Survival and risk assessment in revision arthroplasty of the ankle.

Aims: Implant failure has become more common as the number of primary total ankle arthroplasties (TAAs) performed has increased. Although revision arthroplasty has gained attention for functional preservation, the long-term results remain unclear. This study aimed to assess the long-term outcomes of revision TAA using a mobile-bearing prosthesis in a considerably large cohort; the risk factors for failure were also determined.

Effect of total ankle replacement on the 3-dimensional subtalar joint alignment in varus ankle osteoarthritis.

Background: Varus ankle osteoarthritis (OA) is typically associated with peritalar instability, which may result in altered subtalar joint position. This study aimed to determine the extent to which total ankle replacement (TAR) in varus ankle OA can restore the subtalar alignment.

Methods: Fourteen patients (15 ankles, mean age 61 ± 6 years) who underwent TAR for varus ankle OA were analyzed using semi-automated measurements based on weight-bearing computed tomography.

How Does a Novel In Situ Fixed-bearing Implant Design Perform in Revision Ankle Arthroplasty in the Short Term? A Survival, Clinical, and Radiologic Analysis.

Background: Given the growing number of primary total ankle replacements (TAR), an increase in the number of patients undergoing subsequent revisions might be expected. Achieving a stable and balanced ankle while preserving the remaining bone stock as much as possible is crucial for success in revision TAR. Most reported techniques rely on bulky implants with extended fixation features.

Supramalleolar Osteotomy for Ankle Varus Deformity Alters Subtalar Joint Alignment.

Background: Although correction of ankle and hindfoot deformity after supramalleolar osteotomy has been investigated extensively, the specific effect on the subtalar joint alignment remains elusive. This can be attributed to the limitations of 2-dimensional measurements, which impede an exact quantification of the 3-dimensional subtalar joint alignment. Therefore, we determined both the ankle, hindfoot, and subtalar joint alignment before and after supramalleolar osteotomy using autogenerated 3-dimensional measurements based on weightbearing CT imaging.

Long-Term Survival of HINTEGRA Total Ankle Replacement in 683 Patients: A Concise 20-Year Follow-up of a Previous Report.

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Assessment of Progressive Collapsing Foot Deformity Using Semiautomated 3D Measurements Derived From Weightbearing CT Scans.

Background: In progressive collapsing foot deformity (PCFD), hind- and midfoot deformities can be hard to characterize based on weightbearing plain radiography. Semiautomated 3-dimensional (3D) measurements derived from weightbearing computed tomography (WBCT) scans may provide a more accurate deformity assessment. In the present study, automated 3D measurements based on WBCT were used to compare hindfoot alignment of healthy individuals to patients with PCFD.

High Reliability for Semiautomated 3D Measurements Based on Weightbearing CT Scans.

Background: A reliable assessment of the ankle using weightbearing radiography remains challenging. Semiautomated 3-dimensional (3D) measurements derived from weightbearing computed tomography (WBCT) scans may provide a more reliable approach.

Methods: Thirty healthy individuals without any foot and ankle disorder were analyzed.

Open anatomical glenoid reconstruction with an iliac crest bone autograft effectively resolves off-track Hill-Sachs lesions to on-track lesions.

Introduction: The purpose of this study was to determine if "off-track" Hill-Sachs lesions in patients with dynamic anteroinferior instability were transformed into "on-track" lesions using iliac bone autografts with screw fixation. The secondary purpose was to observe if postoperative bony remodeling would occur over time, resulting in recurrent "off-track" Hill-Sachs lesions with corresponding instability.

Materials And Methods: We retrospectively reviewed clinical and CT records of 8 patients with an "off-track" Hill-Sachs lesion who underwent open anatomical glenoid reconstruction with an iliac crest bone autograft.

What Are the Indications for Implant Revision in Three-component Total Ankle Arthroplasty?

Background: Given the increasing usage of total ankle arthroplasty (TAA), a better understanding of the reasons leading to implant revision and the factors that might influence those indications is necessary to identify at-risk patients.

Question/purposes: Using a single-design three-component ankle prosthesis, we asked: (1) What is the cumulative incidence of implant revision at 5 and 10 years? (2) What are the indications for implant revision in our population? (3) What factors are associated with an increased likelihood of implant revision during the time frame in question?

