Takedown of Painful Ankle Arthrodesis to Total Ankle Arthroplasty: A Case Series of 77 Patients.

Treatment of painful or malaligned ankle arthrodesis can present as a challenging issue. Several published studies have demonstrated that takedown of a painful ankle arthrodesis to total ankle arthroplasty can assist in restoring some sagittal plane motion and improving functional scores. The goal of this study was to contribute to the limited body of literature with the largest cohort and longest follow-up to date.

Revision Total Ankle Arthroplasty.

With total ankle arthroplasty, documented complications can be categorized chronologically into intraoperative, postoperative, and late complications. Factors such as patient selection, surgeon experience, implant features, and prosthetic device selection can influence functional outcomes as well as incidence of complications. Even with impeccable surgical technique and optimal patient selection, complications that require revision may still arise and the most common complications with revision solutions are discussed in this article.

Guide Pin Placement Technique for Total Ankle Replacement in Patients Who Had Ipsilateral Total Knee Arthroplasty.

Unlabelled: We describe a simple technique for guide pin placement for total ankle replacement in patients who underwent previous ipsilateral total knee arthroplasty.

Levels Of Evidence: Level V.

A positive Tinel sign as predictor of pain relief or sensory recovery after decompression of chronic tibial nerve compression in patients with diabetic neuropathy.

Predictive ability of a positive Tinel sign over the tibial nerve in the tarsal was evaluated as a prognostic sign in determining sensory outcomes after distal tibial neurolysis in diabetics with chronic nerve compression at this location. Outcomes were evaluated with a visual analog score (VAS) for pain and measurements of the cutaneous pressure threshold/two-point discrimination. A multicenter prospective study enrolled 628 patients who had a positive Tinel sign.

Prevention of ulceration, amputation, and reduction of hospitalization: outcomes of a prospective multicenter trial of tibial neurolysis in patients with diabetic neuropathy.

This is the first multicenter prospective study of outcomes of tibial neurolysis in diabetics with neuropathy and chronic compression of the tibial nerve in the tarsal tunnels. A total of 38 surgeons enrolled 628 patients using the same technique for diagnosis of compression, neurolysis of four medial ankle tunnels, and objective outcomes: ulceration, amputation, and hospitalization for foot infection. Contralateral limb tibial neurolysis occurred in 211 patients for a total of 839 operated limbs.

Total ankle arthroplasty: indications and avoiding complications.

New designs and a better understanding of kinematics, patient selection, and surgical techniques have lead to a rejuvenated interest in total ankle arthroplasty (TAA). Although improved design has decreased the frequency of revision, the causes and inherent difficulty associated with TAA remain challenging. Surgeon experience and proper patient selection are consistently the most important factors in fostering favorable outcomes.

Reversal of toe clawing in the patient with neuropathy by neurolysis of the distal tibial nerve.

The distinction between hammer toes and clawed toes is poorly emphasized. The neural origin of clawing in the foot is related to the lateral plantar nerve, and suggests that surgical treatment directed at decompression or neurolysis of the lateral plantar nerve may either reverse or prevent progression of intrinsic motor paralysis. The purpose of this report is to provide criteria to distinguish between the musculoskeletal imbalances that creates hammer versus clawing of the toes, and to demonstrate examples of improvement in clawing that resulted from neurolysis of the tibial nerve and the lateral plantar nerve.

Zone of traction injury of the common peroneal nerve.

The history of functional motor recovery after reconstruction of traction injury to the common peroneal nerve is poor, regardless of technique and regardless of the experience of the surgeon doing the reconstruction. The hypothesis tested is that the failure of functional motor recovery after common peroneal nerve traction injury is because the zone of injury extends beyond the visible region of peroneal nerve in continuity injury and into the muscle entry zone of the motor nerve terminations. The opportunity arose to examine pathologically this suspected distal zone of injury in one patient.