Medial malleolar osteotomy for the correction of tibiotalar varus deformity during total ankle arthroplasty: Results in 95 ankles.

Background: The importance of deformity correction before or during total ankle replacement (TAR) has been recognized for a long time. Our results of TAR, combined with medial malleolar lengthening osteotomy, for the reconstruction of osteoarthritic ankles with varus deformity are hereby reported.

Methods: All ankles in which a medial malleolar osteotomy was performed during implantation of an ankle prosthesis during the period 1998-2018 were filtered out of our database.

Etiopathogenesis of osteolytic cysts associated with total ankle arthroplasty, a histological study.

Background: Osteolytic cyst formation after total ankle arthroplasty has been identified in recent years and is probably an important problem with longer follow-up. The aim of this study is to describe the outcome of a histological analysis of samples from periprosthetic intra-osseous cysts and joint capsules, retrieved during revision surgery after primary total ankle arthroplasty.

Methods: All samples (n=22) were analyzed and scored using a semi-quantitative grading system.

Total ankle replacement for posttraumatic arthritis. Similar outcome in postfracture and instability arthritis: a comparison of 90 ankles.

Background And Purpose: Most studies on total ankle replacement (TAR) have used a case mix of patients. We evaluated the outcome of TAR performed for end-stage arthritis either because of fracture or ligamentous injury.

Patients And Methods: We prospectively followed 88 consecutive patients (50 postfracture ankles and 40 ankles with instability arthritis (2 bilateral)) who underwent TAR between 2001 and 2009.

Long-term follow-up of mobile-bearing total ankle replacement in patients with inflammatory joint disease.

Little is known about the long-term outcome of mobile-bearing total ankle replacement (TAR) in the treatment of end-stage arthritis of the ankle, and in particular for patients with inflammatory joint disease. The aim of this study was to assess the minimum ten-year outcome of TAR in this group of patients. We prospectively followed 76 patients (93 TARs) who underwent surgery between 1988 and 1999.

A titanium plasma-sprayed cup with and without hydroxyapatite-coating: a randomised radiostereometric study of stability and osseointegration.

We present a prospective, two-centre radiostereometric analysis (RSA) regarding the stability of a flattened pole titanium press-fit cup (EP-FIT PLUS), and whether additional hydroxyapatite coating leads to faster bone ingrowth into the porous coating. Forty-two postmenopausal female patients (44 hips) undergoing total hip arthroplasty for primary osteoarthritis, selected to avoid hormonal factors influencing bone metabolism, were randomised to receive this cup with a titanium-plasma-sprayed surface with or without an additional hydroxyapatite coating. RSA was used to measure cup translation and rotation along three cardinal axes with respect to the host bone at the following time points: immediately postoperatively, at 6 weeks, and at 3, 6, 12, and 24 months.

Cementless total hip arthroplasty in rheumatoid arthritis: a systematic review of the literature.

Background: Compromised rheumatic bone is a potential risk factor for mechanical complications in cementless total hip arthroplasty (THA) in cases of rheumatoid arthritis (RA). Increased rates of intra-operative fractures, component migration and (early) aseptic loosening are to be expected. Despite this, cementless THA is performed in cases of RA.

Metabolic cost and mechanical work during walking after tibiotalar arthrodesis and the influence of footwear.

Background: This study examined metabolic energy cost and external mechanical work for step-to-step transitions after tibiotalar arthrodesis, and the effect of MBT rocker bottom shoes.

Methods: Oxygen uptake, forceplate and kinematic data were recorded in 18 controls and 15 patients while walking at a fixed speed of 1.25 m/s in three walking conditions: barefoot, normal walking shoes and MBT rocker bottom shoes.

Computational assessment of press-fit acetabular implant fixation: the effect of implant design, interference fit, bone quality, and frictional properties.

Patients suffering from rheumatoid arthritis typically have a poor subchondral bone quality, endangering implant fixation. Using finite element analysis (FEA) an investigation was made to find whether a press-fit acetabular implant with a polar clearance would reduce interfacial micromotions and improve fixation compared with a standard hemispherical design. In addition, the effects of interference fit, friction, and implant material were analysed.

Salvage arthrodesis for failed total ankle arthroplasty.

Background And Purpose: Total ankle arthroplasty (TAA) has gained popularity in recent years. If it fails, however, salvage arthrodesis must be reliable as a rescue procedure. We therefore investigated the clinical, radiographic, and subjective outcome after salvage arthrodesis in a consecutive group of patients, and concentrated on the influence of the method of fixation on union rate and on salvage in inflammatory joint disease.

Midterm results of cementless total hip replacement in rapidly destructive arthropathy and a review of the literature.

Background And Purpose: Rapidly destructive arthropathy (RDA) of the hip is a disease of unknown etiology characterized by a rapid destruction of the acetabular and femoral aspects of the hip joint. The purpose of this study was to assess the outcome of cementless total hip replacement in this category of patients.

Methods: A prospective study was performed of all cases of rapidly destructive arthropathy treated by cementless total hip replacement between 1998 and 2005.

