Commercially available trabecular metal ankle interpositional spacer for tibiotalocalcaneal arthrodesis secondary to severe bone loss of the ankle.

Retrograde tibiotalocalcaneal nailing arthrodesis has proved to be a viable salvage procedure; however, extended bone loss around the ankle has been associated with high rates of nonunion and considerable shortening of the hindfoot. We present the surgical technique and the first 2 cases in which a trabecular metal™ interpositional spacer, specifically designed for tibiotalocalcaneal nailing arthrodesis, was used. The spacer can be implanted using either an anterior or a lateral approach.

Demonstration of suppressed phonon tunneling losses in phononic bandgap shielded membrane resonators for high-Q optomechanics.

Dielectric membranes with exceptional mechanical and optical properties present one of the most promising platforms in quantum opto-mechanics. The performance of stressed silicon nitride nanomembranes as mechanical resonators notoriously depends on how their frame is clamped to the sample mount, which in practice usually necessitates delicate, and difficult-to-reproduce mounting solutions. Here, we demonstrate that a phononic bandgap shield integrated in the membrane's silicon frame eliminates this dependence, by suppressing dissipation through phonon tunneling.

Radiological morphology of peritalar instability in varus and valgus tilted ankles.

Background: Varus and valgus talar tilt in weight-bearing ankles can be explained by loss of peritalar stability allowing the talus to shift and rotate on the calcaneal and navicular surfaces. Little is known about the underlying destabilization process or the resulting talar malpositions. The purpose of this study was to determine talar position in 3 radiographic planes of varus and valgus tilted ankles.

Dental composite materials containing carolacton inhibit biofilm growth of Streptococcus mutans.

Objective: Caries adjacent to restorations is one of the main causes for restoration replacement. Antimicrobial substances incorporated into dental materials would potentially be able to reduce secondary caries initiation and progression. This study investigated biofilm growth of Streptococcus mutans UA159 on the surface of composite materials containing the biomolecule carolacton compared to materials containing chlorhexidine (CHX) and triclosan.

Thrombembolic complications after total ankle replacement.

The literature addressing functional outcome and survivorship of prosthesis components is constantly growing. However, the data on thromboprophylaxis and thrombembolic complications in patients who underwent TAR are scarce. A total of 31 studies were included in the systemic literature review.

Peritalar instability after tibiotalar fusion for valgus unstable ankle in stage IV adult acquired flatfoot deformity: case series.

Background: An unstable valgus ankle with an incompetent medial ligament complex is still treated by many surgeons with isolated tibiotalar (TT) arthrodesis. To date, it is unknown whether rigid fixation of the talus within the ankle mortise sufficiently corrects and stabilizes the hindfoot complex. The purpose of this study was to critically analyze patients with this problem and to assess the underlying causes for their acquired peritalar instability.

Chondral and osteochondral reconstruction of local ankle degeneration.

Local cartilage or osteochondral degeneration of the ankle are common, painful posttraumatic conditions in young, sport-active patients. Conservative treatment of the acute initial stage of local cartilage or osteochondral damage might be indicated, but commonly fails in the presence of local or asymmetric osteoarthritic disease. Many surgical treatment methods are available for the orthopedic surgeon, which show satisfactory short-term to mid-term results.

Joint-preserving surgery of asymmetric ankle osteoarthritis with peritalar instability.

A varus or valgus talar tilt that increases under weight-bearing is commonly seen in osteoarthritic ankles. Loss of peritalar stability may be the underlying cause for the talus shifting and rotating on the calcaneonavicular surfaces, as given by applied forces. The instability pattern and the resulting deformity can be assessed and classified using weight-bearing conventional radiographs.

Joint-preserving surgery of valgus ankle osteoarthritis.

Patients with posttraumatic ankle osteoarthritis (OA) typically present with asymmetric involvement of the tibiotalar joint, resulting in valgus or varus deformity of the ankle and hindfoot. Without appropriate treatment, patients with asymmetric ankle OA typically develop full end-stage ankle OA. Ankles with valgus deformities suffer from a lateral joint overload with subsequent lateral tibiotalar joint degeneration, which causes further lateral load shift.

Ankle joint distraction arthroplasty: why and how?

For select patients, distraction ankle arthroplasty may be a promising treatment approach for ankle osteoarthritis; however, there is still limited literature addressing its efficacy and clinical long-term results. In this article, the literature regarding the outcome after ankle distraction arthroscopy is reviewed, the indications and contraindication for this procedure are listed, our surgical technique is described, and our preliminary results with this procedure are presented.

Biomechanics of asymmetric ankle osteoarthritis and its joint-preserving surgery.

More than half of the patients with ankle osteoarthritis have a malalignment of the hindfoot. These patients might benefit from joint-preserving realignment surgery. This article provides an overview of the effects of asymmetric ankle osteoarthritis on the patients' biomechanical and neuromuscular gait patterns in comparison to data from healthy subjects.

Ankle osteoarthritis: etiology, diagnostics, and classification.

Osteoarthritis (OA) is defined as the syndrome of joint pain and dysfunction caused by substantial joint degeneration. In general, OA is the most common joint disease and is one of the most frequent and symptomatic health problems for middle-aged and older people: OA disables more than 10% of people who are older than 60 years. This article reviews the etiology of ankle OA, and describes the onset and development of posttraumatic ankle OA, the most common form of OA in the tibiotalar joint.

[Thromboembolic complications following ankle prosthesis implantation].

