CRIS

Permanent URI for this communityhttps://investigadores.udd.cl/handle/123456789/1

Browse

Search Results

Now showing 1 - 8 of 8

Some of the metrics are blocked by your
consent settings
Outcomes of Total Ankle Arthroplasty in Postfracture Ankle Arthritis
(2023)
Jaeyoung Kim
;
Ruben Radkievich
;
Rami Mizher
;
Isabel Shaffrey
;
Martin O’Malley
<jats:sec><jats:title>Background:</jats:title><jats:p> Ankle arthritis that develops after fracture accounts for a significant portion of ankle arthritis necessitating total ankle arthroplasty (TAA). It remains unknown whether TAA in postfracture patients produces equivalent outcomes to those without fracture history. The purpose of this study was to evaluate the medium-term outcomes of TAA in postfracture ankle arthritis compared to those without fracture history. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> This study reviewed 178 ankles from 171 consecutive patients who underwent TAA in our institution between 2007 and 2017 and completed a minimum 5-year follow-up. Four different TAA systems were utilized by 6 surgeons. Based on fracture history, patients were divided into 2 groups: the postfracture group (n = 63; median age 65.7 years; median follow-up 5.9 years) and the nonfracture group (n = 115; median age 64.4 years; median follow-up 6.2 years). Types and rates of complications including revision and reoperation were compared. Minimum 5-year Foot and Ankle Outcome Score (FAOS) and postoperative improvement were investigated. A subgroup analysis was performed to determine whether outcomes differ between intraarticular fracture patients (n = 43) and extraarticular fracture patients (n = 20). </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> Both groups exhibited comparable postoperative improvement and final FAOS scores. The postfracture group had a significantly higher reoperation rate than the nonfracture group (20 of 63, 31.7%, vs 17 of 115, 14.8%; P = .011), with gutter impingement being the most common cause. There were 3 revisions in each group. In the subgroup analysis, we found no evidence of statistical difference between the intraarticular fracture group and the extraarticular fracture group in terms of FAOS scores, revision, and reoperation rates. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> In this single-center, retrospective comparative study, we found total ankle arthroplasty in patients with a history of fractures around the ankle joint had no evidence of statistical difference in patient-reported outcomes and implant survivorship but led to a higher rate of nonrevision reoperation following surgery. In the much smaller subset of patients with previous fracture, we did not find that those with a history of intraarticular fracture had inferior outcomes after TAA when compared to those with a history of extraarticular fracture. </jats:p></jats:sec><jats:sec><jats:title>Level of Evidence:</jats:title><jats:p> Level III, case-control study. </jats:p></jats:sec>
6Scopus© Citations 2
Some of the metrics are blocked by your
consent settings
Acute Deltoid Injury in Ankle Fractures: A Biomechanical Analysis of Different Repair Constructs
(2023)
WAGNER HITSCHFFELD, EMILIO
;
WAGNER HITSCHFELD, PABLO
;
Mario I. Escudero
;
Florencia Pacheco
;
David-osvaldo Salinas-sanchez
<jats:sec><jats:title>Background:</jats:title><jats:p> The importance of the deltoid ligament in the congruency and coupling of the tibiotalar joint is well known. The current trend is to repair it in cases of acute injuries in the context of ankle fractures; however, there is limited information on how it should be reconstructed. The objective of this study was to compare different deltoid ligament repair types in an ankle fracture cadaveric model. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> Sixteen cadaveric foot-ankle-distal tibia specimens were used. All samples were prepared as a supination external rotation ankle fracture model. Axial load and cyclic axial rotations were applied on every specimen using a specifically designed frame. This test was performed without deltoid injury, with deltoid injury, and after repair. The reconstruction was performed in 4 different ways (anterior, posterior, middle, and combined). Medial clear space (MCS) was measured for each condition on simulated weightbearing (WB) and gravity stress (GS) radiographs. Reflective markers were used in tibia and talus, registering the kinematics through a motion analysis system to record the tibiotalar uncoupling. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> After deltoid damage, in all cases the MCS increased significantly on GS radiographs, but there was no increase in the MCS on WB radiographs. After repair, in all cases, the MCS was normalized. Kinematically, after deltoid damage, the tibiotalar uncoupling increased significantly. All isolated repairs achieved a similar tibiotalar uncoupling value as its baseline condition. The combined repair resulted in a significant decrease in tibiotalar uncoupling. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Our results show that deltoid repair recovers the tibiotalar coupling mechanism in an ankle fracture model. Isolated deltoid repairs recovered baseline MCS and tibiotalar uncoupling values. Combined repairs may lead to overconstraint, which could lead to postoperative stiffness. Clinical studies are needed to prove these results and show clinically improved outcomes. </jats:p></jats:sec><jats:sec><jats:title>Clinical Relevance:</jats:title><jats:p> This study helps in finding the optimum deltoid repair to use in an acute trauma setting. </jats:p></jats:sec>
Scopus© Citations 4 8
Some of the metrics are blocked by your
consent settings
Achilles insertional tendinopathy: state of the art
(2019)
Nicola Maffulli
;
Amol Saxena
;
WAGNER, EMILIO
;
Guglielmo Torre
Scopus© Citations 40 1
Some of the metrics are blocked by your
consent settings
