Lower Bone Density on Preoperative Computed Tomography Predicts Periprosthetic Fracture Risk in Total Ankle Arthroplasty.


BACKGROUND::The effect of bone mineral density (BMD) on outcomes from total ankle arthroplasty (TAA) has not been studied. BMD can be estimated by measuring Hounsfield units (HU) on standard computed tomography (CT), which is frequently performed prior to TAA. We aimed to identify whether tibial and talar HU measured from preoperative CT scans were associated with periprosthetic fracture or revision risk in patients undergoing TAA. METHODS::A prospectively collected database was used to retrospectively screen all patients undergoing primary TAA. Only patients with a preoperative CT within 1 year of surgery were included. Primary outcomes were periprosthetic fracture and prosthetic revision. HU were measured on axial CT cuts in the distal tibia and talus. Additional patient factors analyzed included age, sex, weight, body mass index (BMI), tobacco use, presence of rheumatoid arthritis, and preoperative deformity. A total of 198 ankles were included, with a mean 2.4 years of follow-up. RESULTS::There were 7 intraoperative and 9 postoperative periprosthetic fractures (3.5% and 4.5%, respectively). Seven patients (3.5%) underwent prosthetic removal or revision. Lower tibial and talar HU, lower weight, and lower BMI were associated with periprosthetic fractures ( P < .05). After controlling for age, sex, and weight, only tibial HU was significantly associated with periprosthetic fracture ( P = .018). All intraoperative fractures occurred in patients with tibial HU less than 200. None of the patient factors analyzed were associated with revision. CONCLUSIONS::Lower tibial HU on preoperative CT was strongly associated with periprosthetic fracture risk with TAA. In patients with tibial HU less than 200, surgeons may consider prophylactic internal fixation of the medial malleolus. LEVEL OF EVIDENCE::Level III, retrospective cohort study.


Foot Ankle Int


Cody EA,Lachman JR,Gausden EB,Nunley JA 2nd,Easley ME




Has Abstract


2019-01-01 00:00:00












  • Single-photon-emission computed tomography in painful total ankle replacements.

    abstract:BACKGROUND:The use of single-photon-emission computed tomography (SPECT) in identifying unexplained pain in the foot and ankle has been described, where other imaging modalities have failed. The investigation of a painful total ankle replacement (TAR) is difficult, often not delineating a definitive cause. Our aim in t...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Mason LW,Wyatt J,Butcher C,Wieshmann H,Molloy AP

    更新日期:2015-06-01 00:00:00

  • Computer Assisted Surgery (CAS) guided arthrodesis of the foot and ankle: an analysis of accuracy in 100 cases.

    abstract:BACKGROUND:Computer Assisted Surgery (CAS) has shown the potential to increase the accuracy of surgical procedures in different fields of orthopedic surgery. The clinical experiences of 100 cases with CAS guided arthrodeses were evaluated. MATERIALS AND METHODS:Two navigation systems were used (VectorVision/Navivision...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Richter M,Zech S

    更新日期:2008-12-01 00:00:00

  • Arthroscopic subtalar arthrodesis for symptomatic osteoarthritis of the hindfoot: a prospective study of 41 cases.

    abstract:BACKGROUND:This prospective study evaluated the results of arthroscopic subtalar arthrodesis for painful hindfoot osteoarthritis. METHODS:The hypotheses were that (1) the arthroscopic technique results in a reliable fusion rate, (2) the clinical outcome is better than the open procedure and (3) complication rates are ...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Glanzmann MC,Sanhueza-Hernandez R

    更新日期:2007-01-01 00:00:00

  • Inverse Relationship Between Radiographic Lateral Ankle Instability and Osteochondral Lesions of the Talus in Patients With Ankle Inversion Injuries.

    abstract:BACKGROUND:Insufficient or excessive bony constraint surrounding the talus might contribute to the occurrence of ligamentous injury or bone contusion, respectively, at the time of ankle inversion injuries. This study aimed to investigate the relationship between radiographic lateral ankle instability and osteochondral ...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Park BS,Chung CY,Park MS,Sung KH,Choi Y,Park C,Koo S,Lee KM

    更新日期:2019-12-01 00:00:00

  • Effect of a steel toe cap on forefoot injury pattern in a cadaveric model.

