Functional limitations after lateral column lengthening osteotomy of the calcaneus are associated with lower quality of life.

Purpose: The purpose of this study was to quantify limitations in sagittal ankle range of motion (ROM) at least two years after lateral column lengthening osteotomy of the calcaneus (LLC) and their implications regarding quality of life.

Methods: Fifteen patients with a mean follow-up of 80 ± 27 months after LLC and 15 age-matched healthy persons participated in this study. Ankle joint complex ROM in plantarflexion and dorsiflexion was measured bilaterally using a goniometer and fluoroscopy (patients only).

The natural initiation and progression of osteoarthritis in the anterior cruciate ligament deficient feline knee.

Objective: The aim of this study was to document the natural history of development and long-term progression of osteoarthritis (OA) in the feline knee after minimally invasive anterior cruciate ligament (ACL) transection.

Design: ACL transections of the left knee joint of 14 skeletally mature cats were performed. Radiographic scores, tibiofemoral and patellofemoral joint space and anterior tibial translation were assessed before, immediately and every 3 months after ACL transection (longest follow-up: 93 months).

Intra- and inter-observer reliability of a new standardized diagnostic method using SPECT/CT in patients with osteochondral lesions of the ankle joint.

Background: Single Photon Emission Computed Tomography-Computed Tomography (SPECT/CT) gains an important part of diagnostics in patients with osteochondral lesions (OCL). SPECT/CT is a hybrid imaging modality, which combines a 3D scintigraphy (SPECT) and computerized tomography (CT) into one single procedure and combines metabolic data, structural and mechanical information. The purpose of the study was to develop and evaluate a standardized method to anatomically localize and quantitatively analyze the bone SPECT tracer activity of the ankle joint using SPECT/CT.

Medial malleolar osteotomy for the treatment of talar osteochondral lesions: anatomical and morbidity considerations.

Purpose: Osteochondral lesions of the talus are often located posteromedially requiring open surgery to facilitate solid and complete osteochondral reconstruction. The aim of the study was to identify the optimal anatomical site for medial malleolar osteotomy based on the criteria of minimal cartilage damage (Study I) and to report on the morbidity in patients receiving osteotomy performed at the previously identified site (Study II).

Methods: For Study I, cartilage coverage of the tibiofibular ankle joint facet was measured in 40 cadaveric ankles (20 cadaver specimens).

Mineral density and penetration strength of the subchondral bone plate of the talar dome: high correlation and specific distribution patterns.

The subchondral bone plate plays an important role in stabilizing the osteochondral joint unit and in the pathomechanism of osteochondral lesions and osteoarthritis. The objective of the present study was to measure the mineral density distribution and subchondral bone plate penetration strength of the talar dome joint facet to display and compare the specific distribution patterns. Ten cadaver specimens were used for computed tomography (CT) scans, from which densitograms were derived using CT-osteoabsorptiometry, and for mechanical indentation testing from which the penetration strength was obtained.

Tibiofemoral loss of contact area but no changes in peak pressures after meniscectomy in a Lapine in vivo quadriceps force transfer model.

Purpose: The menisci are thought to modulate load transfer and to absorb shocks in the knee joint. No study has experimentally measured the meniscal functions in the intact, in vivo joint loaded by physiologically relevant muscular contractions.

Methods: Right knee joints of seven New Zealand white rabbits were loaded using isometric contractions of the quadriceps femoris muscles controlled by femoral nerve stimulation.

Retrograde synovial biopsy of the knee joint using a novel biopsy forceps.

Synovial biopsies of the knee joint are commonly performed arthroscopically with the patient under full or regional anesthesia. To overcome the effort, costs, and potential risks of surgery, we developed an office-based technique for retrograde synovial biopsy using a designated novel biopsy forceps. Using this technique, no arthroscopic or radiologic control is needed to perform rapid synovial biopsies of the knee joint.

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.

Histomorphometric, CT arthrographic, and biomechanical mapping of the human ankle.

Background: The specific morphological and biomechanical characteristics of the osteochondral unit of the ankle joint are not yet fully understood. This anatomical study aimed to map regional thickness of the articular hyaline uncalcified cartilage and its adjacent layers of mineralized cartilage and subchondral bone as well as to measure the regional indentation stiffness of human ankle joint cartilage.

Materials And Methods: A total of 20 pairs of human cadaver ankle joints (median age: 78 years) were evaluated by histomorphometry and multidetector row double-contrast CT arthrography for cartilage thickness in 17 distinct anatomical regions.

Reconstruction of osteochondral lesions of the talus with autologous spongiosa grafts and autologous matrix-induced chondrogenesis.

