Outcome comparison of rotational ankle fractures: Supination external rotation versus pronation external rotation.

Background: Ankle fractures are among the most common types of fractures in the orthopaedic field, and the Lauge-Hansen classification is commonly used to categorize rotational ankle fractures. This study evaluated and compared the clinical and radiological outcomes of surgically treated supination external rotation (SER) and pronation external rotation (PER) injuries of grades III or IV.

Methods: We retrospectively reviewed and enrolled 104 patients who underwent open reduction and internal fixation for SER or PER injuries classified as Grades III or IV between January 2016 and December 2021, all performed at a single center.

The Role of Receptor Activator of Nuclear Factor-κB Ligand/Osteoprotegerin Ratio in Synovial Fluid as a Potential Marker for Periprosthetic Osteolysis Following Total Ankle Arthroplasty.

Background: Periprosthetic osteolysis is a prevalent complication following total ankle arthroplasty (TAA), implicating various cytokines in osteoclastogenesis as pivotal in this process. This study aimed to evaluate the relationship between osteolysis and the concentrations of osteoclastogenesis-related cytokines in synovial fluid and investigate its clinical value following TAA.

Methods: Synovial fluid samples from 23 ankles that underwent revision surgery for osteolysis following TAA were analyzed as the osteolysis group.

Tibial Axis-to-Talus Distance: A Clinically Reliable Measurement for Sagittal Translation of the Talus in Total Ankle Arthroplasty.

Background: Sagittal talar translation is an important factor influencing the sagittal alignment of total ankle arthroplasty (TAA). Thus, accurate measurement of sagittal talar translation is crucial. This study proposes a simple method (tibiotalar distance [TTD]) that can quantify talar translation without being affected by the ankle and subtalar joint condition or the talar component position in patients with TAA.

Bone grafting for periprosthetic bone cysts following total ankle arthroplasty.

Aims: The purpose of this study was to assess the success rate and functional outcomes of bone grafting for periprosthetic bone cysts following total ankle arthroplasty (TAA). Additionally, we evaluated the rate of graft incorporation and identified associated predisposing factors using CT scan.

Methods: We reviewed a total of 37 ankles (34 patients) that had undergone bone grafting for periprosthetic bone cysts.

Effect of diabetes mellitus on the outcomes of total ankle arthroplasty: is controlled diabetes mellitus a risk factor?

Background: It is still uncertain whether diabetes mellitus (DM) is a risk factor for poor outcomes and increased complications after total ankle arthroplasty (TAA). The objective of this study was to compare clinical outcomes and complication rates of TAA in patients with and without DM.

Methods: This study enrolled patients with symptomatic end-stage ankle osteoarthritis with a minimum follow-up period of 24 months after TAA.

LIM Homeobox Transcription Factor 1-β Expression is Upregulated in Patients with Osteolysis after Total Ankle Arthroplasty and Inhibits Receptor Activator of Nuclear Factor-κB Ligand-Induced Osteoclast Differentiation in Vitro.

Background: Osteolysis is one of the most common problems that occurs after total hip and knee arthroplasty and has recently become a significant problem after total ankle arthroplasty (TAA). In this study, we investigated the role of LIM homeobox transcription factor 1-β (Lmx1b) in osteoclast differentiation. By evaluating the expression profiles associated with osteolysis following TAA treatment, Lmx1b was found to be differentially expressed in patients with osteolysis after TAA.

Periprosthetic Osteolysis as a Risk Factor for Revision After Total Ankle Arthroplasty: A Single-Center Experience of 250 Consecutive Cases.

Background: Periprosthetic osteolysis after total ankle arthroplasty (TAA) is a challenging problem. This study aimed to evaluate the prevalence of and predisposing factors for osteolysis and its effects on clinical outcomes.

Methods: We enrolled 236 patients (250 ankles) who underwent primary TAA using a mobile-bearing HINTEGRA prosthesis, with a mean follow-up of 83.

Transcription Factor Lmx1b Negatively Regulates Osteoblast Differentiation and Bone Formation.

The LIM-homeodomain transcription factor Lmx1b plays a key role in body pattern formation during development. Although Lmx1b is essential for the normal development of multiple tissues, its regulatory mechanism in bone cells remains unclear. Here, we demonstrated that Lmx1b negatively regulates bone morphogenic protein 2 (BMP2)-induced osteoblast differentiation.