    abstract:BACKGROUND:Crush injuries to the foot are a common workplace injury and a significant source of morbidity, disability and lost wages. Many regulatory bodies including the Occupational Safety and Health Administration (OSHA) recommend the use of safety shoes in certain occupations to help protect against these occupatio...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Kwon JY,Campbell JT,Myerson MS,Jeng CL

    更新日期:2011-04-01 00:00:00

  • Surgical strategies: lateral ligament reconstruction as part of the management of varus ankle deformity with ankle replacement.

    abstract::Improved designs and surgical technique has led to much better mid-term and longer term outcomes than the first generation ankle replacements of the 1970's. However, there remains multiple recent papers discussing the many potential complications with total ankle replacement surgery. As we proceed into the future, one...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Coetzee JC

    更新日期:2010-03-01 00:00:00

  • Tibiotalar motion--effect of fibular displacement and deltoid ligament transection: in vitro study.

    abstract::The purpose of this study was to quantify tibiotalar translation and rotation under various stages of fibular displacement and injury to the syndesmotic and deltoid ligaments. Ten unpaired specimens amputated below the knee were studied using an unconstrained testing apparatus. The specimens were moved through a dorsi...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Sasse M,Nigg BM,Stefanyshyn DJ

    更新日期:1999-11-01 00:00:00

  • Tibiotalocalcaneal arthrodesis using a straight intramedullary nail.

    abstract:BACKGROUND:Tibiotalocalcaneal (TTC) arthrodesis is a proven solution for severe hindfoot arthropathy that reestablishes stability for plantigrade gait and alleviates pain, while correcting deformity. Intramedullary nailing is an effective option for fixation. The aim of this study was to determine clinical outcome, ana...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Lucas Y Hernandez J,Abad J,Remy S,Darcel V,Chauveaux D,Laffenetre O

    更新日期:2015-05-01 00:00:00

  • Consensus for the Use of Weightbearing CT in the Assessment of Progressive Collapsing Foot Deformity.

    abstract:RECOMMENDATION:There is evidence that the use of WEIGHTBEARING imaging aids in the assessment of progressive collapsing foot deformity (PCFD). The following WEIGHTBEARING conventional radiographs (CRs) are necessary in the assessment of PCFD patients: anteroposterior (AP) foot, AP or mortise ankle, and lateral foot. If...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: de Cesar Netto C,Myerson MS,Day J,Ellis SJ,Hintermann B,Johnson JE,Sangeorzan BJ,Schon LC,Thordarson DB,Deland JT

    更新日期:2020-10-01 00:00:00

  • Comparison of rates of union and hardware removal between large and small cannulated screws for calcaneal osteotomy.

    abstract:BACKGROUND:The calcaneal osteotomy is a common procedure to correct hindfoot malalignment. Reported union rates are high, utilizing fixation methods including staples, plates, and most commonly cannulated screws. We began our practice using 6.5 mm and 7.3 mm cannulated screws, but complaints of postoperative posterior ...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Sayres SC,Gu Y,Kiernan S,DeSandis BA,Elliott AJ,O'Malley MJ

    更新日期:2015-01-01 00:00:00

  • Fracture of an interphalangeal coalition: a report of two cases.

    abstract::Congenital coalition of the middle and distal phalanges in the fifth toe are common. They have been reported to occur in up to 50% of American and European populations and in up to 73% of people of Japanese descent. Congenital interphalangeal coalition of the other toes is less common. We report two cases of fracture ...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Sammarco GJ,Hockenbury RT

    更新日期:2000-08-01 00:00:00

  • Anterior dislocation of the subtalar joint: a case report.

    abstract::We report a very rare case of anterior dislocation of the subtalar joint. Forceful supination of the foot and dorsiflexion of the ankle was considered the cause of the injury in this case. Closed reduction was successful for the talocalcaneal component of subtalar joint, although surgery was subsequently performed bec...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Kanda T,Sakai H,Koseki K,Tamai K,Takeyama N,Saotome K

    更新日期:2001-07-01 00:00:00

  • Stabilization of Lisfranc joint injuries: a biomechanical study.

