Posttraumatic ankle osteoarthritis

NewsBot · Dec 25, 2008

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Posttraumatic ankle osteoarthritis after ankle-related fractures.
Horisberger M, Valderrabano V, Hintermann B.
J Orthop Trauma. 2009 Jan;23(1):60-7.

OBJECTIVES:: The present study analyzes etiologies, pathomechanisms, and predisposing factors that lead to the development and progression of posttraumatic ankle osteoarthritis (OA) after ankle-related fractures.

DESIGN:: Retrospective cohort study. SETTING:: Tertiary health care center. PATIENTS:: The underlying cohort was 257 painful end-stage ankle OA patients (270 cases) presenting to the authors' clinic. Patients from this cohort with a history of ankle-related fracture (141 patients) were evaluated. INTERVENTION:: Analysis of individual clinical and radiologic history since the time of injury; physical and radiologic examination at the time of ankle OA. MAIN OUTCOME MEASURES:: OA latency time, fracture type, treatment methods, complication of fracture healing, soft tissue situation, age, pain score, American Orthopedic Foot and Ankle Society ankle score, range of motion, radiologic tibiotalar alignment, and radiologic ankle OA grading were evaluated.

RESULTS:: The latency time between injury and end-stage ankle OA was 20.9 years (1-52 years). Malleolar fracture was the most common fracture (53.2%). A negative correlation of the OA latency time with the fracture severity was observed for some fracture types (pilon fractures, r = -0.4, P < 0.01). Patients with complications during the healing process showed significantly shorter OA latency time (P < 0.01). The patients' age at time of injury correlated negatively with the OA latency time (r = -0.6, P < 0.01).

CONCLUSIONS:: The present study addresses the link between ankle-related fractures and secondary posttraumatic ankle OA. The latency time between injury and OA depends on fracture type and severity, occurrence of complications in the healing process, and patient-related factors, for example, age.
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NewsBot · Jan 16, 2013

The comparative morphology of idiopathic ankle osteoarthritis.
Schaefer KL, Sangeorzan BJ, Fassbind MJ, Ledoux WR.
J Bone Joint Surg Am. 2012 Dec 19;94(24):e1811

BACKGROUND:
Osteoarthritis is the most common joint disease and the leading cause of chronic disability in the U.S. However, symptomatic osteoarthritis at the ankle occurs nine times less frequently than at the knee and hip, even though the ankle experiences greater pressure and is the most commonly injured joint in the human body. This study sought to quantify the shape and coverage of the talar and tibial articular surfaces by comparing the three-dimensional morphology of the ankle in patients with ankle osteoarthritis and in those without arthritis, including a subset of different foot shapes.

METHODS:
We created three-dimensional models of the joint surfaces of ankles with and without arthritis. We fit cylinders to the joint surfaces, and measured the radius of the tibial and talar articular surfaces, the tibial coverage angle of the talus, and the degree of joint skew. We hypothesized that these measurements would be different between those with and without ankle osteoarthritis and among foot types. We evaluated a total of 108 limbs.

RESULTS:
The mean tibial and talar radii were significantly higher and the mean coverage angle was significantly lower in feet with ankle osteoarthritis than in all other foot categories. The mean coronal skew in limbs with ankle osteoarthritis was significantly higher than in the neutral and flatfoot groups. The high arched feet had several significantly different skew angles from other foot types. No significant differences in joint morphology measures between neutrally aligned feet and flatfeet were found.

CONCLUSIONS:
Ankles with osteoarthritis had larger tibial and talar radii, a smaller coverage angle, and larger skew angles than ankles without osteoarthritis. Together, these findings suggest a flatter ankle joint with less stability, depth, and containment and reduced articular constraint and support.

CLINICAL RELEVANCE:
These findings offer an objective standard that supports the principle that ankle osteoarthritis pathology is related to loss of ankle joint containment.
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NewsBot · Oct 22, 2016

The Concept of Modern Ankle Joint Arthrodesis in Posttraumatic Crusarthrosis, Grade III–IV
Текст научной статьи по специальности «Медицина и здравоохранение»
Современные технологии в медицине

The aim of the investigation was to work out a concept of modern arthrodesis of the ankle joint in posttraumatic crusarthrosis, grade III–IV, using innovative fixing implants. Materials and Methods. The results of treating 53 patients covering the period from 1 to 15 years after 56 operations of arthrodesis, performed for posttraumatic crusarthrosis, grade III–IV (according to Kellgren and Lawrence classification), have been analyzes. The conclusions were based on the data of radiographic, clinical examination and the scoring according to the international rating scale AOFAS. Arthrodesis was performed using state-of-the-art fixing implants: with the help of the screws, retrograde intramedullary HAN rod, Ilizarov apparatus for external fixation, wires. Results. In the majority of patients (41%) the main cause of developing posttraumatic crusarthrosis of grade III–IV was unrepaired intraarticular dislocation of the ankle fragments and a large fragment (more than 1/3) of the posterior tibia margin. The best results, i.e. fewer ligamentous ankylosis (32%) and the greatest number of good (39%) and satisfied (54%) results according to AOFAS scale were obtained when crossed screws were used in arthrodesis. It was estimated, that the assessment of clinical and functional signs according to the international scale AOFAS does not reflects the most vital spectrum of life activity indices of patients, therefore, it has been suggested to use additionally individualized indices characterizing the quality of life of patients of various professions, levels of every-day activity and psychological motivation to adequate rehabilitation. Unsatisfied radiographic findings did not always corresponded to the poor clinical results. In 56% of patients with ligamentous ankylosis the result according to AOFAS was good or satisfactory (slight pains in prolonged walking, moving without additional supporting means, absence of evident limping). Conclusion. The worked out concept of modern arthrodesis is as follows: 1) the choice of ankle arthrodesis method and the type of a fixing implant must depend not only on the type of deformation, but on the patient’s age, gender traits, diseases contributing to the development of unfavorable treatment results; 2) the best clinical and functional results are connected with the method of fixation providing primary stability, and with regenerative and adaptive capabilities of patients in diverse age groups; 3) the most optimal state-of-the-art implants for arthrodesis are crossed screws for fixation, providing the greatest strength and good primary compression, if there is no marked disorder of blood supply of the articular bones and radical removal of the cartilaginous tissue.
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Posttraumatic ankle osteoarthritis

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NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

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Posttraumatic ankle osteoarthritis

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Management of posttraumatic osteoarthritis with an integrated orthotic and rehabilitation initiative

Dysplasia epiphysealis hemimelica (Trevor's disease) in the foot and ankle

Sudden exertions causing acute pain at ankle/top of foot

Workers' Compensation After Foot and Ankle Surgery

Burning pain outer left foot/ankle

Controlled ankle motion (CAM) Walker boots

Mental health and outcomes of foot and ankle surgery

Share This Page

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