Effects and Safety of Intra-Articular Sodium Hyaluronate Injection for the Treatment of Ankle Osteoarthritis: A Prospective Clinical Trial.

Various nonoperative treatments have been implemented to reduce pain and improve the quality of life in patients with ankle osteoarthritis. Among these treatments, intra-articular hyaluronate injection has proven efficacy and safety in patients with knee osteoarthritis. The purpose of this study was to evaluate the efficacy and complications of hyaluronate injection using various clinical scoring systems.

Comparison of 2-octyl cyanoacrylate skin adhesive and interrupted polypropylene sutures for wound closure in total ankle arthroplasty.

Background: Adhesive skin materials have increasingly been used in orthopedic surgery. We aimed to compare the efficacy and safety of skin adhesive (2-octyl cyanoacrylate and polymer mesh, Dermabond Prineo) and interrupted polypropylene sutures for wound closure in patients undergoing total ankle arthroplasty (TAA).

Methods: We prospectively enrolled 107 consecutive patients (108 ankles) undergoing TAA and divided them into two groups: skin adhesive group (36 ankles) and suture group (72 ankles).

IRF2 enhances RANKL-induced osteoclast differentiation via regulating NF-κB/NFATc1 signaling.

Interferon regulatory factors (IRFs) play roles in various biological processes including cytokine signaling, cell growth regulation and hematopoietic development. Although it has been reported that several IRFs are involved in bone metabolism, the role of IRF2 in bone cells has not been elucidated. Here, we investigated the involvement of IRF2 in RANKL-induced osteoclast differentiation.

Comparison of Preoperative Bone Density in Patients With and Without Periprosthetic Osteolysis Following Total Ankle Arthroplasty.

Background: Modern total ankle arthroplasty (TAA) prostheses are uncemented press-fit designs whose stability is dependent on bone ingrowth. Preoperative insufficient bone density reduces initial local stability at the bone-implant interface, and we hypothesized that this may play a role in periprosthetic osteolysis. We aimed to investigate the preoperative bone density of the distal tibia and talus and compare these in patients with and without osteolysis.

Unrecognized tibial nerve injury in total-ankle arthroplasty: Two case reports.

Rationale: Tibial nerve injury is a sustainable but rare complication during total-ankle arthroplasty (TAA). We outlined 2 previously unreported cases of tibial nerve injury in TAA, including the prognoses and possible causes.

Patient Concerns: First, a 63-year-old woman complained of a 5-month history of persistent tingling sensation and numbness on the medial and plantar aspects of her foot after TAA.

Does gender influence the outcomes of total ankle arthroplasty in patients with ankle osteoarthritis?

Background: Total ankle arthroplasty has progressed as a treatment option for patients with ankle osteoarthritis. However, no studies have been conducted to evaluate the effect of gender on the outcome. The purpose of the present study was to evaluate outcomes, survivorship, and complications rates of total ankle arthroplasty, according to gender differences.

Arthroscopic Microfracture for Osteochondral Lesions of the Talus: Functional Outcomes at a Mean of 6.7 Years in 165 Consecutive Ankles.

Background: Arthroscopic microfracture for osteochondral lesions of the talus (OLT) has shown good functional outcomes. However, some studies have reported that functional outcomes deteriorate over time after surgery.

Purpose: To use various functional scoring systems to evaluate functional outcomes in a large sample of patients with OLT treated by arthroscopic microfracture.

Outcomes of Total Ankle Arthroplasty in Ankles with >20° of Coronal Plane Deformity.

Background: A preoperative severe coronal plane deformity of >20° has been considered a contraindication for total ankle arthroplasty. We aimed to evaluate whether outcomes of total ankle arthroplasty in ankles with severe coronal plane deformity (20° to 35° of varus or valgus) are comparable with those with moderate deformity (5° to 15° of varus or valgus).

Methods: A total of 148 consecutive ankles (142 patients) that underwent primary total ankle arthroplasty using the HINTEGRA prosthesis were included.

Arthroscopic Microfracture for Osteochondral Lesions of the Talus: Second-Look Arthroscopic and Magnetic Resonance Analysis of Cartilage Repair Tissue Outcomes.

Background: Arthroscopic microfracture is considered the primary treatment strategy for osteochondral lesions of the talus and has been shown to provide successful outcomes. However, deterioration of clinical outcomes and fibrocartilage infill over time is now a recognized concern. The purpose of the present study was to evaluate the outcomes related to cartilage repair tissue after microfracture with use of second-look arthroscopy and magnetic resonance imaging (MRI) and to compare these findings with functional outcomes.

