 low grade) in 11 ankles (20%) were recorded according to the Glazebrook classification system. Conclusion INFINITY survivorship was 98.2% at a mean of 1.8 years of follow-up, and only 1 ankle required prosthetic revision. Additional studies with longer follow-up are warranted for fourth-generation TAA prostheses. Levels of Evidence: Level IV: Case series

Early Prospective Results of the Salto-Talaris™ Total Ankle Prosthesis

2012 ◽  
Vol 2 (1) ◽  
pp. 23-34 ◽  
Author(s):  
Karl M Schweitzer ◽  
Samuel B Adams ◽  
Nicholas A Viens ◽  
Robin M Queen ◽  
Mark E Easley ◽  
...  
Keyword(s):  
Clinical Results ◽  
The United States ◽  
Fixed Bearing ◽  
Ankle Arthritis ◽  
Ankle Prosthesis ◽  
Additional Surgery ◽  
Sf 36 ◽  
Functional Scores ◽  
End Stage

ABSTRACT Background Several fixed-bearing total ankle arthroplasty (TAA) systems are available in the United States (US). We report on the early clinical results of the largest known US cohort of patients who received a Salto-Talaris total ankle replacement for end-stage ankle arthritis. Methods We prospectively followed 67 TAA patients with a minimum clinical follow-up of 2 years. Patients completed standardized assessments, including visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot score, short form (36) health survey (SF-36), and the short musculoskeletal function assessment (SMFA), along with physical examination, functional assessment, and radiographic evaluation, preoperatively and yearly thereafter through most recent follow-up. Results Implant survival was 96% using metallic component revision, removal, or impending failure as endpoints, with a mean follow-up of 2.81 years. Three patients developed aseptic loosening, all involving the tibial component. Of these, one underwent revision to another fixed-bearing TAA system, one patient is awaiting revision surgery, and the other patient has remained minimally symptomatic and fully functional without additional surgery. Forty-five patients underwent at least one additional procedure at the time of their index surgery. The most common concurrent procedure performed was a deltoid ligament release (n = 21), followed by removal of previous hardware (n = 16) and gastrocnemius recession (n = 11). Eight patients underwent additional surgery following their index TAA, most commonly debridement for medial and/or lateral impingement (n = 4). Patients demonstrated significant improvement in VAS, AOFAS hindfoot, several SF-36 subscales, SMFA, and functional scores at most recent follow-up (p < 0.001). Conclusion Early clinical results indicate that the Salto-Talaris fixed-bearing TAA system can provide significant improvement in pain, quality of life, and standard functional measures in patients suffering from end-stage ankle arthritis. The majority of patients underwent at least one concurrent procedure, most commonly to address varus hindfoot deformity, hardware removal, or equinus contracture. Schweitzer Jr KM, Adams Jr SB, Viens NA, Queen RM, Easley ME, DeOrio JK, Nunley II JA. Early Prospective Results of the Salto-Talaris™ Total Ankle Prosthesis. The Duke Orthop J 2012;2(1):23-34.

Total Ankle Arthroplasty Survivorship, Complication, and Revision Rates in Patients Younger Than 55 Years

2021 ◽  
pp. 193864002098092
Author(s):  
Devon W. Consul ◽  
Anson Chu ◽  
Travis M. Langan ◽  
Christopher F. Hyer ◽  
Gregory Berlet
Keyword(s):  
Case Series ◽  
Ankle Arthrodesis ◽  
Total Ankle Replacement ◽  
Implant Survival ◽  
Ankle Arthritis ◽  
Single Institution ◽  
Retrospective Case ◽  
Ankle Replacement ◽  
End Stage

Total ankle replacement has become a viable alternative to ankle arthrodesis in the surgical management of advanced ankle arthritis. Total ankle replacement has generally been reserved for patients who are older and for those who will have a lower demand on the replacement. The purpose of the current study is to review patient outcomes, complications, and implant survival in patients younger than 55 years who underwent total ankle replacement at a single institution. A single-center chart and radiographic review was performed of consecutive patients who underwent total ankle replacement for treatment of end-stage ankle arthritis. All surgeries were performed by 1 of 5 fellowship-trained foot and ankle surgeons at a single institution. A total of 51 patients met inclusion criteria with a mean follow-up of 31.2 months (SD = 16.2). Implant survival was 94%, There were 7 major complications (13%) requiring an unplanned return to the operating room and 8 minor complications (15%) that resolved with conservative care. The results of this study show that total ankle replacement is a viable treatment option for patients younger than 55 years. Levels of Evidence: A retrospective case series