Soleus muscle and Achilles tendon compressive stiffness is related to knee and ankle positioning
(2022)
Carlos Cruz-Montecinos
;
BESOMI MOLINA, MANUELA
;
Nicolás Acevedo-Valenzuela
;
Kevin Cares-Marambio
;
Alejandro Bustamante
3Scopus© Citations 10
Some of the metrics are blocked by your
consent settings
The double posteromedial portals endoscopy for posterior ankle impingement syndrome in athletes
(2022)
Nicola Maffulli
;
Rocco Aicale
;
Filippo Migliorini
;
WAGNER, EMILIO
;
Amol Saxena
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Posterior ankle impingement syndrome (PAIS) may result from flexor hallucis longus tendinopathy, compression of the posterior process of the talus from the presence of an os trigonum, soft-tissue impingement, or a combination of these. Posterior extra-articular endoscopy performed with the patient supine through the double posteromedial portals, with excision of adhesions, excision of the posterior process of the talus or an os trigonum, and decompression of the tendon of the flexor hallucis longus (FHL), can be used in athletes with PAIS.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Thirty-four athletes with PAIS in whom conservative management had failed underwent posterior ankle endoscopy in the supine position using the double posteromedial portals. The patients were assessed pre- and postoperatively using the American Orthopaedic Foot and Ankle Society hindfoot scale score, the Tegner scale, and the simple visual analogue scale. Time of surgery, return to sports, patient satisfaction, and complications were recorded and analysed. The average length of postoperative follow-up was 26.7 ± 12.6 (range 24 to 72) months.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>The mean Tegner activity scale score improved to 9 ± 0.2 postoperatively (<jats:italic>p</jats:italic> < 0.05), while the mean American Orthopaedic Foot and Ankle Society scale score improved to 96 ± 5.1 (range 87 to 100) postoperatively, with 29 of 34 patients (85.3%) achieving a perfect score of 100 (<jats:italic>p</jats:italic> < 0.05). The mean time to return to sports was 8.7 ± 0.7 (range 8 to 10) weeks. The complication rate was low, with no superficial wound infections or venous thromboembolism events; only two patients (5.9%) reported pain and tenderness by 3 months after the index procedure.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Posterior ankle endoscopy for the resection of a posterior process of the talus or an os trigonum and decompression of the tendon of FHL is safe and allows excellent outcomes with low morbidity in athletes with PAIS.</jats:p> </jats:sec>
Scopus© Citations 4 1
Some of the metrics are blocked by your
consent settings
Correction of Sagittal Plane Deformity of the Distal Tibia
(2022)
WAGNER, EMILIO
;
WAGNER HITSCHFELD, PABLO
30 1Scopus© Citations 4
Some of the metrics are blocked by your
consent settings
AOFAS Position Statement Regarding Patient-Reported Outcome Measures
(2018)
Harold B. Kitaoka
;
James E. Meeker
;
Phinit Phisitkul
;
Samuel B. Adams
;
Jonathan R. Kaplan
<jats:p> Outcome measures evaluate various aspects of patient health, and when appropriately utilized can provide valuable information in both clinical practice and research settings. The orthopedic community has placed increasing emphasis on patient-reported outcome measures, recognizing their value for understanding patients’ perspectives of treatment outcomes. Patient-reported outcomes are information directly reported by patients regarding their perceptions of health, quality of life, or functional status without interpretation by healthcare providers. The American Orthopaedic Foot & Ankle Society (AOFAS) supports the use of validated patient-reported outcome (PRO) instruments to assess patient general health, functional status, and outcomes of treatment. It is not possible to recommend a single instrument to collect quality orthopedic data as the selection is dependent on the population being examined and the question being asked. We support the use of the PROMIS Physical Function Computerized Adaptive Test (PF CAT) or Lower Extremity Computerized Adaptive Test (LE CAT), which can be assessed with other domains such as Pain Interference. In addition, a disease-specific measure can be used when available. </jats:p>
1Scopus© Citations 90
Some of the metrics are blocked by your
consent settings
SOFT-TISSUE INJURY TO THE FOOT AND ANKLE: LITERATURE REVIEW AND STAGED MANAGEMENT PROTOCOL
(2019)
Alexandre Leme Godoy-Santos
;
Tim Schepers
;
Cristian Ortiz
<jats:p>ABSTRACT Complex trauma of the foot and ankle is characterized by fractures with severe soft tissue damage associated with neurovascular injury and joint involvement. These injuries are frequently present in the polytraumatized patient and are a predictor of unfavorable clinical outcome. In the initial approach to a patient with complex foot and ankle trauma, the decision between amputation and reconstruction is crucial. The various existing classification systems are of limited effectiveness and should serve as tools to assist and support a clinical decision rather than as determinants of conduct. In the emergency department, one of two treatment options must be adopted: early complete treatment or staged treatment. The former consists of definitive fixation and immediate skin coverage, using either primary closure (suturing) or flaps, and is usually reserved for less complex cases. Staged treatment is divided into initial and definitive. The objectives in the first phase are: prevention of the progression of ischemia, necrosis and infection. The principles of definitive treatment are: proximal-to-distal bone reconstruction, anatomic foot alignment, fusions in severe cartilage lesions or gross instabilities, stable internal fixation and adequate skin coverage. Level of evidence III, Systematic review of level III studies.</jats:p>
Scopus© Citations 7 1

CRIS

Browse

Filters

Settings

Sort By

Results per page

Search Results