Abstract:
BACKGROUND:Failed total ankle arthroplasty (TAA) often results in significant bone loss and requires salvage arthrodesis. This study quantified the bone loss following failed TAA and reports the outcome of seven arthrodesis reconstructions using the Ilizarov method. METHODS:A retrospective review of ankle fusions was performed for failed TAA to collect the mode of implant failure, presenting limb length discrepancy (LLD), total bone defect, postarthrodesis LLD, and treatment type (shoe lift versus distraction osteogenesis) and amount (shoe lift or lengthening). RESULTS:Four mechanical failures and three infections were found. Four of seven cases had prior revision TAAs. Four of seven patients were treated with tibiotalar arthrodesis; three of the seven patients required talar resection and tibiocalcaneal arthrodesis. The mean presenting LLD was 2.2 (range, 1.2 to 3.5) cm. The mean time in frame was 197 (range, 146 to 229) days. With a mean postexplantation total bone defect of 5.1 (range, 3.7 to 8.5) cm, four of seven patients elected tibial lengthening following fusion [mean lengthening 4.6 (range, 2.5 to 8.0) cm; external fixation index (EFI) 42.6 (range, 16.5 to 55.6) days/cm)]. Three of seven patients were treated with a shoe lift [mean lift height 2.9 (range 2.5 to 3.2) cm]. There was no failure of fixation, refracture, or infection. All patients had a stable plantigrade foot and walked with minimal limp. Association for the Study and Application of the Method of Ilizarov (ASAMI) functional scores were six good and one fair. ASAMI bone scores were four excellent and three good. CONCLUSIONS:Ankle arthrodesis following failed TAA results in large LLDs secondary to bone loss during implant failure and subsequent explantation. External fixation can produce an excellent fusion rate in complex, possibly infected, failed TAAs. Limb length equalization (by either distraction osteogenesis or shoe lift) provides a means of obtaining good functional outcomes following failed TAA.
journal_name
Foot Ankle Intjournal_title
Foot & ankle internationalauthors
McCoy TH,Goldman V,Fragomen AT,Rozbruch SRdoi
10.3113/FAI.2012.0947subject
Has Abstractpub_date
2012-11-01 00:00:00pages
947-55issue
11eissn
1071-1007issn
1944-7876pii
50065063journal_volume
33pub_type
杂志文章abstract:BACKGROUND:Morton's neuroma is a common cause of metatarsalgia. This study evaluated the efficacy of ultrasound guided alcohol injection as a treatment for this condition. METHOD:Data from 87 treatment courses were included in this study with a mean follow of 14.3 months. RESULTS:Technical success was 100%. One patie...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2012.0196
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abstract:BACKGROUND:Nonunion risk factor identification and modification are subjective. We describe and validate a predictive nonunion risk factor model to identify foot and ankle operative patients at risk for nonunion. MATERIALS AND METHODS:One hundred international experts in foot and ankle surgery were surveyed. Nineteen ...
journal_title:Foot & ankle international
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abstract::Three hundred and eleven patients have been enrolled in a multi-center prospective study evaluating the outcome of hallux valgus surgery by the members of the American Orthopaedic Foot and Ankle Society. One hundred seventy-nine of these patients have completed six-month follow-up questionnaires, and 195 have complete...
journal_title:Foot & ankle international
pub_type: 杂志文章,多中心研究
doi:10.1177/107110070102201205
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journal_title:Foot & ankle international
pub_type: 杂志文章,评审
doi:10.1177/107110079701800302
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journal_title:Foot & ankle international
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journal_title:Foot & ankle international
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abstract:BACKGROUND:The nature of the sesamoid complex in the development of hallux rigidus or limitus (HL) has been poorly characterized and the role of the sesamoids in the surgical management of this condition has not been explored. Previous surgical approaches in younger active patients unsuited to destructive procedures ha...
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journal_title:Foot & ankle international
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journal_title:Foot & ankle international
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