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Ugeskrift For Laeger Oct 2020Symptomatic ankle arthrosis affects 1-4% of the population, and the most common aetiology is post-traumatic. Symptoms include pain, swelling and reduced range of motion.... (Review)
Review
Symptomatic ankle arthrosis affects 1-4% of the population, and the most common aetiology is post-traumatic. Symptoms include pain, swelling and reduced range of motion. Diagnosis is based on weight-bearing X-rays of the ankle joint, and treatment depends on the arthrosis grade and patient characteristics. Non-operative therapy, i.e. physiotherapy, analgesics, injection therapy and/or braces/orthoses is first-line treatment, as we argue in this review. Arthroscopy can be an effective treatment for some patients, but in case of severe arthrosis, osteotomies, total ankle replacement or arthrodesis may be necessary.
Topics: Ankle; Ankle Joint; Arthrodesis; Humans; Joint Diseases; Osteoarthritis
PubMed: 33046192
DOI: No ID Found -
Der Unfallchirurg Mar 2021
Topics: Ankle Fractures; Ankle Joint; Fractures, Bone; Humans
PubMed: 33646326
DOI: 10.1007/s00113-021-00968-x -
Clinics in Podiatric Medicine and... Oct 2023Segmental bone loss of the distal tibia and/or talus presents a challenge to successful reconstruction for the foot and ankle surgeon. When conservative care has been... (Review)
Review
Segmental bone loss of the distal tibia and/or talus presents a challenge to successful reconstruction for the foot and ankle surgeon. When conservative care has been exhausted, multiple surgical treatment options are available including bone transport, bulk allografts, bulk autografts, titanium cages, and external fixation techniques. The primary goals of surgical correction include restoration of limb length as well as a plantigrade, stable lower extremity.
Topics: Humans; Ankle Joint; Arthrodesis; Lower Extremity; Autografts; Talus
PubMed: 37716747
DOI: 10.1016/j.cpm.2023.05.012 -
Knee Surgery, Sports Traumatology,... May 2010Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain....
Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the ankle are grouped, depending on their anatomic orientation, and each of the ankle ligaments is discussed in detail.
Topics: Ankle; Ankle Joint; Biomechanical Phenomena; Epiphyses; Humans; Ligaments, Articular; Minimally Invasive Surgical Procedures; Orthopedic Procedures
PubMed: 20309522
DOI: 10.1007/s00167-010-1100-x -
Clinics in Podiatric Medicine and... Oct 2023Ankle arthrodesis has been a time-tested procedure for osteoarthritis, avascular necrosis of the talus, deformity correction, and significant trauma of the ankle.... (Review)
Review
Ankle arthrodesis has been a time-tested procedure for osteoarthritis, avascular necrosis of the talus, deformity correction, and significant trauma of the ankle. Technique guides have created dissection pearls, ease of fixation, and arthroscopic techniques to mitigate complications of the procedure. Major complications, such as nonunion, malunion, or implant infection are the most worrisome and cumbersome complications to handle. The aim of this article is to provide the practicing surgeon evidence to provide innovative management techniques for nonunion, malunion, and infection following primary ankle arthrodesis.
Topics: Humans; Ankle Joint; Ankle; Arthrodesis; Osteoarthritis; Osteonecrosis
PubMed: 37716746
DOI: 10.1016/j.cpm.2023.05.011 -
Clinics in Podiatric Medicine and... Jan 2023Posterior ankle impingement is typically seen in athletes, primarily dancers and soccer players, secondary to dynamic and repetitive push-off maneuvers and forced... (Review)
Review
Posterior ankle impingement is typically seen in athletes, primarily dancers and soccer players, secondary to dynamic and repetitive push-off maneuvers and forced hyperplantarflexion. Posterior ankle impingement results from chronic, repetitive trauma to the posterior ankle capsule, flexor hallucis longus tendon, and/or os trigonum. It is important to perform a thorough workup by isolating and testing the posterior compartment muscles and obtaining proper imaging with radiographs to identify any osseous abnormalities and MRI to evaluate the soft tissue structures. Nonsurgical treatment includes activity modification, physical therapy, and steroid injections.
Topics: Humans; Ankle; Joint Diseases; Ankle Joint; Talus; Syndrome; Magnetic Resonance Imaging
PubMed: 36368844
DOI: 10.1016/j.cpm.2022.07.014 -
Journal of Orthopaedic Surgery (Hong... 2022The compensation mechanism of subtalar joint in ankle with varus or valgus deformity is controversial and not well established. This biomechanical study aims to...
The compensation mechanism of subtalar joint in ankle with varus or valgus deformity is controversial and not well established. This biomechanical study aims to investigate how subtalar joint arthrodesis will affect the ankle joint pressure in varus and valgus malalignment of the tibia. Eight fresh-frozen human cadaver legs were tested in this study. A custom-made fixture was utilized and a total of 600N was applied to simulate weight-bearing. Intra-articular sensors (TeckScan) were inserted in the ankle joint to demonstrate the ankle joint pressure. Conditions include: Neutral, 5°, 10°, 15° and 20° varus, 5°, 10°, 15° and 20° valgus. After the fusion of the subtalar joint, when the tibia is gradually inverted, the inside pressure of the ankle joint gradually increases, and the pressure on the outside of the ankle joint gradually decreases. When the tibia is gradually eversion, the pressure on the outside of the ankle joint gradually increases, and the inside of the ankle joint gradually decreases. After the subtalar joint is fused, the compensatory activity of the subtalar joint disappears, and the regulation of the pressure in the ankle joint will be lost. We hypothesized that the inversion compensation of the subtalar joint is more likely to occur than the eversion compensation.
