Identifying optimal treatment strategies for inpatients with traumatic foot and ankle injuries has been hampered by a wide variety of outcome measures with unproven reliability and validity. It remains plausible that the choice of functional outcome measures may influence measurement of treatment effects. This prospective observational study aims to measure the correlation and agreement across six functional outcome measures in patients with traumatic foot and ankle injuries. Patients 18 years of age or older with a traumatic foot or ankle injury completed the Short Form-12 (SF-12), Short Musculoskeletal Functional Assessment (SMFA), Foot Function Index (FFI), Foot and Ankle Ability Measure (FAAM), American Academy of Orthopaedic Surgeons (AAOS) Foot and Ankle Questionnaire and American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale at a single follow-up visit. Raw scores were calculated and transformed to a functional level of excellent, very good, good, fair or poor. Pearson correlation co-efficients providing measures of correlation and agreement between functional levels were assessed.Purpose
Methods
Unicompartmental knee arthroplasty provides a good alternative to total knee arthroplasty in patients with isolated medial compartment osteoarthritis. Reported ten-year survival for the Oxford medial unicompartmental knee arthroplasty is variable, ranging from 80.2% to 97.7% in the originator series. The aim of this study was to determine the survival and reasons for revision of the Oxford medial unicompartmental knee arthroplasty when performed at a specialist orthopaedic centre. Details of consecutive patients undergoing Oxford unicompartmental knee arthroplasty at our centre between January 2000 and December 2009 were collected prospectively. Failure of the implant was defined as conversion to total knee arthroplasty. Survival was determined using the Kaplan-Meier method.Background
Methods
Knee arthroplasty provides not only pain relief but also an improvement in function and range of movement. Limited joint mobility (LJM), secondary to peri-articular connective tissues stiffness, is a common complication of diabetes mellitus. We therefore examined functional outcome post-total knee arthroplasty (TKA) in a cohort of subjects with and without diabetes mellitus. The effect of TKA on indices of knee function (fixed flexion, maximum flexion, total ROM and knee society score) was examined in 367 subjects with type 2 diabetes and 367 subjects without diabetes. The groups were matched for age, sex, BMI and functional movement at baseline. Participants were examined at baseline (pre-operatively), 1, 5 and 10 years post-TKA.Introduction
Method
Trabecular materials show great promise for soft-tissue attachment to prosthetic implants. Results with Tantalum have been very encouraging, however, it remains unclear if this in-growth is secondary to the specific metal or its generic structure,. If structure, is there a specific tolerance with respect to porosity and pore size? In a canine model, bulk blocks of porous alumina ceramic were shown to be completely ingrown by four weeks. The type material was not a factor, and effect of pore size revealed that there is a wide tolerance in facilitating in-growth with the larger pores having the greatest attachment strength (p=0.004).
Alumina ceramic implants of fixed porosity (~ 85%) were designed in three pore size ranges (100–200, 250–400 and 600–800 μM). Using an established canine model, six implants (two of each type) were implanted in the dorsal subcutaneous tissues of tweleve mature canines and examined histologically and mechanically at four, eight and sixteen weeks with respect to type, amount and strength of soft tissue in-growth. Soft tissue in-growth was grossly evident in all implants at each time interval, and in each pore size. Microscopic examination revealed neo-vascularized in-growth throughout the implant, without evidence of inflammation or foreign body reaction. Numerous blood vessels were visible at the implant interface and within the porous alumina ceramic structure. With peel testing, the weakest attachment strength was with the small pore size with no differences between the medium and large pore sizes. An increase of attachment strength in each pore size was observed over time. This study suggests that architecture of porous structures in general, and not the type of material used, confers the biologic activity and that there is a wide tolerance for pore size in facilitating this process in soft tissue in-growth. Further study of other inert foam structures will be useful in further defining the assets and limitations of this genre of trabecular materials as a whole. Funding: Stryker Orthopaedics, Mahwah, NJ Please contact author for figures, graphs, and/or diagrams.
