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Orthopedics Jun 1988A new process for arthrodesis in humans is presented. The process has been used successfully in the cervical spine of horses and has potential for human use. The concept...
A new process for arthrodesis in humans is presented. The process has been used successfully in the cervical spine of horses and has potential for human use. The concept is encompassed in the process of an anterior cervical fusion and is an adaptation of that established practice but using an implant of stainless steel containing autogenous bone graft to encourage through-the-implant growth of bone. In the future, it may have use in the human spine and other joints.
Topics: Animals; Arthrodesis; Horses; Humans; Prostheses and Implants; Spinal Fusion; Stainless Steel
PubMed: 3387340
DOI: 10.3928/0147-7447-19880601-13 -
Foot & Ankle International Aug 2003Maintaining mobility of the fourth and fifth tarsometatarsal joints has been reported to be important in arthrodesis of the midfoot. A review of the records at a...
Maintaining mobility of the fourth and fifth tarsometatarsal joints has been reported to be important in arthrodesis of the midfoot. A review of the records at a tertiary care center of 23 patients (28 feet) with arthrodesis of these joints and a minimum 2-year follow-up showed that 22 complete midfoot arthrodeses were performed as part of the correction for a neuroarthropathic rocker-bottom deformity. Six arthrodeses of the fourth and fifth metatarsal joints were performed on normosensate feet with painful arthritis involving the lateral joints. Clinical and radiographic fusion occurred in 26 of 28 feet. Comparing average preoperative and postoperative scores, functional incapacity from lateral midfoot pathology decreased (8.4/10 to 2.2/10), overall pain scores improved (5.1/10 to 1.3/10), pain scores in the arthritic subgroup decreased (8.2/10 to 2.4/10), and the modified overall AOFAS midfoot score improved (35/100 to 78/100).
Topics: Aged; Arthritis; Arthrodesis; Female; Follow-Up Studies; Foot Deformities; Foot Joints; Humans; Male; Middle Aged; Retrospective Studies
PubMed: 12956562
DOI: 10.1177/107110070302400803 -
The Journal of Hand Surgery, European... Jan 2011Salvage of failed total wrist arthroplasty by arthrodesis may be difficult because of bone loss and poor quality of bone and soft tissues. We examined the outcomes of...
Salvage of failed total wrist arthroplasty by arthrodesis may be difficult because of bone loss and poor quality of bone and soft tissues. We examined the outcomes of wrist arthrodesis for failed total wrist arthroplasty in a retrospective study of 21 wrists in 17 patients. Clinical data, radiographs, patient-reported outcomes and DASH questionnaires were used. Thirteen women and four men had undergone total wrist arthroplasty at an average age of 55 years. The mode of failure was aseptic loosening in 13 wrists. The average time from the index arthroplasty to wrist arthrodesis was 7.6 years. Autograft and/or allograft bone graft was used in all of the wrists. Arthrodesis was achieved in 11 wrists and ten had a nonunion. Six arthrodeses underwent eight revisions for nonunion, with two achieving union. The mean DASH score was 29 in wrists that fused and 36 in those that did not fuse. Pain scores averaged 2.1 in the wrists that fused and 3.3 in the nonunion group. Most patients had clinical improvement.
Topics: Adult; Aged; Aged, 80 and over; Arthrodesis; Arthroplasty, Replacement; Female; Follow-Up Studies; Humans; Limb Salvage; Male; Middle Aged; Postoperative Complications; Prosthesis Failure; Reoperation; Retrospective Studies
PubMed: 20621939
DOI: 10.1177/1753193410376283 -
Foot & Ankle International Jul 2002Currently no data or guidelines exist for the surgeon on how to advise patients about returning to sports participation after arthrodesis within the foot or ankle....
Currently no data or guidelines exist for the surgeon on how to advise patients about returning to sports participation after arthrodesis within the foot or ankle. Sequelae of inappropriate activity after arthrodesis includes periarticular arthrosis, arthrodesis failure and stress fracture. Some arthrodeses will preclude certain sports because it limits the patient's ability to perform movement vital to the game, for example, ankle arthrodesis preventing basketball players from jumping. Questionnaires were sent to members of the American Orthopaedic Foot and Ankle Society (AOFAS) and to trainers of professional basketball and American football teams. This paper reports on the responses of orthopaedic foot and ankle surgeons about return to sports participation, after arthrodeses within the foot and ankle, and suggests guidelines for sports participation after an arthrodesis of the lower extremity. A selective sports participation policy is advised. Patients with an ankle or triple fusion should avoid high-impact sports, while those with more distal arthrodeses should be monitored for arthrosis and stress fracture.