Comparison of Intermediate-term Outcomes of Total Ankle Arthroplasty in Primary and Ligamentous Post-traumatic Osteoarthritis.

Background: Ankle ligamentous injuries without fracture can result in end-stage ligamentous post-traumatic osteoarthritis, which may cause ligamentous imbalance after total ankle arthroplasty (TAA). However, outcomes of TAA in these patients are not well known. The purpose of this study was to evaluate intermediate-term clinical and radiographic outcomes of TAA in patients with ligamentous post-traumatic osteoarthritis and compare them with results of TAA for patients with primary osteoarthritis.

Comparison of Intermediate-Term Outcomes of Total Ankle Arthroplasty in Patients Younger and Older Than 55 Years.

Background: Total ankle arthroplasty is often not recommended to younger patients with ankle arthritis because of their high functional demands. The purpose of this study was to compare intermediate-term clinical and radiographic outcomes and survivorship rates of total ankle arthroplasty between patients younger and older than 55 years.

Methods: A total of 117 consecutive patients (123 ankles) who underwent primary total ankle arthroplasty using Hintegra prosthesis with a mean follow-up of 78 months were enrolled and divided into 2 age groups: under 55 years (38 ankles; mean age 45 years) and over 55 years (85 ankles; mean age 65 years).

Importance of postoperative sesamoid reduction on the outcomes of proximal chevron osteotomy for moderate to severe hallux valgus deformity.

Background: The purpose of this study was to compare the clinical and radiographic outcomes between feet with or without postoperative sesamoid reduction of proximal metatarsal chevron osteotomy for moderate to severe hallux valgus deformity.

Methods: All of 110 feet were allocated into two groups (reduction group; 66 feet, non-reduction group; 44 feet) according to the reduction status of sesamoid at 6 months after surgery. The clinical and radiographic results of the two groups were compared preoperatively, 6 months follow-up, and at last follow-up.

Comparison of Intermediate to Long-Term Outcomes of Total Ankle Arthroplasty in Ankles with Preoperative Varus, Valgus, and Neutral Alignment.

Background: Preoperative ankle coronal malalignment has been considered as a risk factor for poor outcomes and failure after total ankle arthroplasty. The present study evaluated whether intermediate to long-term outcomes of total ankle arthroplasty in ankles with preoperative varus and valgus malalignment (5° to 20°) are comparable with those with neutral alignment (<5°).

Methods: We enrolled 144 consecutive ankles that underwent primary total ankle arthroplasty (140 patients) using a mobile-bearing HINTEGRA prosthesis with a minimum follow-up of 4 years; the mean overall follow-up duration was 89 months (51 to 145 months).

BCAP promotes osteoclast differentiation through regulation of the p38-dependent CREB signaling pathway.

Many studies have determined that PI3K-Akt signaling pathways play important roles in osteoclast differentiation and function. In the present study, we investigated the roles of B-cell adaptor for PI3K (BCAP), which is a PI3K binding molecule, in osteoclasts. Overexpression of BCAP in osteoclast precursor cells enhanced osteoclast differentiation induced by tumor necrosis factor alpha (TNF-α) as well as receptor activator of nuclear factor-κB ligand (RANKL).

Accuracy assessment of measuring component position after total ankle arthroplasty using a conventional method.

Background: This study was to assess the accuracy of measuring the tibial and talar components position and to investigate the outlier rate of each component and predisposing factors related to component malalignment after total ankle arthroplasty (TAA) using a conventional method.

Methods: One hundred fifty consecutive primary total ankle arthroplasty were performed using the three-component HINTEGRA prosthesis for ankle end-stage osteoarthritis. Radiographic analysis for the accuracy of component position in coronal and sagittal plane was conducted at postoperative 6 months.

Total knee arthroplasty using ultra-congruent inserts can provide similar stability and function compared with cruciate-retaining total knee arthroplasty.

Purpose: Recently, ultra-congruent (UC) inserts have shown successful outcomes following total knee arthroplasty (TKA). It was hypothesized that patients in the UC group would not show significantly different in vivo stability or functional outcomes from those in the cruciate-retaining (CR) group.

Methods: The prospective study enrolled patients who had been treated with either CR or UC TKAs (38 cases in each group), after a minimum 3-year follow-up.