Background: Osteochondral lesions (OCLs) of the talus are a common entity in sports orthopaedics. There are several operative techniques with a good outcome on follow-up examinations. However, limitations such as sacrificing healthy cartilage (osteochondral autograft transfer system [OATS], mosaicplasty), multiple-stage operative procedures (matrix-induced autologous chondrocyte transplantation [MACI], autologous chondrocyte implantation [ACI]), high costs (ACI, allograft), and limited availability (allograft) do remain and reflect potential drawbacks of the currently used techniques.

Dynamic in-vivo force transfer in the lapine knee loaded by quadriceps muscle contraction.

Background: The rabbit knee is a frequently used model for experimental osteoarthritis (OA). Despite the acknowledged importance of joint loading in the onset and progression of OA, the load transfer in the three compartments of the intact rabbit knee remains unknown. Therefore, this study was aimed at determining load transfer in the three compartments for isometric, concentric, and eccentric knee extensor contractions.

Micro CT analysis of the subarticular bone structure in the area of the talar trochlea.

Purpose: Certain regions of the talar trochlea are recognized as exhibiting varying cartilage thickness and degrees of subchondral bone mineralization. These changes have been attributed to the long-term loading history. For the current study, we accepted the hypothesis that stress-induced alterations of the joint surface include not only varying degrees of subchondral lamellar mineralization, but also structural changes of the subarticular cancellous bone.

Computed tomography analysis of knee pose and geometry before and after total knee arthroplasty.

Using a three-dimensional (3D) modality to image patients' knees before and after total knee arthroplasty (TKA) allows researchers and clinicians to evaluate causes of pain after TKA, differences in implant design, and changes in the articular geometry as a result of surgery. Computed tomography (CT) has not been fully utilized to date for evaluating the knee after TKA due to metal artifacts obscuring part of the image. We describe an accurate, validated protocol, which has been implemented in vivo, that improves visibility of the patellofemoral joint, matches implant models automatically in 3D, segments preoperative bone semi-automatically, detects and sets coordinate systems automatically, determines the six degrees of freedom of knee pose and geometry, and allows for multiple other measurements that are clinically relevant.

Computer tomographic evaluation of talar edge configuration for osteochondral graft transplantation.

To successfully surgically reconstruct osteochondral lesions of the talus, the exact three-dimensional (3D) configuration of the upper articular surface of the talus has to be respected. We assessed the talar geometry by measuring the coronal and sagittal talar edge radius and the frontal talar profile in multiplanar reconstructions of computer tomographic (CT) studies of 79 patients (83 feet) with a healthy ankle joint. An image visualization software designated for coordinate measurement was used to perform the measurement.

Open lateral patellar retinacular lengthening versus open retinacular release in lateral patellar hypercompression syndrome: a prospective double-blinded comparative study on complications and outcome.

Purpose: To compare complication rates and outcome of open lateral retinacular (LR) lengthening and open LR release in the treatment of lateral patellar hypercompression syndrome (LPHS).

Methods: In a prospective double-blinded study, 28 patients (mean age, 48 years; 21 women and 7 men) received either LR release (14 patients) or LR lengthening (14 patients) in alternating fashion over the same lateral parapatellar skin incision for LPHS (blinding of patients to surgical procedure [i.e.

[Total ankle arthroplasty in valgus ankle osteoarthritis].

Ankle osteoarthritis (OA) is often associated with deformities. Valgus OA is less frequent than varus OA and causes of valgus OA include medial ligament instability, flat foot and posttraumatic situations, e.g.

Altered cell metabolism in tissues of the knee joint in a rabbit model of Botulinum toxin A-induced quadriceps muscle weakness.

Quadriceps muscle weakness is frequently associated with knee injuries in sports. The influence of quadriceps weakness on knee joint homeostasis remains undefined. We hypothesized that quadriceps weakness will lead to tissue-specific alterations in the cell metabolism of tissues of the knee.

A novel imaging method for osteochondral lesions of the talus--comparison of SPECT-CT with MRI.

Background: Magnetic resonance imaging (MRI) is the current standard in noninvasive diagnostics of osteochondral lesions (OCLs) of the talus. Single-photon emission computed tomography-computed tomography (SPECT-CT) is a new technique that displays different imaging qualities. The influence of the aforementioned diagnostic information on treatment decision making in talar OCLs is not known.

Distinctive pain course during first year after total ankle arthroplasty: a prospective, observational study.

Background: Patients and health care professionals alike are often surprised by the course of pain after total ankle arthroplasty (TAA). The current study aimed to determine the baseline patterns of postoperative symptoms during the first year following uncomplicated TAA.

Materials And Methods: In a prospective observational study 28 patients with unilateral posttraumatic osteoarthritis were tested for pain with a visual analogue scale, swelling (min grade, 0; max grade, 4), ankle range of motion, and AOFAS ankle score.