Topics: Ankle Joint; Arthrodesis; Humans; Orthopedics; Practice Guidelines as Topic; Sports; Surveys and Questionnaires; Tarsal Joints
PubMed: 12146773
DOI: 10.1177/107110070202300707 -
Foot & Ankle International Jun 2010More than 40 fusion techniques for the ankle joint have been reported. The purpose of this retrospective study was to review our preliminary clinical and radiographic...
BACKGROUND
More than 40 fusion techniques for the ankle joint have been reported. The purpose of this retrospective study was to review our preliminary clinical and radiographic results using an anatomically contoured anterior plate for ankle arthrodesis.
MATERIALS AND METHODS
Ten ankle arthrodeses with an anatomically contoured anterior plate performed by a single surgeon were reviewed with an average of 14 months followup. One underwent revision surgery due to screw loosening by reapplying the same plate. Plain radiographs were taken to help determine the stability of fixation and time of fusion. The AOFAS clinical rating system was applied to evaluate patients preoperatively and postoperatively.
RESULTS
Nine of ten patients achieved solid fusion radiographically and clinically at an average of 15 (range, 12 to 22) weeks. Bony healing was achieved after an additional 12 weeks for the patient who underwent revision fusion. There were no postoperative wound problems or infections. All patients reported an improvement in their pain level following successful fusion.
CONCLUSION
The application of an anatomically contoured plate provides many advantages, including less soft tissue disruption by using a single anterior incision, ease of deformity correction, early rehabilitation, and high rate of union.
Topics: Adult; Aged; Ankle Joint; Arthritis; Arthrodesis; Bone Plates; Female; Follow-Up Studies; Humans; Ilium; Male; Middle Aged; Pain Measurement; Radiography; Reoperation
PubMed: 20557814
DOI: 10.3113/FAI.2010.0492 -
Foot and Ankle Clinics Mar 2002In the longest-term follow-up study on triple arthrodesis published to date, Saltzman et al found at 44 years post-fusion, 95% of surviving patients were satisfied with...
In the longest-term follow-up study on triple arthrodesis published to date, Saltzman et al found at 44 years post-fusion, 95% of surviving patients were satisfied with their outcomes despite deteriorating function and some increase in pain with time [13]. All of the cases in this review were performed through a single anterolateral surgical approach and without internal fixation. In symptomatic severe or arthritic pes planovalgus or cavovarus deformity, few operative alternatives to triple arthrodesis are available. Attempts at subtalar resurfacing prostheses led to poor results and subsequent abandonment [46,47], whereas tendon transfer procedures and osteotomy realignments are not always possible or feasible in every patient. Although the indications for and surgical techniques used in triple arthrodesis have evolved and improved with time (predictably improving results in the intermediate term), triple arthrodesis remains a salvage procedure. Thus, deteriorating results with time may be an expected consequence and should not necessarily represent a failure of the technique. The surgical procedure is technically challenging and should be reserved for those surgeons trained and comfortable with all aspects of the surgery. Patient selection is vital, with most triple arthrodeses reserved for older patients. The two-incision approach allows better visualization, particularly of the talonavicular articulation, allowing for adequate resection of cartilage and alignment of the joints. Avoidance of excessive bony resection or wedge resection and the use of rigid internal fixation has increased the reliability of the procedure and diminished the pseudarthrosis rate and the rate of recurrence of the deformity. Failure to perform the procedure in an optimal fashion, however, can lead to a devastating failure with severe pain and dysfunction for the patient.
Topics: Arthrodesis; Foot Deformities; Foot Joints; Humans; Salvage Therapy; Subtalar Joint; Treatment Failure
PubMed: 12380385
DOI: 10.1016/s1083-7515(02)00016-5 -
The Journal of Foot and Ankle Surgery :... 2012Arthrodesis of the first metatarsophalangeal joint is a commonly accepted technique to treat various afflictions of the hallux. Many techniques have been described to... (Comparative Study)
Comparative Study
Arthrodesis of the first metatarsophalangeal joint is a commonly accepted technique to treat various afflictions of the hallux. Many techniques have been described to fixate the arthrodesis. However, no superior fixation technique has been identified in regard to nonunion. We performed a retrospective analysis of first metatarsophalangeal joint arthrodeses in our clinic from January 2000 to April 2010, focusing on plate and screw fixation. Our aim was to identify the best fixation construct in regard to fusion rates and radiologic nonunion. We identified 72 arthrodeses performed using 1 oblique (n = 24) or 2 crossed (n = 21) lag screws or a plate (n = 13) or a plate augmented with plantar lag screw fixation (n = 14). Our analysis showed that plate fixation alone results in significantly fewer nonunions than single screw fixation. A comparison of the other fixation types showed no significant differences with regard to nonunion. Although our analysis showed that plate fixation alone is superior to single screw fixation, no definitive conclusion can be drawn owing to methodologic shortcomings. We believe a randomized controlled trial with larger sample sizes is necessary to find the clinically superior fixation technique.