Evolution of Surgical Approaches in the Treatment of Petroclival Meningiomas: A Retrospective Review

2007 ◽  
Vol 61 (suppl_5) ◽  
pp. ONS202-ONS211 ◽  
Author(s):  
Nicholas C. Bambakidis ◽  
U. Kumar Kakarla ◽  
Louis J. Kim ◽  
Peter Nakaji ◽  
Randall W. Porter ◽  
...  
Keyword(s):  
Survival Rates ◽  
Progression Free Survival ◽  
Surgical Approaches ◽  
Single Institution ◽  
Short Term ◽  
Total Resection ◽  
Free Survival ◽  
Petroclival Meningioma ◽  
Petroclival Meningiomas

Abstract Objective: We examined the surgical approaches used at a single institution to treat petroclival meningioma and evaluated changes in method utilization over time. Methods: Craniotomies performed to treat petroclival meningioma between September of 1994 and July of 2005 were examined retrospectively. We reviewed 46 patients (mean follow-up, 3.6 yr). Techniques included combined petrosal or transcochlear approaches (15% of patients), retrosigmoid craniotomies with or without some degree of petrosectomy (59% of patients), orbitozygomatic craniotomies (7% of patients), and combined orbitozygomatic-retrosigmoid approaches (19% of patients). In 18 patients, the tumor extended supratentorially. Overall, the rate of gross total resection was 43%. Seven patients demonstrated progression over a mean of 5.9 years. No patients died. At 36 months, the progression-free survival rate for patients treated without petrosal approaches was 96%. Of 14 patients treated with stereotactic radiosurgery, none developed progression. Conclusion: Over the study period, a diminishing proportion of patients with petroclival meningioma were treated using petrosal approaches. Utilization of the orbitozygomatic and retrosigmoid approaches alone or in combination provided a viable alternative to petrosal approaches for treatment of petroclival meningioma. Regardless of approach, progression-free survival rates were excellent over short-term follow-up period.

Short-term follow-up systems for positive newborn screens in the Washington Metropolitan Area and the United States

2015 ◽  
Vol 116 (4) ◽  
pp. 226-230 ◽  
Author(s):  
Sarah Viall ◽  
Sneha Jain ◽  
Kimberly Chapman ◽  
Nicholas Ah Mew ◽  
Marshall Summar ◽  
...  
Keyword(s):  
United States ◽  
Metropolitan Area ◽  
The United States ◽  
Short Term

scholarly journals Incidence and Causes of Tibial Component Loosening Based on Level of Obesity in a Large Consecutive Cohort of Cemented Primary TKAs without Stem Extensions

2020 ◽  
Vol 3 ◽  
Author(s):  
Lilly Longawa ◽  
Leonard Buller ◽  
Mary Ziemba-Davis ◽  
R. Michael Meneghini
Keyword(s):  
Aseptic Loosening ◽  
Medical Records ◽  
Tibial Component ◽  
Low Viscosity ◽  
Primary Tkas ◽  
Total Knee ◽  
Potential Impact ◽  
Component Loosening ◽  
Component Revision

