Restoration of ankle alignment is thought to be critical in total ankle arthroplasty (TAA) outcomes, but previous research is primarily focused on coronal alignment. The purpose of this study was to investigate the sagittal alignment of the talar component. The talar component inclination, measured by the previously-described gamma angle, was hypothesized to be predictive of TAA outcomes.

A retrospective review of the Canadian Orthopaedic Foot and Ankle Society (COFAS) database of ankle arthritis was performed on all TAA cases at a single center over a 11-year period utilizing one of two modern implant designs. Cases without postoperative x-rays taken between 6 and 12 weeks were excluded. The gamma angle was measured by two independent orthopaedic surgeons twice each and standard descriptive statistics was done in addition to a survival analysis. The postoperative gamma angles were analyzed against several definitions of TAA failure and patient-reported outcome measures from the COFAS database by an expert biostatistician.

109 TAA cases satisfied inclusion and exclusion criteria. An elevated postoperative gamma angle higher than 22 degrees was associated with talar component subsidence, defined as a change in gamma angle of 5 degrees or more between postoperative and last available followup radiographs. This finding was true when adjusting for age, gender, body mass index (BMI), and inflammatory arthritis status. All measured angles were found to have good inter- and intraobserver reliability.

Surgeons should take care to not excessively dorsiflex the talar cuts during TAA surgery. The gamma angle is a simple and reliable radiographic measurement to predict long-term outcomes of TAA and can help surgeons counsel their patients postoperatively.

Adhered bacteria on titanium surfaces are able to decrease its corrosion potential and impedance values at the lowest frequencies. This result points to the detrimental influence of the biofilm on the passive film formed on the surfaces, independently on the surface finishes.

Titanium is one of the most used metallic biomaterials for biological and implant applications. The spontaneous formation of a protective passive film around 2–5 nm thick, make titanium unique as a biomaterial for implants. Its composition has been described by a three-layer model: TiO2/Ti2O3/TiO and its stability is ultimately responsible for the success of osseointegrated titanium implants. The cases of breakdown of the protective passive film are associated with highly acidic environments induced by bacterial biofilms and/or inflammatory processes that lead to localized corrosion of titanium and, in extreme cases, implant failure. Bearing in mind that the surface design of a titanium implant is a key element involved in the healing mechanisms at the bone-implant interface, the surface modifications have sought to enhance the biomechanical anchorage of the implant and promote osseointegration at the cell-biomolecular level. However, little attention has been paid to the effects of these surface modifications in the microbiologically induced corrosion (MIC). The aim of this work is to evaluate the potential for MIC of titanium in the short term under viable bacterial cells of Streptococcus mutansas a representative microorganism of oral biofilm considered to be a highly cariogenic pathogen.

Discs of 64 mm²surface area of commercially pure titanium, grade 4, were supplied by Biotechnology Institute (BTI, Vitoria, Spain). Four surface treatments were studied: two acid etchings (low roughness, opN and high roughness, opV). In addition, acid etched plus anodic oxidation (opNT). For comparative purposes, two surface finishes have been included: high roughness – corresponding with sandblasting-large grit plus acid (SLA); and, as-machined titanium (mach). The oral strain used for assessing the biofilm formation on the corrosion behavior of Ti surfaces was Streptococus mutansATCC 25175, obtained from the Spanish Type Culture Collection (CECT). The study of MIC from Streptococcus mutanson surfaces of Ti was carried out in an electrochemical cell specifically designed and patented by some of the present authors [1]. A three set up configuration of the electrochemical cell was used in the experiments. The measurement of the corrosion potential and electrochemical impedance was performed at different periods of incubation of bacteria: 2, 7, 15, 21 and 28 days.

Out Slight but continuous decrease in the corrosion potential and impedance values at the lowest frequencies indicate the deleterious influence of the biofilm on the passive film formed on the surfaces, independently on the surface finishes.

This research suggests that the most appropriate surface modification for the dental implant portion at the bone level would be the acid etched of high roughness (opV) surface.