Metabolic cost and mechanical work for the step-to-step transition in walking after successful total ankle arthroplasty.

The aim of this study was to investigate whether impaired ankle function after total ankle arthroplasty (TAA) affects the mechanical work during the step-to-step transition and the metabolic cost of walking. Respiratory and force plate data were recorded in 11 patients and 11 healthy controls while they walked barefoot at a fixed walking speed (FWS, 1.25 m/s) and at their self-selected speed (SWS).

Primary total hip arthroplasty with a flattened press-fit acetabular component in osteoarthritis and inflammatory arthritis: a prospective study on 416 hips with 6-10 years follow-up.

Introduction: A flattened cup was designed to create a more physiological load transfer to the pelvic bone compared to hemispherical cups, and to allow more bone contact compared to low-profile' spherical cups. To investigate these theoretical advantages and the potential influence of the quality of the acetabular bone, a clinical study was performed in patients with osteoarthritis (OA) and inflammatory arthritis (IA). The aims of the study were (1) to evaluate the fixation of the cup, postoperatively and later when osseous integration should have taken place, (2) to assess perioperative complications such as acetabular fractures and (3) to monitor the polar gap, a potential risk factor for osteolysis.

Medial malleolar osteotomy for the correction of varus deformity during total ankle arthroplasty: results in 15 ankles.

Background: Preoperative deformity in the frontal plane in the arthritic ankle is a risk factor for failure after total ankle arthroplasty. Medial malleolar lengthening osteotomy was developed to correct varus malalignment.

Materials And Methods: From 1998 to 2005 total ankle arthroplasty combined with medial malleolar lengthening osteotomy was done in 15 ankles (13 patients) with a mean preoperative varus deformity of 14.

Joint stiffness of the ankle during walking after successful mobile-bearing total ankle replacement.

Introduction: It has been shown that walking kinematics remain near to normal after mobile bearing total ankle replacement (TAR). However, no information is available on mechanical joint loading. The purpose of this study was to determine whether mechanical load and 'quasi-stiffness' of the ankle joint after TAR differs from the normal load and stiffness of a healthy ankle joint during walking.

Gait analysis after successful mobile bearing total ankle replacement.

Background: The effect of total ankle replacement on gait is not fully known in terms of joint kinematics, ground reaction force, and activity of the muscles of the lower leg.

Methods: A comparative gait study was done in 10 patients after uneventful unilateral mobile-bearing total ankle replacement and 10 healthy controls. A rigid body model was used to describe the motion of the knee and the three-dimensional motion of the ankle-hindfoot complex during barefoot walking.

Early migration of the tibial component of the buechel-pappas total ankle prosthesis.

Unlabelled: Interest in mobile-bearing total ankle arthroplasty has increased in recent years. Clinical studies show favorable but varying results, with survival rates between 70% and 90% at 10-year followup. Design-specific differences in early migration patterns might explain variations in the results and modes of failure.

Total ankle arthroplasty in inflammatory joint disease with use of two mobile-bearing designs.

Background: Interest in mobile-bearing total ankle arthroplasty has increased in recent years. However, to our knowledge, no study has focused exclusively on patients with the diagnosis of inflammatory joint disease or has provided a detailed analysis of the risk factors for failure.

Methods: A prospective observational study of the results of cementless mobile-bearing total ankle arthroplasty in patients with inflammatory joint disease (mainly rheumatoid arthritis) was conducted at two centers.

Increased risk of dislocation after primary total hip arthroplasty in inflammatory arthritis: a prospective observational study of 410 hips.

Background: It is unclear whether patients with inflammatory arthritis have a higher risk of dislocation after hip replacement.

Patients And Material: We carried out a prospective study assessing the incidence of dislocation within 2 years after surgery for patients diagnosed with inflammatory arthritis (IA) and osteoarthrosis (OA). One single type of prosthesis was implanted using a lateral approach.

Radiolunate arthrodesis: A procedure for stabilising and preserving mobility in the arthritic wrist.

We carried out arthrodesis of the radiolunate joint in 46 wrists (38 patients) for pain and ulnar translation of the carpus because of rheumatoid (42) or psoriatic arthritis (4). At follow-up, three patients had died and in three (1 bilateral) an additional midcarpal arthrodesis had been undertaken. The remaining 32 patients (39 wrists) were evaluated after a mean of five years.

Socket wear in ceramic-on-polyethylene total hip arthroplasties: fixed versus rotating heads.

We measured radiographically the polyethylene socket wear in 34 hip prostheses with a 32 mm Al2O3-ceramic head with a rotating bearing and in 37 prostheses with a "fixed" ceramic head. The mean follow-up was 12 years in both groups. The mean annual linear wear of the polyethylene was 0.

Synovectomy of the rheumatoid knee does not prevent deterioration. 7-year follow-up of 83 cases.

Eighty-three knees in 65 patients were studied retrospectively 7 (3-11) years after synovectomy for rheumatoid arthritis. Half of all the knees had an osteotomy or prosthesis operation after a median interval of 4 years. Early synovectomy had been performed in 67 knees; half of these had a satisfactory result.