Secondary Subtalar Joint Osteoarthritis Following Total Ankle Replacement.

Background: An advantage of total ankle replacement (TAR) compared to ankle fusion is that by maintaining motion, the occurrence of hypermobility of adjacent joints may be prevented. This could affect the development of symptomatic subtalar joint osteoarthritis (OA). The aim of the study was to determine the incidence of subtalar joint fusion and the progression of subtalar joint OA following TAR.

Extraarticular Supramalleolar Osteotomy in Asymmetric Varus Ankle Osteoarthritis.

Background: In recent years, supramalleolar osteotomy has become a valuable alternative for treatment of ankle osteoarthritis. The aim of this study was to investigate whether the preoperative stage of ankle osteoarthritis or tilt of the talus in the ankle mortise impacts radiologic and clinical outcomes following a supramalleolar osteotomy.

Methods: Forty-four patients who underwent a supramalleolar osteotomy for posttraumatic asymmetric varus ankle osteoarthritis were included.

The effect of foot type on the Achilles tendon moment arm and biomechanics.

Background: The aim was to calculate the Achilles tendon moment arm in different degrees of plantarflexion for pes planus, pes cavus and normal arched feet.

Methods: 99 patients (99 radiographs; 40 males, 59 females; mean age 49 years, SD 15) with a healthy ankle joint and a preoperative weightbearing lateral radiograph of the foot were included. Three groups (pes planus, pes cavus and normal-arched feet) with equal sample sizes (n=33) were formed.

Imaging of the subtalar joint: A novel approach to an old problem.

Evaluation of the subtalar joint using conventional radiographs is difficult. The purpose of this study was to assess how the posterior facet of the subtalar joint is projected on eight standard radiographic views of the foot and ankle. Weightbearing computed tomography (CT) scans of 27 volunteers without ankle pathology were performed.

Vascularized Bone Autograft for the Treatment of Chondroblastoma of the Talus at Imminent Risk of Joint Breakdown: Three Case Reports.

Surgical treatment options in a chondroblastoma of the talus breaching the subchondral layer with imminent risk of talar collapse in the weightbearing area are limited. A joint-preserving surgery should be advocated. Because current treatment options such as curettage, cryosurgery, or radiofrequency ablation may not be able to prevent a talar dome breakdown in large defects, nonvascularized bone grafting has been advocated to fill the void.

Combined Subtalar and Naviculocuneiform Fusion for Treating Adult Acquired Flatfoot Deformity With Medial Arch Collapse at the Level of the Naviculocuneiform Joint.

Background:: A challenge in treating acquired flatfoot deformities is the collapse of the medial arch at the level of the naviculocuneiform (NC) joint. Triple fusions, being a treatment option, may lead to problems such as increased foot stiffness. We thus established a method that combines subtalar (ST) fusion with NC fusion while preserving the Chopart joint.

The Use of Supramalleolar Osteotomies in Posttraumatic Deformity and Arthritis of the Ankle.

Osteoarthritis of the ankle is a debilitating musculoskeletal disease that affects approximately 1% of adults worldwide. The most common etiology of ankle osteoarthritis is trauma. In general, patients with ankle osteoarthritis are 12 to 15 years younger than patients with hip or knee osteoarthritis.

Long-term results of revision total hip arthroplasty with a cemented femoral component.

Introduction: In revision total hip arthroplasty (THA), the cancellous bone is normally completely removed out of the femoral canal during stem extraction. This situation is comparable to primary THA following the shape-closed concept, with some authors advocating to remove the metaphyseal cancellous bone to enhance press-fit stability ("French paradox"). The aim of this study was to investigate the long-term outcome, regarding survival and radiological results, of a cemented straight stem when used for revision THA and to compare these results to the results of the same stem in primary THA.

Long-term survival of the cemented Müller CDH stem: a minimum follow-up of 10 years.

Introduction: Total hip arthroplasty in patients with altered anatomy of the hip and femur, such as in congenital dysplasia of the hip, is challenging and often requires specially designed stems. Müller straight stems have shown excellent long-term results; however, long-term data on the analogous cemented Müller CDH stem are still missing. The aim of this study was to analyze long-term survival, identify potential risk factors for aseptic loosening, and analyze radiological outcome of the cemented Müller CDH stems.

Subtalar joint alignment in ankle osteoarthritis.

Background: Although it has been proposed that in mid-stage ankle osteoarthritis, the subtalar joint can compensate for deformities above the ankle joint, the evidence is weak. We thus investigated subtalar joint alignment in different stages of ankle osteoarthritis using weightbearing computed tomography (CT) scans.

Methods: The subtalar joint of 88 patients with osteoarthritis of the ankle joint and a control group of 27 healthy volunteers were assessed.

Mid-term results of revision total hip arthroplasty with an uncemented modular femoral component.

Introduction: During revision total hip arthroplasty (THA), the surgeon commonly faces deficient proximal femoral bone. In this situation, distal fixation of the prosthesis is required. The aim of the current retrospective study is to assess the clinical and radiographic mid-term outcome of revision total hip arthroplasty using a modular uncemented, tapered, grit-blasted, distal straight stem system.

Excellent long-term results of the Müller acetabular reinforcement ring in primary cup revision.

