Infected and deformed neuropathic feet and ankles are serious challenges for surgical management. In this study we present our experience in performing ankle arthrodesis in a closed manner, without surgical preparation of the joint surfaces by cartilaginous debridement, but instead using an Ilizarov ring fixator (IRF) for deformity correction and facilitating fusion, in arthritic neuropathic ankles with associated osteomyelitis. We retrospectively reviewed all the patients who underwent closed ankle arthrodesis (CAA) in Ilizarov Scientific Centre from 2013 to 2018 (Group A) and compared them with a similar group of patients (Group B) who underwent open ankle arthrodesis (OAA). We then divided the neuropathic patients into three arthritic subgroups: Charcot joint, Charcot-Maire-Tooth disease, and post-traumatic arthritis. All arthrodeses were performed by using an Ilizarov ring fixator. All patients were followed up clinically and radiologically for a minimum of 12 months to assess union and function.Aims
Methods
Aims. Tibiotalocalcaneal (TTC) fusion is used to treat a variety of conditions affecting the ankle and subtalar joint, including osteoarthritis (OA), Charcot arthropathy,
The purpose of this study was to determine the functional outcome and implant survivorship of mobile-bearing total ankle arthroplasty (TAA) performed by a single surgeon. We reviewed 205 consecutive patients (210 ankles) who had undergone mobile-bearing TAA (205 patients) for osteoarthritis of the ankle between January 2005 and December 2015. Their mean follow-up was 6.4 years (2.0 to 13.4). Functional outcome was assessed using the Ankle Osteoarthritis Scale, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, 36-Item Short-Form Health Survey (SF-36) score, visual analogue scale, and range of movement. Implant survivorship and complications were also evaluated.Aims
Patients and Methods
This retrospective cohort study compared the results of vascularised
and non-vascularised anterior sliding tibial grafts for the treatment
of osteoarthritis (OA)of the ankle secondary to osteonecrosis of
the talus. We reviewed the clinical and radiological outcomes of 27 patients
who underwent arthrodesis with either vascularised or non-vascularised
(conventional) grafts, comparing the outcomes (clinical scores,
proportion with successful union and time to union) between the
two groups. The clinical outcome was assessed using the Mazur and
American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot
scores. The mean follow-up was 35 months (24 to 68).Aims
Patients and Methods
A new method of vascularised tibial grafting
has been developed for the treatment of
The main object of this study was to use a geometric morphometric
approach to quantify the left-right symmetry of talus bones. Analysis was carried out using CT scan images of 11 pairs of
intact tali. Two important geometric parameters, volume and surface
area, were quantified for left and right talus bones. The geometric
shape variations between the right and left talus bones were also
measured using deviation analysis. Furthermore, location of asymmetry
in the geometric shapes were identified. Numerical results showed that talus bones are bilaterally symmetrical
in nature, and the difference between the surface area of the left
and right talus bones was less than 7.5%. Similarly, the difference
in the volume of both bones was less than 7.5%. Results of the three-dimensional
(3D) deviation analyses demonstrated the mean deviation between
left and right talus bones were in the range of -0.74 mm to 0.62
mm. It was observed that in eight of 11 subjects, the deviation
in symmetry occurred in regions that are clinically less important
during talus surgery. Objective
Methods
Results
Achieving arthrodesis of the ankle can be difficult
in the presence of infection, deformity, poor soft tissues and bone loss.
We present a series of 48 patients with complex ankle pathology,
treated with the Ilizarov technique. Infection was present in 30
patients and 30 had significant deformity before surgery. Outcome
was assessed clinically and with patient-reported outcome measures
(Modified American Orthopaedic Foot and Ankle Society (MAOFAS) scale and
the Short-Form (SF-36)). Arthrodesis was achieved in 40 patients with the Ilizarov technique
alone and in six further patients with additional surgery. Infection
was eradicated in all patients at a mean follow-up of 46.6 months
(13 to 162). Successful arthrodesis was less likely in those with
comorbidities and in tibiocalcaneal fusion compared with tibiotalar
fusion. These patients had poor general health scores compared with the
normal population before surgery. The mean MAOFAS score improved
significantly from 24.3 (0 to 90) pre-operatively to 56.2 (30 to
90) post-operatively, but there was only a modest improvement in
general health; the mean SF-36 improved from 44.8 (19 to 66) to
50.1 (21 to 76). There was a major benefit in terms of pain relief. Arthrodesis using the Ilizarov technique is an effective treatment
for complex ankle pathology, with good clinical outcomes and eradication
of infection. However, even after successful arthrodesis general
health scores remain limited. Cite this article:
The purpose of this study was to evaluate the
clinical results of a newly designed prosthesis to replace the body
of the