    abstract:BACKGROUND:Lisfranc joint injuries are often misdiagnosed, leading to significant morbidity. Methods for anatomic reduction of the tarsometatarsal joint include closed reduction with casting or surgical stabilization with either Kirschner wires and/or cortical screw fixation. Controversy exists as to which fixation tec...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Lee CA,Birkedal JP,Dickerson EA,Vieta PA Jr,Webb LX,Teasdall RD

    更新日期:2004-05-01 00:00:00

  • The management of concomitant tears of the peroneus longus and brevis tendons.

    abstract:BACKGROUND:Concomitant chronic tears of both peroneal tendons rarely are reported. We present our experience in treating these injuries and suggest an algorithm for surgical treatment, determined by the presence of a functioning tendon or tendons, mobility of the remaining peroneal musculature, ankle stability, and pos...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Redfern D,Myerson M

    更新日期:2004-10-01 00:00:00

  • Anatomy of the plantar plate and its attachments in the lesser metatarsal phalangeal joint.

    abstract::The plantar plate is a rarely seen, yet central structure to the lesser metatarsal phalangeal (MP) joint. Thirty cadaver lesser MP joints were studied to obtain a detailed description of the plate, including its dimensions, connections, and histology. The plate was found to be made of fibrocartilage with fiber orienta...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Deland JT,Lee KT,Sobel M,DiCarlo EF

    更新日期:1995-08-01 00:00:00

  • Validation of the foot and ankle outcome score for ankle ligament reconstruction.

    abstract::We studied the validity and reliability of the Foot and Ankle Outcome Score (FAOS) when used to evaluate the outcome of 213 patients (mean age 40 years, 85 females) who underwent anatomical reconstruction of the lateral ankle ligaments with an average postoperative follow-up of 12 years (range, three to 24 years). The...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Roos EM,Brandsson S,Karlsson J

    更新日期:2001-10-01 00:00:00

  • A biochemical analysis of the squeeze test for sprains of the syndesmotic ligaments of the ankle.

    abstract::The "squeeze test" is a clinical test for detecting "stable" syndesmosis injuries. The test is positive when proximal compression of the calf produces pain in the area of the distal tibiofibular and interosseous ligaments. The purpose of this study was to examine what fibular movement, if any, occurs at the level of t...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Teitz CC,Harrington RM

    更新日期:1998-07-01 00:00:00

  • Floating-toe deformity as a complication of the Weil osteotomy.

    abstract:BACKGROUND:The Weil osteotomy for treatment of central metatarsalgia is an oblique osteotomy of the metatarsal neck and shaft parallel to the ground that provides controlled shortening of the metatarsal without additional depression. It offers many advantages over more traditional osteotomies, including stability and a...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Migues A,Slullitel G,Bilbao F,Carrasco M,Solari G

    更新日期:2004-09-01 00:00:00

  • Liposomal bupivacaine in forefoot surgery.

    abstract:BACKGROUND:Liposomal bupivacaine is increasingly being utilized in attempts to provide prolonged local analgesia in the immediate postoperative period. The purpose of this study was to quantify the reduction in opioid consumption as well as postoperative pain scores in the postoperative period when liposomal bupivacain...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Robbins J,Green CL,Parekh SG

    更新日期:2015-05-01 00:00:00

  • Treatment of os calcis fractures by open reduction and internal fixation.

    abstract::Over a 3-year period, 47 displaced intra-articular fractures of the os calcis in 43 patients underwent open reduction and internal fixation. A significant feature of this series is that computed tomography was used to assess all fractures both before and after surgery. Seventy-seven percent demonstrated a consistent f...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Hutchinson F 3rd,Huebner MK

    更新日期:1994-05-01 00:00:00

  • Treatment of myotendinous Achilles ruptures.

    abstract:BACKGROUND:There is scant literature regarding the treatment of myotendinous Achilles ruptures. The purpose of this study was to retrospectively examine clinical outcomes from uniform nonsurgical treatment of these injuries. METHODS:Between November 2005 and May 2011, 30 patients presented with an acute, complete myot...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Ahmad J,Repka M,Raikin SM

    更新日期:2013-08-01 00:00:00

  • Preliminary results on the safety and efficacy of the OssaTron for treatment of plantar fasciitis.