Background and Hypothesis: Aseptic loosening is one of the most common failure mechanisms of total knee arthroplasty (TKA) requiring revision.  The influence of obesity on tibial component aseptic loosening remains unknown. Some surgeons advocate the addition of a tibial stem extension to reduce the risk of loosening. The purpose of this study was to quantify the incidence and causes of revision for tibial component loosening in a large consecutive cohort of cemented primary TKAs without stem extensions based upon level of obesity.     Experimental Design or Project Methods: 534 consecutive cemented primary TKAs performed between 2016 and 2018 by one surgeon were retrospectively reviewed. Procedures were performed using consistent surgical, perioperative medical, and pain-control protocols. All tibial implants were tapered thin keeled designs without stem extensions and implanted with low viscosity cement. Medical records were examined and all-cause revisions of the index surgery were documented.     Results: After exclusions for confounds, 525 TKAs were analyzed. Mean age and BMI were 67.8 years and 33.9kg/m2 respectively and 72% were female. Mean follow-up was 19.1 (SD 10.5) months and 48% had minimum two-year follow-up. 41.3% of patients had a BMI greater than 35kg/m2 and 21.9% above 40kg/m2. There were 11 revisions in 10 patients, 1.9% out of all TKAs performed.  Five TKAs required both-component revision and three involved the femoral component only. No tibial component revisions were performed for aseptic loosening.    Conclusion and Potential Impact: None of the standard tibial implants with a keeled design without stem extensions failed in a patient population with greater than 40% obesity.  Despite some suggesting tibial stem extensions should be used in obese TKA patients, these findings suggest that tibial component failure in obese patients may be design specific and routinely utilizing stem extensions may not be warranted and could result in deleterious bone loss at revision if required for reasons other than aseptic loosening. 

scholarly journals Radiographic and Clinical Analysis of the Salto Talaris Total Ankle Arthroplasty

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0018
Author(s):  
Jonathan Day ◽  
Jaeyoung Kim ◽  
Andrew R. Roney ◽  
Jonathan H. Garfinkel ◽  
Scott J. Ellis ◽  
...  
Keyword(s):  
Total Ankle Arthroplasty ◽  
High Survival ◽  
X Rays ◽  
Ankle Arthritis ◽  
Term Survival ◽  
Ankle Arthroplasty ◽  
Patient Reported ◽  
Component Revision

Category: Ankle Arthritis; Ankle Introduction/Purpose: Total ankle arthroplasty (TAA) has garnered significant interest and increased use over the past decade, with advancements made in both design and surgical technique. The main advantage of TAA for the surgical treatment of ankle arthritis is to preserve range of motion compared to ankle arthrodesis. Among the criteria guiding the choice between arthroplasty and arthrodesis, the long-term survival and postoperative outcomes are of crucial importance. The Salto Talaris is a fixed-bearing implant first approved in the US in 2006, and long-term survivorship data is limited. The purpose of this study is to determine minimum 5-year survivorship of the Salto Talaris prosthesis and causes of failure. In addition, we evaluate long-term radiographic and patient-reported outcomes. Methods: We retrospectively identified 86 prospectively followed patients from 2007 to 2014 who underwent TAA with the Salto Talaris prosthesis at our institution. Of these, 81 patients (84 feet) had a minimum follow-up of 5 years (mean, 7.1; range, 5 to 12). Mean age was 63.5 years (range, 42 to 82) and mean BMI was 28.1 (range, 17.9 to 41.2). Survivorship was determined by incidence of revision, defined as removal/exchange of a metal component. Chart review was performed to record incidences of revision and reoperation. Preoperative, immediate and minimum 5-year postoperative x-rays were reviewed; coronal tibiotalar alignment (TTA) was measured on standing AP radiographs to assess alignment of the prosthesis. A TTA of +-5° from 90° indicated neutral alignment, while <85° and >95° was considered varus and valgus alignment, respectively. Radiographic subsidence as well as presence and location of periprosthetic cysts were documented. Pre- and minimum 5-year FAOS domains were compared. Results: Survivorship was 97.6% with two revisions. One patient underwent tibial and talar component revision for varus malalignment of the ankle, another underwent talar component revision for aseptic loosening and subsidence. The rate of other reoperations was 19.5% (18) with the main reoperation being exostectomy with debridement for ankle impingement (12). Average preoperative TTA was 88.8° with 48 neutral (average TTA of 90.1°), 18 varus (82.3°) and 8 valgus (99.6°) ankles. Average postoperative TTA was 89.0° with 69 neutral (89.7°), 6 varus (83°), and 1 valgus ankle (99.3°). Radiographic subsidence was observed in one patient who underwent revision, and periprosthetic cysts were observed in 18 patients. There was significant improvement in all FAOS domains at final follow-up. Conclusion: This is the largest study to date dedicated to evaluating survivorship of the Salto Talaris prosthesis. Our data reflects a high survival rate and moderate reoperation rate with long-term follow-up of the Salto Talaris implant. We observed significant improvement in radiographic alignment as well as patient-reported clinical outcomes at minimum 5-year follow-up.

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