Topics: Adult; Aged; Aged, 80 and over; Arthrodesis; Bone Plates; Bone Screws; Female; Humans; Male; Metatarsophalangeal Joint; Middle Aged; Osseointegration; Retrospective Studies
PubMed: 22178200
DOI: 10.1053/j.jfas.2011.10.044 -
Orthopedics May 1999The findings of studies on DBM in the surgical management of osseous defects, arthrodeses, and reconstructive procedures have been promising. In general, DBM grafts have... (Review)
Review
The findings of studies on DBM in the surgical management of osseous defects, arthrodeses, and reconstructive procedures have been promising. In general, DBM grafts have supported healing in a timely fashion without complication and with a diminished need to harvest bone from a secondary operative site. Nonetheless, controlled prospective trials are needed to confirm the comparative effectiveness of DBM and to quantitate the benefits of avoiding secondary site autologous bone harvesting. Notwithstanding the known deleterious effects of certain processing steps, current commercial demineralization processes vary widely and use ancillary procedures aimed at attenuating potential residual antigens and pathogens. While some of these procedures may improve or facilitate graft performance (eg, lipid and lipoprotein removal with detergents), others may be deleterious (eg, sterilization with radiation or ethylene oxide) (Table 1). Therefore, it is important that DBM be processed using methods that consistently establish conditions known to preserve DBM's documented osteoinductive potential and that authors appropriately identify processing methods known to have effects on graft performance.
Topics: Arthrodesis; Bone Diseases; Bone Matrix; Humans; Osseointegration; Research Design; Tissue Preservation; Treatment Outcome
PubMed: 10348114
DOI: No ID Found -
Acta Orthopaedica Scandinavica Jun 1989Thirty-three arthrodeses were performed for arthrosis of the first carpometacarpal joint in 29 patients. The patients were reexamined 5 (2-10) years after the operation....
Thirty-three arthrodeses were performed for arthrosis of the first carpometacarpal joint in 29 patients. The patients were reexamined 5 (2-10) years after the operation. Twenty arthrodeses were clinically satisfactory, although two had failed to unite. Analysis of this group showed that a painless stiff carpometacarpal joint causes some functional impairment, considered negligible by most patients. The remaining 13 cases were unsatisfactory due to pain caused by arthrosis in the peritrapezoidal joints (7 cases), nonunion (4), radial nerve neuroma (1), and unknown reason (1).
Topics: Adult; Aged; Aged, 80 and over; Arthrodesis; Carpal Bones; Female; Finger Joint; Follow-Up Studies; Humans; Joint Diseases; Male; Middle Aged; Postoperative Complications; Thumb
PubMed: 2750494
DOI: 10.3109/17453678909149271 -
Revue de Chirurgie Orthopedique Et... 1979The authors have studied the complications and long term results of 91 cases of tibio-talar arthrodesis and 43 cases of tibio-talar arthrodesis associated with subtalar...
The authors have studied the complications and long term results of 91 cases of tibio-talar arthrodesis and 43 cases of tibio-talar arthrodesis associated with subtalar arthrodesis. Minor complications such as limited skin necrosis were noted in 13 p. 100 of the cases, and no-fusion occurred in 7 p. 100. The results were satisfactory in 75 p. 100 of the cases, fair in 13 p. 100, poor in 12 p. 100. Most of the poor results were related to painfull subtalar joints after isolated tibio-talar arthrodesis. This happened often following conditions : excessive equinus, protrusion of screws in the subtalar joint, preoperative lesions of the subtalar joint. In cases of associated tibio-tarsal and subtalar arthrodesis, the long term study revealed moderate and painless secondary arthrosis of the mid-tarsal joint. It is concluded that associated fusion of the subtalar joint should always be considered when tibio-talar arthrodesis is indicated.
Topics: Adolescent; Adult; Aged; Arthrodesis; Female; Follow-Up Studies; Fractures, Bone; Humans; Male; Middle Aged; Radiography; Talus; Tibia
PubMed: 161044
DOI: No ID Found