Intermediate-term Experience With the STAR Total Ankle in the United States.

Background:: Limited intermediate and no real long-term follow-up data have been published for total ankle arthroplasty (TAA) in the United States. This is a report of clinical follow-up data of a prospective, consecutive cohort of patients who underwent TAA by a single surgeon from 1999 to 2013 with the Scandinavian Total Ankle Replacement (STAR) prosthesis.

Methods:: Patients undergoing TAA at a single US institution were enrolled into a prospective study.

Salvage arthrodesis after failed ankle replacement: surgical decision making.

Fusion remains the primary technique to salvage the failed total ankle. Fusions present a daunting challenge because of the large bone defect left by the explanted arthroplasty components and the difficulty obtaining stable fixation. Limiting the fusion to the tibiotalar joint preserves the essential motion of the hindfoot.

Salvage of failed total ankle arthroplasty with fusion using structural allograft and internal fixation.

Background: The current study presents our experience with conversion of failed TAA to fusion.

Materials And Methods: A retrospective review of all failed total ankles converted to fusion from 1999 to 2009 was performed at our institution.

Results: Twelve total ankles were converted to isolated ankle fusions (Group I) and 12 converted to ankle-hindfoot fusions (Group II).

The use of tricortical autograft versus allograft in lateral column lengthening for adult acquired flatfoot deformity: an analysis of union rates and complications.

Background: The management of adult acquired flatfoot is an evolving practice with the optimal lateral column lengthening procedure still left to considerable debate. The usual choices include lengthening with the use of autograft or allograft through a calcaneocuboid lengthening arthrodesis or Evans' calcaneal lengthening osteotomy. To our knowledge there is only one other study comparing autograft to allograft in adult lateral column lengthening procedures.

Prospective controlled trial of STAR total ankle replacement versus ankle fusion: initial results.

Background: Mobile-bearing ankle replacements have become popular outside of the United States over the past two decades. The goal of the present study was to perform a prospective evaluation of the safety and efficacy of a mobile-bearing prosthesis to treat end stage ankle arthritis. We report the results of three separate cohorts of patients: a group of Scandanavian Total Ankle Replacement (STAR) patients and a control group of ankle fusion patients (the Pivotal Study Groups) and another group of STAR total ankle patients (Continued Access Group) whose surgery was performed following the completion of enrollment in the Pivotal Study.

Posttraumatic avascular necrosis of the talus.

Avascular necrosis of the talus is one the most challenging problems encountered in posttraumatic reconstruction of the hindfoot. Since the first description of the talus injury in 1608 by Fabricius of Hilden, our knowledge of the talar anatomy, injuries, sequelae, and management has increased significantly. Adequate knowledge of the etiology, the extent of the disease, and the degree of patient symptoms are required to determine optimal treatment.

Simple (unicameral) bone cyst of the calcaneus: a pathologic variant revisited.

A 17-year-old girl was admitted to the hospital for surgery of an enlarging, painful mass of the left calcaneus. Preoperative imaging studies suggested either a simple (unicameral) or aneurysmal bone cyst. Intraoperative biopsy of the lesion revealed a simple bone cyst with extensive cholesterol clefts.

The adult clubfoot (congenital pes cavus).

Clubfoot occurs in approximately 1 of every 1000 live births, with multiple theories proposed regarding the cause. The pathologic anatomy of the adult clubfoot consists of four components (cavus, adductus, varus, and equinus) and the specific soft tissue and bony procedures indicated for correction depend completely on the constellation of residual deformity that may exist. If the patient was successfully treated at a younger age and has only limited deformity, all that may be required is symptomatic treatment or bracing.

Anterior plate supplementation increases ankle arthrodesis construct rigidity.

Background: The success of ankle arthrodesis for the treatment of post-traumatic ankle arthritis depends on achieving and maintaining rigid fixation of the prepared tibiotalar interface. The purpose of this study was to examine the biomechanical effect of anterior plate supplementation of a popular three-screw fusion construct.

Methods: Six fresh-frozen cadaver ankles were prepared and instrumented with three partially threaded screws compressing the tibiotalar interface.

Open fractures of the calcaneus: soft-tissue injury determines outcome.

Background: Studies of open calcaneal fractures have been limited and have not analyzed results according to wound location, severity of soft-tissue disruption, fracture type, or treatment method. In this study, results were evaluated on the basis of the hypothesis that early surgical intervention was indicated.

Methods: Between 1989 and 1997, 503 calcaneal fractures were treated at our institution, and forty-three of these fractures, in forty-two patients, were open (8.