    abstract::The OssaTron may be another alternative for management of plantar fasciitis (heel pain syndrome) after failure of non-operative management and prior to surgical management. This study evaluated primarily the safety and early preliminary efficacy of the OssaTron in treatment of patients with plantar fasciitis unrespons...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Alvarez R

    更新日期:2002-03-01 00:00:00

  • Patellar tendon-bearing, patten-bottom caliper suspension orthosis in active Charcot arthropathy: crutch-free ambulation with no weight bearing in the foot.

    abstract::A custom, patellar-tendon bearing (PTB), patten-bottom, caliper suspension orthosis was constructed for six patients with severe, active (Eichenholtz stage I) Charcot arthropathy of the ankle and hindfoot. With the orthosis, the suspended foot and ankle remained completely non-weight-bearing, and the lower extremity s...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Trepman E,Donnelly P

    更新日期:2002-04-01 00:00:00

  • Irreducible proximal interphalangeal dislocation of the fourth toe: a case report.

    abstract::Dislocation of the interphalangeal joints of the lesser toes is an uncommon injury, and complex (irreducible) dislocation has rarely been reported. All previous reports note that, during open reduction, the volar plate is interposed within the joint, thereby blocking reduction. In this case, the medial collateral liga...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Weinstein RN,Insler HP

    更新日期:1994-11-01 00:00:00

  • Opinions on lesser toe deformities among Dutch orthopaedic departments.

    abstract:BACKGROUND:Wide variations in definitions of lesser toe deformities exist. In addition, a general consensus regarding treatment of lesser toe deformities is lacking. The objective of this study was to evaluate of the definitions, current concepts, and treatment protocols for lesser toe deformities among orthopaedic dep...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Schrier JC,Louwerens JW,Verheyen CC

    更新日期:2007-12-01 00:00:00

  • The effect of terrain on foot pressures during walking.

    abstract:BACKGROUND:High plantar pressures are associated with the development of foot ulcers in people with diabetic neuropathy. The effect of terrain on plantar pressures during walking has not been fully explored. METHODS:Twenty 23- to 40-year-old subjects with no known musculoskeletal pathology walked across three terrains...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Mohamed O,Cerny K,Jones W,Burnfield JM

    更新日期:2005-10-01 00:00:00

  • Mid-substance peroneal tendon defects augmented with an acellular dermal matrix allograft.

    abstract:BACKGROUND:This study evaluated an acellular dermal matrix allograft augmentation for chronic mid-substance peroneous longus and brevis tendon tears. The hypothesis was that acellular dermal matrix allograft augmentation of chronic longitudinal mid-substance or complete tears of both peroneal tendons provides sufficien...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Rapley JH,Crates J,Barber A

    更新日期:2010-02-01 00:00:00

  • Functional outcome and gait analysis after triple or double arthrodesis.

    abstract::Thirteen patients who had undergone unilateral triple or double arthrodesis were studied an average of 5.2 years after surgery. Patients with a neuromuscular disorder; inflammatory arthritis; or any other focus of lower extremity arthritis, deformity, or joint dysfunction were excluded from the study. Clinical and rad...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Beischer AD,Brodsky JW,Pollo FE,Peereboom J

    更新日期:1999-09-01 00:00:00

  • Treatment of symptomatic hammertoe with a proximal interphalangeal joint arthrodesis.

    abstract::This study examined 76 consecutive patients (100 feet) treated by a single surgeon for both flexible and rigid hammertoes with a PIP arthrodesis using custom-machined drills, a peg cutter, and hole cutter, combined with an extensor tenotomy and dorsal capsulotomy. Forty-eight percent of patients were defined as satisf...

    journal_title:Foot & ankle international

    pub_type: 临床试验,杂志文章


    authors: Lehman DE,Smith RW

    更新日期:1995-09-01 00:00:00

  • Surgical Tips for Performing Open Fasciotomies for Chronic Exertional Compartment Syndrome of the Leg.

    abstract::Chronic exertional compartment syndrome (CECS) of the leg is a debilitating condition that has previously been characterized in athletes and military personnel. The results of surgical management in these patient populations have previously been published with inconsistencies in surgical methods and patient outcomes n...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Scully WF,Benavides JM

    更新日期:2019-07-01 00:00:00