Topics: Ankle Joint; Arthrodesis; Humans; Subtalar Joint; Tibia; Weight-Bearing
PubMed: 35467445
DOI: 10.1177/10225536221098478 -
Foot and Ankle Surgery : Official... Jun 2011The ankle is a highly congruent joint with a surface area of 11-13 cm(2). Total ankle replacements have been attempted since the early 1970s and design has continually... (Review)
Review
The ankle is a highly congruent joint with a surface area of 11-13 cm(2). Total ankle replacements have been attempted since the early 1970s and design has continually evolved as the early designs were a failure. This was because the stresses involved and the mutiaxial motion of the ankle has not been understood until recently. It has been shown that the talus slides as well as rolls during the ankle arc of motion from plantarflexion to dorsiflexion. Furthermore, the articular surfaces and the calcaneofibular and tibiocalcaneal ligaments have been shown to form a four bar linkage dictating ankle motion. A new design ankle replacement has been suggested recently which allows multiaxial motion at the ankle while maintaining congruency throughout the arc of motion. The early results of this ankle replacement have been encouraging without any reported failures due to mechanical loosening.
Topics: Ankle Joint; Arthroplasty, Replacement, Ankle; Biomechanical Phenomena; Humans; Joint Prosthesis; Ligaments, Articular; Prosthesis Design; Range of Motion, Articular; Weight-Bearing
PubMed: 21549973
DOI: 10.1016/j.fas.2011.02.002 -
Foot and Ankle Clinics Sep 2013The goal of osteotomy in the treatment of varus ankle arthritis is to shift the forces imparted to the ankle to a portion of the joint that is not involved in the... (Review)
Review
The goal of osteotomy in the treatment of varus ankle arthritis is to shift the forces imparted to the ankle to a portion of the joint that is not involved in the degenerative process. The redistribution of loads and stresses seen by the tibiotalar joint can be approached either above or below the ankle with an osteotomy of the tibia or calcaneus. Evaluation of the deformity as being subtalar, supramalleolar, or a combination allows the surgeon to best address the increased joint stresses, thereby reducing the risk of failure of the osteotomy.
Topics: Ankle Joint; Foot Deformities, Acquired; Humans; Osteoarthritis; Osteotomy
PubMed: 24008213
DOI: 10.1016/j.fcl.2013.06.006 -
Foot & Ankle International Mar 2021Joint-preserving procedures of the ankle may postpone the need for ankle arthrodesis (AA) or total ankle replacement (TAR). The challenge for the surgeon is to determine...
BACKGROUND
Joint-preserving procedures of the ankle may postpone the need for ankle arthrodesis (AA) or total ankle replacement (TAR). The challenge for the surgeon is to determine which patients may benefit from these joint-preserving procedures. We hypothesized that patents with less than 2 mm of ankle joint space on preoperative radiographs would report inferior outcomes following joint-preserving surgery compared with those with 2 mm or greater joint space.
METHODS
Patients 18 years of age or older treated with joint-preserving ankle surgery with a minimum of 2 years of follow-up were considered for study inclusion. The ankle joint space was measured on standardized weightbearing preoperative radiographs. At follow-up, patients completed questionnaires including the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sports subscales, the Short Form-12 (SF-12) Physical Component Summary and Mental Component Summary, the Tegner Activity Scale, and satisfaction with outcome.
RESULTS
A total of 251 patients were included in the study. Forty-three patients had an ankle joint space of less than 2 mm. Compared with the 208 patients with an ankle joint space of 2 mm or greater, they had inferior FAAM ADL, FAAM Sports, and SF-12 Physical Component Summary scores ( = .001, = .001, and = .006, respectively). Additionally, a statistically significant positive correlation between joint space distance and the FAAM ADL ( = .012, = 0.158), FAAM Sports ( < .001, = 0.301), and SF-12 Physical Component Summary ( < .010, = 0.163) scores was found.
CONCLUSION
Patients with a preoperatively narrowed ankle joint space of less than 2 mm had significantly lower outcome scores following joint-preserving ankle surgery compared with patients with preserved ankle joint space. These results may assist clinicians in selecting patients who may benefit from ankle joint-preserving procedures, as well as counseling patients with a narrowed ankle joint space regarding expected outcome after joint-preserving ankle surgery.
LEVEL OF EVIDENCE
Level II, prognostic comparative study.
Topics: Activities of Daily Living; Adolescent; Adult; Ankle Joint; Arthroplasty, Replacement, Ankle; Humans; Sports; Surveys and Questionnaires; Tibia
PubMed: 33030037
DOI: 10.1177/1071100720962490