Tibiotalocalcaneal arthrodesis with a triple-bend intramedullary nail (A3)—2-year follow-up in 60 patients

Richter, Martinus; Zech, Stefan

doi:10.1016/j.fas.2015.06.005

Cited by 21 publications

(17 citation statements)

References 35 publications

(85 reference statements)

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“…Their group reported an arthrodesis rate of 91% of the entire cohort as well as significant improvements in VAS pain scores postoperatively. 11 The purpose of this study was to evaluate the rate of successful TTC arthrodesis for a novel anatomical intramedullary nail (A3, Stryker, Kalamazoo, MI). We report a 70% rate of successful TTC arthrodesis using the A3 Fusion Nail.…”

Section: Discussionmentioning

confidence: 99%

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Tibiotalocalcaneal Arthrodesis Using a Novel Retrograde Intramedullary Nail

Steele

Lazarides

DeOrio

2019

Foot & Ankle Specialist

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Background. Tibiotalocalcaneal (TTC) arthrodesis is a common treatment option for complex hindfoot pathology. Overall union rates range from 50% to 86% but can be even lower in certain populations. A novel retrograde intramedullary nail has recently been developed. The purpose of this study was to report fusion rates, time to weight-bearing, and complications with the use of the A3 Fusion Nail. Methods. All patients 18 years or older who underwent TTC arthrodesis with an A3 Fusion Nail at a single institution from 2010 to 2015 with a minimum 3-month follow-up were included in this study. Rates of successful fusion, time to union, time to weight-bearing, and complications were evaluated. A total of 20 patients with an average age of 58.1 years and an average follow-up of 12.5 months met inclusion criteria. Results. Successful TTC arthrodesis was achieved in 14 of 20 patients (70%) overall. Average time to union was 8.1 months, and average time to weight-bearing was 6.8 weeks. Of 20 patients, 17 (85%) required femoral head allograft for bulk bone defects, and the union rate in this subset of patients was 76.5%. The rates of revision surgery (10%) and complications were low. Conclusion. The A3 Fusion Nail demonstrated a favorable safety profile and achieved TTC arthrodesis at a rate consistent with historical data despite being used in a patient population at high risk for nonunion. In patients with bulk bone defects at high risk for nonunion, the A3 Fusion Nail demonstrated superior rates of fusion (76.5%) to those reported in the literature (50%). Level of Evidence: Level III: Retrospective cohort study

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Section: Discussionmentioning

confidence: 99%

“…There is an aiming device for preparation of the canal for the nail and an aiming arm for precise locking screw placement. 11…”

Section: Implantmentioning

confidence: 99%

Tibiotalocalcaneal Arthrodesis Using a Novel Retrograde Intramedullary Nail

Steele

Lazarides

DeOrio

2019

Foot & Ankle Specialist

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“…( 2015 ), Thomas et al. ( 2015 ), Richter and Zech ( 2016 ). A 12% non-union rate was found in a study by Pelton et al.…”

Section: Discussionmentioning

confidence: 99%

Re-arthrodesis after primary ankle fusion: 134/1,716 cases from the Swedish Ankle Registry

et al. 2018

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Background and purpose — Arthrodesis is the most common treatment of severe ankle arthritis. Large studies on the occurrence of re-arthrodesis are few, especially with information in terms of risk. We used the National Swedish Ankle Registry to assess incidence and risk factors for re-arthrodesis.Patients and methods — In the Registry, we examined the occurrence of re-arthrodesis in 1,716 patients with a primary ankle arthrodesis. We also analyzed associations between the re-arthrodesis risk and sex, diagnosis, and surgical method.Results — The risk of first re-arthrodesis at 2.5 years was 7.4% and the rate at 9 years 7.8%. The risk following arthroscopic surgery with fixation by screws was 15%, which is statistically significantly higher than the 8% following the gold standard technique with open screw fixation, the 5% following fixation by intramedullary nailing, and the 3% following fixation by plate and screws. Patients with either idiopathic osteoarthritis or posttraumatic arthritis had a higher risk of re-arthrodesis than patients with rheumatoid arthritis. We could not find that the risk of re-arthrodesis was associated with sex.Interpretation — In Sweden, the re-arthrodesis risk varied by primary technique and was especially high after arthroscopic surgery. Reasons are unknown but poor surgical technique and/or surgeon inexperience may contribute, as may patient selection.

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“…16,21 A recent clinical study with a 2-year follow-up for TTCAs with A3 nails showed sufficient union rates after 2 years. 24 The authors included 60 patients with a mean age of 58.5 years (range 22-80 years). Control of bony fusion of an arthrodesis was performed by clinical checkups and standard radiographs of the ankle.…”

Section: Discussionmentioning

confidence: 99%