Background and purpose - The original Müller acetabular reinforcement ring (ARR) was developed to be used for acetabular revisions with small cavitary and/or segmental defects or poor acetabular bone quality. Long-term data for this device are scarce. We therefore investigated long-term survival and radiographic outcome for revision total hip arthroplasty using the ARR.

Supramalleolar Osteotomy for Tibial Component Malposition in Total Ankle Replacement.

Background: Persistent pain despite a total ankle replacement is not uncommon. A main source of pain may be an insufficiently balanced ankle. An alternative to the revision of the existing arthroplasty is the use of a corrective osteotomy of the distal tibia, above the stable implant.

Mid- to Long-term Results of Supramalleolar Osteotomy.

Background: Good clinical and radiographic short-term results have been reported for patients who underwent realignment surgery of the hindfoot for treatment of early- and mid-stage ankle osteoarthrosis (OA). However, no mid- to long-term results have been reported. The aim of this study was to gain a better insight into the indications and contraindications for realignment surgery.

Eradication of infection, survival, and radiological results of uncemented revision stems in infected total hip arthroplasties.

Background and purpose - The use of uncemented revision stems is an established option in 2-stage procedures in patients with periprosthetic joint infection (PJI) after total hip arthroplasty (THA). However, in 1-stage procedures, they are still rarely used. There are still no detailed data on radiological outcome after uncemented 1-stage revisions.

Prospective two-year subsidence analysis of 100 cemented polished straight stems - a short-term clinical and radiological observation.

Background: Cemented stems show good long-term results and the survival of new implants can be predicted by their early subsidence. With EBRA-FCA (Femoral Component Analysis using Einzel-Bild-Röntgen-Analyse) early subsidence as an early indicator for later aseptic loosening can be analysed. For the cemented TwinSys stem mid- and long-term data is only avalible from the New Zeeland Arthroplasty register, thus close monitoring of this implant system is still mandatory.

Chronic Ankle Instability (Medial and Lateral).

Ankle ligament injuries are among the most frequent reasons for emergency consultations of athletes. A majority of these can be treated conservatively; however, up to 40% develop chronic ankle instability requiring surgical reconstruction to restore functionality.

Metal backed fixed-bearing unicondylar knee arthroplasties using minimal invasive surgery: a promising outcome analysis of 132 cases.

Background: Unicondylar knee arthroplasty (UKA) is a well-established treatment for isolated osteoarthritis (OA) of the medial knee compartment. Aim of this retrospective study was to evaluate the early clinical and radiological outcomes of a consecutive series of patients treated with medial metal backed fixed-bearing UKA. Furthermore, the influence of the component orientation on the outcome was analyzed.

One-stage revision of infected hip arthroplasty: outcome of 39 consecutive hips.

Purpose: There are various options for treating periprosthetic joint infection (PJI). Two-stage exchange has traditionally been the gold standard. However, if the appropriate surgical intervention is chosen according to a rational algorithm, the outcome is similar when using all types of interventions.

Medial approach to the subtalar joint: anatomy, indications, technique tips.

The medial approach to the subtalar joint allows good visualization of the articular surfaces. Compared with the lateral approach, advantages are found particularly in flatfoot correction, in which the single-incision technique can be used for corrective fusions of rigid flatfoot deformity. Union rates are comparable with the traditional lateral approach; however, wound healing problems occur less frequently.

Isolated talonavicular fusion with tension band for Müller-Weiss syndrome.

Background: There are still controversies with regard to the operative treatment in advanced Müller-Weiss syndrome (MWS), where the navicular undergoes avascular necrosis and the talonavicular (TN) joint becomes arthritic. Most authors advocate extended fusion, sacrificing hindfoot mobility. To restore TN alignment and to achieve stable fixation, we developed a new isolated TN fusion technique applying the principles of a static tension band.

Subtalar joint configuration on weightbearing CT scan.

Background: Standard values that describe the morphology of the subtalar (ST) joint have previously been obtained from cadaveric studies or by using conventional unloaded radiographs. It is known that these parameters differ significantly from those measured in vivo and in loaded images, limiting the diagnostic value of the previously published morphological parameters in the literature. However, the morphology of the ST joint clearly affects its function.

Poor outcome of a spherical pressfit cup with a modern ceramic liner: a prospective cohort study of 181 cups.

A spherical pressfit cup with a new ceramic liner was introduced in a clinical trial in order to improve range of motion and reduce wear induced problems. The early clinical and radiological outcome was assessed.In a prospective cohort study 181 hips received a seleXys TH+ cup (Mathys, Bettlach, Switzerland) in combination with a third generation ceramic liner (ceramys, Mathys, Bettlach, Switzerland).

Standard Transgluteal versus Minimal Invasive Anterior Approach in hip Arthroplasty: A Prospective, Consecutive Cohort Study.

A minimally invasive anterior approach (MIS) was compared to a standard lateral approach in primary total hip arthroplasty. Clinical and radiological outcomes were analyzed 6 weeks, 12 weeks, one year and two years after surgery. The duration of surgery was longer, mobility one week after surgery was better and time of hospitalization was shorter for minimally invasive-treated patients.

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.