Ankle deformity is a disabling condition especially if concomitant with osteoarthritis (OA). Varus ankle OA is one of the most common ankle OA deformities. This deformity usually leads to unequal load distribution in the ankle joint and decreases joint contact surface area, leading to a progressive degenerative arthritic situation. Varus ankle OA might have multiple causative factors, which might present as a single isolated factor or encompassed together in a single patient. The etiologies can be classified as post-traumatic (e.g., after fractures and lateral ligament instability), degenerative, systemic, neuromuscular, congenital, and others. Treatment options are determined by the degree of the deformity and analyzing the pathology, which range from the conservative treatments up to surgical interventions. Surgical treatment of the varus ankle OA can be classified into two categories, joint-preserving surgery (JPS) and joint-sacrificing surgery (JSS) as total ankle arthroplasty and ankle arthrodesis. JPS is a valuable treatment option in varus ankle OA, which should not be neglected since it has showed a promising result, optimizing biomechanics and improving the survivorship of the ankle joint.
Purpose: This study aims to analyze the return to normal activities and sports after surgical management of peroneal tendon dislocation through different surgical techniques. Methods: This review included studies (retrospective case series, prospective cohort study) that analyzed different aspects: return to sport (RTS), American Orthopedic Foot and Ankle Society Score (AOFAS), Visual Analogue Scale (VAS), satisfaction, and redislocation episodes after surgical treatment. We performed a systematic review, analyzing 1699 articles. We researched our selected studies through PubMed, Scopus, and Cochrane. The last search was performed in December 2022. We used the MINORS score to perform a quality assessment of pooled data. In total, 20 studies were included. Results: The postoperative AOFAS score, VAS scale, and high satisfaction percentages all improve with surgical therapy. At long-term follow-up, the redislocation following surgical treatment is minimal. Compared to patients who only receive superior peroneal retinaculum (SPR) repair and other surgical procedures, patients with groove deepening and SPR repair have greater rates of returning to sports (bony and rerouting procedures). Conclusions: Peroneal tendon dislocation surgery offers good outcomes, a quick return to sport, and high patient satisfaction. Those who received both groove deepening and SPR repair as opposed to other surgical procedures have greater rates of returning to sports.
Dislocations or subluxations of the metatarsophalangeal joints are rare, and open reduction is necessary in special cases. In this case report, we present the case of a 30-year-old man who had chronic dislocation of the V metatarsophalangeal joint after a motorcycle accident. Stiffening of the joint capsule prevented closed reduction therefore the patient underwent surgery, after performing a Gauthier-type osteotomy the joint was stabilized by k-wire. The patient had an excellent recovery with no new dislocation episodes.
Introduction: Revision Total Ankle Arthroplasty (TAA) surgery due to TAA aseptic loosening is increasing. It is possible to exchange the talar component and inlay to another system for isolated talar component loosening in a primary mobile-bearing TAA: Hybrid-Total Ankle Arthroplasty (H-TAA). The purpose of this study was to analyze the results of the revision surgery of an isolated aseptic talar component loosening in a mobile-bearing three-component TAA with a H-TAA solution. Methods: In this prospective case study, nine patients (six women, three men; mean age 59.8 years; range 41–80 years) with symptomatic isolated aseptic loosening of the talar component of a mobile-bearing TAA were treated with an isolated talar component and inlay substitution. In all nine cases, a hybrid TAA revision surgery was performed by implanting a VANTAGE TAA talar and insert component (Flatcut talar component: six cases, standard talar component: three cases). The patients were reviewed with the pain score (VAS Pain Score 0–10), Dorsiflexion/Plantarflexion (DF/PF) Range of Motion (ROM; degrees), the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle/Hindfoot Score (0–100 points), Sports Frequency Score (Level 0–4), and subjective Patients’ Satisfaction Score (0–10 points). Results: The average Pain score improved significantly from preoperative 6.7 points to postoperative 1.1 points (p < 0.001). Average Dorsiflexion/Plantarflexion ROM values increased significantly post-surgery: 21.7° preoperative to 45.6° postoperative (p < 0.001). The postoperative AOFAS scores were significantly greater than the preoperative values: 47.7 points preoperative, 92.3 points postoperative (p < 0.001). The sports activity improved from preoperative to postoperative where, preoperative, none of the patients were able to perform sports. Postoperative, eight patients were able to be sports-active again. The overall average postoperative level of sports activity was 1.4. The postoperative average patient’s satisfaction was 9.3 points. Conclusion: In painful talar component aseptic loosening of a three-component mobile-bearing TAA, H-TAA is a good surgical solution for reducing pain, restoring ankle function, and improving patients’ life quality.
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