Circular External Fixator–Assisted Ankle Arthrodesis following Failed Total Ankle Arthroplasty

McCoy, Thomas H.; Goldman, Vladimir; Fragomen, Austin T.; Rozbruch, S. Robert

doi:10.3113/fai.2012.0947

Cited by 45 publications

(25 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In patients with fused ankle and hindfoot the goal of the treatment should not be exact LLD equalization. An intentional under-correction to a residual LLD of 0.5-1.0 cm is advisable to permit adequate "swing-through" during gait (McCoy et al 2012). Achieving this goal can become challenging in skeletally immature patients.…”

Section: Discussionmentioning

confidence: 99%

Tibial lengthening using a retrograde magnetically driven intramedullary lengthening device in 10 patients with preexisting ankle and hindfoot fusion

Vogt¹,

Roedl²,

Gosheger

et al. 2020

Acta Orthopaedica

View full text Add to dashboard Cite

Background and purpose — Motorized intramedullary lengthening nails (ILNs) have been developed as an alternative to external fixators for long bone lengthening. The antegrade approach represents the standard method for tibial ILN insertion. In patients with preexisting ankle and hindfoot fusion a retrograde approach provides an alternative technique that has not been evaluated so far. We report the outcome of this method in 10 patients. Patients and methods — This retrospective study included 10 patients (mean age 18 years [13–25]) with preexisting ankle and hindfoot fusion who underwent tibial lengthening with a retrograde ILN (PRECICE). The mean leg length discrepancy (LLD) was 58 mm (36–80). The underlying conditions were congenital (n = 9) and post tumor resection (n = 1). The main outcome measures were: ILN reliability, distraction achieved, distraction index (DIX), time to bone healing, consolidation index (CIX), complications, and functional results. Results — All patients achieved the goal of lengthening (mean 48 mm [26–80]). Average DIX was 0.6 mm/day (0.5–0.7) and mean CIX was 44 days/cm (26–60). Delayed consolidation occurred in 2 patients and healed after ILN dynamization or nail exchange with grafting. Toe contractures in 2 other patients were resolved with physiotherapy or tenotomy. Until last follow-up (mean 18 months [12–30]) no true complications were encountered, knee motion remained unaffected, and full osseous consolidation occurred in all patients. Interpretation — In patients with LLD and preexisting ankle and hindfoot fusion distal tibial lengthening using a retrograde ILN is a reliable alternative to the standard approach with equivalent bone healing potential and low complication rates leaving the knee unaffected.

show abstract

Section: Discussionmentioning

confidence: 99%

Tibial lengthening using a retrograde magnetically driven intramedullary lengthening device in 10 patients with preexisting ankle and hindfoot fusion

Vogt¹,

Roedl²,

Gosheger

et al. 2020

Acta Orthopaedica

View full text Add to dashboard Cite

show abstract

“…43 Fusion constructs can be supplemented with linear or circular external fixation for compression across the fusion mass or to help correct limb-length discrepancy through distraction osteogenesis at a separate, proximal location. 44,45 In these select cases, it is important to preoperatively educate and inform patients regarding the potential lengthy rehabilitation and daily pin-site care required with external frames. If tibiotalocalcaneal arthrodesis is required, fixation may include a fusion nail, locking plate, blade plate, or hybrid construct.…”

Section: Arthrodesismentioning

confidence: 99%

Evaluation and Management of the Painful Total Ankle Arthroplasty

Hsu

Haddad

Myerson

2015

Journal of the American Academy of Orthopaedic Surgeons

View full text Add to dashboard Cite

Total ankle arthroplasty (TAA) is an increasingly popular treatment option for patients with end-stage ankle arthritis. Although improved short- and long-term clinical and radiographic outcomes have been achieved with TAA, revision surgery may be necessary in the setting of aseptic loosening, subsidence, impingement, arthrofibrosis, or infection. Factors such as patient selection, implant design, and surgical technique can all contribute to TAA failure. Treatment of patients with a painful TAA is complex and requires careful consideration of symptom history, workup, and nonsurgical and surgical treatment options. Surgical management of failed TAA includes arthrodesis, revision surgery, or below-knee amputation.

show abstract

“…Furthermore, these options are limited by an inability to achieve the precise anatomic shape for reconstruction according to the shape of the osseous defect (14)(15)(16). These grafting techniques are also not specifically designed to withstand the high loads and forces found in the foot and ankle, which predisposes these techniques to graft collapse (17). Thus, a grafting option with improved structural integrity and the ability to accommodate internal fixation is needed.…”

Section: Introductionmentioning

confidence: 99%

Large Osseous Defect Reconstruction Using a Custom Three-Dimensional Printed Titanium Truss Implant

Mandas

Hlad

2018

The Journal of Foot and Ankle Surgery

View full text Add to dashboard Cite

Treatment of large osseous defects remains a difficult surgical challenge. Autografts and allografts have been known to undergo late collapse, because these options are not specifically designed to withstand the high loads of the foot and ankle. The inability to achieve the correct shape for reconstruction further limits their application. Large osseous defects will result during salvage after failed Lapidus bunionectomy, explantation of failed total ankle replacements, and nonunion of Evans calcaneal osteotomy. Each of 3 patients received a 4WEB custom 3-dimensional (3D) titanium truss implant (Patient Specific Custom Implant; 4WEB Medical, Inc., Frisco, TX) for reconstruction. The mean follow-up period was 17.33 ± 3.51 months. Significant improvement was seen in pain, with a successful return to activities of daily living. The 12-month postoperative computed tomography findings demonstrated incorporation of the implant to the surrounding cortical and cancellous bone. No signs of delayed complications, such as stress shielding or implant failure, were found. This is the first case series to describe the use of a custom 3D-printed titanium truss implant to successfully contribute to reconstruction in the setting of failed elective foot and ankle surgery. This technology might play an important role in limb salvage of osseous defects that would otherwise require bone block arthrodesis with structural allograft or autograft bone.

show abstract

Circular External Fixator–Assisted Ankle Arthrodesis following Failed Total Ankle Arthroplasty

Cited by 45 publications

References 61 publications

Tibial lengthening using a retrograde magnetically driven intramedullary lengthening device in 10 patients with preexisting ankle and hindfoot fusion

Tibial lengthening using a retrograde magnetically driven intramedullary lengthening device in 10 patients with preexisting ankle and hindfoot fusion

Evaluation and Management of the Painful Total Ankle Arthroplasty

Large Osseous Defect Reconstruction Using a Custom Three-Dimensional Printed Titanium Truss Implant

Contact Info

Product

Resources

About