Background: Total ankle replacement is becoming an increasingly used treatment for patients with degenerative arthritis of the ankle; however, there is limited literature available addressing the incidence of thromboembolic complications after total ankle replacement. Therefore, we performed a systematic literature review addressing thrombosis prophylaxis and incidence of thromboembolic complications after total ankle replacement. Furthermore, we evaluated the incidence of thromboembolic complications in our clinic.

Supramalleolar osteotomies for degenerative joint disease of the ankle joint: indication, technique and results.

Patients with varus or valgus hindfoot deformities usually present with asymmetric ankle osteoarthritis. In-vitro biomechanical studies have shown that varus or valgus hindfoot deformity may lead to altered load distribution in the tibiotalar joint which may result in medial (varus) or lateral (valgus) tibiotalar joint degeneration in the short or medium term. The treatment of asymmetric ankle osteoarthritis remains challenging, because more than half of the tibiotalar joint surface is usually preserved.

Bony periosteum-covered iliac crest plug transplantation for severe osteochondral lesions of the talus: a modified mosaicplasty procedure.

Purpose: This study reports first evidence of a modified procedure for osteochondral autologous transplantation where bony periosteum-covered plugs are harvested at the iliac crest and transplanted into the talar osteochondral lesion.

Methods: Thirteen out of 14 patients, average age 39.6 (SD 14.

HINTEGRA total ankle replacement: survivorship analysis in 684 patients.

Background: Total ankle replacement is increasingly recommended for patients with end-stage ankle osteoarthritis. We analyzed the survivorship of 722 arthroplasties performed with one type of three-component total ankle prosthesis.

Methods: Seven hundred and seventy-nine primary total ankle arthroplasties (741 patients) were performed between May 2000 and July 2010 with use of the HINTEGRA three-component prosthesis.

HINTEGRA revision arthroplasty for failed total ankle prostheses.

Background: When a total ankle replacement fails, arthrodesis has been advocated as the treatment of choice. With the availability of a wide spectrum of implants, revision arthroplasty may become a viable alternative.

Methods: We reviewed a consecutive series of 117 cases (116 patients [fifty-six female and sixty male]; mean age, 55.

HINTEGRA Revision Arthroplasty for Failed Total Ankle Prostheses: Surgical Technique.

Introduction: In our experience, revision ankle arthroplasty with a three-component total ankle prosthesis following a failed total ankle replacement has provided encouraging midterm results with substantial pain relief while preserving the range of motion of the replaced ankle.

Step 1 Preoperative Assessment And Planning: Determine the treatment using a decision algorithm.

Step 2 Patient Positioning: Use spinal or general anesthesia, administer intravenous antibiotics, position the patient supine, and apply a tourniquet.

[Treatment of isolated fractures of the olecranon: percutaneous double-screw fixation versus conventional tension band wiring].

Background: Isolated fractures of the olecranon account for 7-10% of all osseous injuries in adults. These fractures are usually treated surgically by conventional tension band wiring. The percutaneous double-screw fixation is an optional treatment in patients with two fragment olecranon fractures with some postoperative advantages.

[Malleolar osteotomy--osteotomy as approach].

Both arthroscopic and open surgical techniques may be used for treatment of osteochondral lesions of the ankle joint. Osteotomy around the ankle joint is a well established technique to extend the approach in cases where the osteochondral lesions are located more posteriorly. Medial, oblique, monoplanar malleolar osteotomy should be used in patients with lesions of the medial talus shoulder.

The Scandinavian total ankle replacement: long-term, eleven to fifteen-year, survivorship analysis of the prosthesis in seventy-two consecutive patients.

Background: The objective of this study was to determine the long-term survivorship and clinical and radiographic results of the Scandinavian Total Ankle Replacement (STAR).

Methods: From February 1996 to March 2000, seventy-seven ankles in seventy-two patients (thirty-seven female and thirty-five male patients, with an average age of fifty-six years) underwent total ankle replacement using the STAR prosthesis with a single coating of hydroxyapatite. Two patients were lost to follow-up, and twelve patients with thirteen ankle replacements died.

Autologous matrix-induced chondrogenesis in osteochondral lesions of the talus.

Recurrent ankle sprains and other trauma as well as ankle malalignment can lead to chronic osteochondral lesions of the talus. Conservative treatment frequently fails. Several operative treatment techniques exist; however, the choice of the right procedure is difficult.

Surgical Treatment of Overcorrected Clubfoot Deformity.

Introduction: In our experience, a supramalleolar osteotomy with or without calcaneal osteotomy and midfoot osteotomy has been an effective treatment for sequelae resulting from overcorrected clubfoot deformity.

Step 1 Preoperative Assessment And Planning: Determine the treatment using the decisional algorithm in Figure 3.

Step 2 Patient Positioning: Use spinal or general anesthesia, administer intravenous antibiotics, position the patient supine, apply a tourniquet.

Treatment of the arthritic valgus ankle.

The ankle joint is part of a biomechanical hindfoot complex. Approximately 1% of the world's adult population is affected by ankle osteoarthritis (AO). Trauma is the primary cause of ankle OA, often resulting in varus or valgus deformities.

Total ankle replacement using HINTEGRA, an unconstrained, three-component system: surgical technique and pitfalls.

Total ankle replacement (TAR) has become a valuable treatment option in patients with end-stage ankle osteoarthritis. One popular 3-component system, the HINTEGRA TAR, is an unconstrained system that provides inversion-eversion stability. More natural biomechanics of the replaced ankle may be expected when anatomic considerations drive prosthesis design.