Methods: Between 2003 and 2017, primary TAA using a single-design three-component ankle implant was performed by or under the supervision of the implant designer in 1006 patients (1074 ankles) aged between 17 and 88 years to treat end-stage ankle osteoarthritis. No other TAA systems were used during the study period at the investigators' institution.

3D Assessment in Posttraumatic Ankle Osteoarthritis.

Background: Auto-generated 3-dimensional (3D) measurements based on weightbearing cone-beam computed tomography (CT) scan technology may allow for a more accurate hind- and midfoot assessment. The current study evaluated the reliability and clinical relevance of such measurements in patients with posttraumatic end-stage ankle osteoarthritis.

Methods: Seventy-two patients treated at our institution for posttraumatic end-stage ankle osteoarthritis, with available weightbearing conventional radiographs and a cone-beam CT scan, were analyzed.

Ankle Range of Motion Following 3-Component Total Ankle Arthroplasty.

Background: Although surgeons have argued that preserving motion at the level of the ankle joint may be crucial for the long-term success in the treatment of end-stage ankle osteoarthritis, there is little evidence regarding the potential of total ankle arthroplasty (TAA) to increase ankle range of motion (ROM). In addition, the effect of a percutaneous heel cord lengthening (HCL) during TAA on ankle motion is poorly understood.

Methods: A total of 357 primary TAAs treated with a 3-component device (336 patients, mean age 62.

Hindfoot balancing in total ankle replacement: the role of supramalleolar osteotomies.

Purpose: To compare the obtained deformity correction and clinical/functional outcomes between patients who underwent total ankle replacement (TAR) with or without a concurrent supramalleolar osteotomy (SMO) to address a varus and/or recurvatum deformity of the distal tibia.

Methods: Data of 23 patients treated with an additional SMO to correct a varus and/or recurvatum deformity of the distal tibia at the time of TAR were prospectively collected. Twenty-three matched patients who underwent TAR only served as controls.

Mid- to long-term outcome in patients treated with a mini-open sinus-tarsi approach for calcaneal fractures.

Background: While the extended lateral approach was the gold standard for treatment of calcaneal fractures for decades, the mini-open approach through the sinus tarsi gained popularity in recent years. Although widely used, there are only a few reports available in the literature reporting on mid- to long-term results. Therefore, the purpose of the study was to report on mid- to long-term radiographic and clinical outcomes of calcaneal fractures treated surgically using a mini-open sinus tarsi approach.

Effect of age on outcome and revision in total ankle arthroplasty.

Aims: To assess the effect of age on clinical outcome and revision rates in patients who underwent total ankle arthroplasty (TAA) for end-stage ankle osteoarthritis (OA).

Methods: A consecutive series of 811 ankles (789 patients) that underwent TAA between May 2003 and December 2013 were enrolled. The influence of age on clinical outcome, including the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, and pain according to the visual analogue scale (VAS) was assessed.

Axial Rotational Alignment in Mobile-Bearing Total Ankle Arthroplasty.

Background: The presence of an interface between the tibial component and the polyethylene insert (PI) in mobile-bearing total ankle arthroplasty (TAA) may allow the talus to adapt its axial position according to the patient's anatomy. However, little is known about differences of the axial talar rotation between patients following mobile-bearing TAA. Therefore, the aim of this study was to assess the relative axial rotation between the talar and tibial component intraoperatively and after a minimum follow-up of 3 years following mobile-bearing TAA.

Supramalleolar osteotomy in post-traumatic valgus ankle osteoarthritis.

Purpose: To assess how the level of the deformity, the stage of the osteoarthritic process, and the role of additional surgeries impact radiographic and clinical outcomes following an extra-articular medial closing supramalleolar osteotomy for treatment of post-traumatic valgus ankle osteoarthritis.

Methods: About 56 consecutive patients who underwent an extra-articular medial closing wedge osteotomy for post-traumatic valgus ankle osteoarthritis were retrospectively analyzed. Subgroups were formed according to the pre-operative level of deformity and preoperative stage of ankle osteoarthritis.

Syndesmotic Overload in 3-Component Total Ankle Replacement.

Background: Mobile-bearing total ankle replacement (TAR) potentially enables motion at the tibial implant-polyethylene insert (PI) interface. Such additional freedom of movement may overload periarticular ligaments and subsequently result in coronal translation of the talus. The aim of this study was to assess whether syndesmotic overload affects clinical and radiographic outcomes following mobile-bearing TAR and whether tibiofibular fusion is an effective treatment option.