Triple arthrodesis in older adults. Results after long-term follow-up.

Graves, Stanley C.; Mann, Roger A.; Graves, Karin O.

doi:10.2106/00004623-199303000-00006

Cited by 225 publications

(114 citation statements)

References 8 publications

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“…This observation is theorized to be the reason that increased rates of ankle arthritis is noted after subtalar fusion and triple arthrodesis. [26][27][28] We believe that the technique described in this study has multiple advantages: it allows for in vivo measuring in weight-bearing and non-weightbearing positions, it allows for muscle contraction during measurements, it allows for quantitative measurements of rotation and translation in all planes of motion, and the technique is noninvasive, making subject recruitment easier. The limitation of our current study is that only three positions in the stance phase of walking were studied.…”

Section: Discussionmentioning

confidence: 99%

Six DOF in vivo kinematics of the ankle joint complex: Application of a combined dual‐orthogonal fluoroscopic and magnetic resonance imaging technique

Wan

Rubash

et al. 2006

Journal Orthopaedic Research

150

128

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Accurate knowledge of in vivo ankle joint complex (AJC) biomechanics is critical for understanding AJC disease states and for improvement of surgical treatments. This study investigated 6 degrees-of-freedom (DOF) in vivo kinematics of the human AJC using a combined dual-orthogonal fluoroscopic and magnetic resonance imaging (MRI) technique. Five healthy ankles of living subjects were studied during three in vivo activities of the foot, including maximum plantarflexion and dorsiflexion, maximum supination and pronation, and three weight-bearing positions in simulated stance phases of walking. A three-dimensional (3D) computer model of the AJC (including tibia, fibula, talus, and calcaneus) was constructed using 3D MR images of the foot. The in vivo AJC position at each selected position of the foot was captured using two orthogonally positioned fluoroscopes. In vivo AJC motion could then be reproduced by coupling the orthogonal images with the 3D AJC model in a virtual dual-orthogonal fluoroscopic system. From maximum dorsiflexion to plantarflexion, the arc of motion of the talocrural joint (47.5 AE 2.28) was significantly larger than that of the subtalar joint (3.1 AE 6.88). Both joints showed similar degrees of internalexternal and inversion-eversion rotation. From maximum supination to pronation, all rotations and translations of the subtalar joint were significantly larger than those of the talocrural joint. From heel strike to midstance, the plantarflexion contribution from the talocrural joint (9.1 AE 5.38) was significantly larger than that of the subtalar joint (À0.9 AE 1.28). From midstance to toe off, internal rotation and inversion of the subtalar joint (12.3 AE 8.38 and À10.7 AE 3.88, respectively) were significantly larger than those of the talocrural joint (À1.6 AE 5.98 and À1.7 AE 2.78). Strong kinematic coupling between the talocrural and subtalar joints was observed during in vivo AJC activities. The contribution of the talocrural joint to active dorsi-plantarflexion was higher than that of the subtalar joint, whereas the contribution of the subtalar joint to active supination-pronation was higher than that of the talocrural joint. In addition, the talocrural joint demonstrated larger motion during the early part of stance phase while the subtalar joint contributes more motion during the later part of stance phase. The results add quantitative data to an in vivo database of normals that can be used in clinical diagnosis, treatment, and evaluation of the AJC after injuries. ß

show abstract

Section: Discussionmentioning

confidence: 99%

Six DOF in vivo kinematics of the ankle joint complex: Application of a combined dual‐orthogonal fluoroscopic and magnetic resonance imaging technique

Wan

Rubash

et al. 2006

Journal Orthopaedic Research

150

128

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“…Triple arthrodesis is more technically demanding than talocalcaneal arthrodesis and is associated with a higher likelihood of problems such as infection, nonunion, malunion, and avascular necrosis of the talus. 7,8,12,14 It should be reserved for patients with more complex problems such as arthritis affecting multiple joints or severe, rigid deformities of the hindfoot.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Triple arthrodesis has been judged to be the standard treatment by some surgeons, 5,6 but because of the complications which may occur, less extensive options such as subtalar arthrodesis have been considered. [1][2][3][4][7][8][9][10] In the few published reports of subtalar arthrodesis in adults, the operation was considered successful in 44% to 89% of patients. [2][3][4] Many different techniques and methods of internal fixation have been used for patients with a variety of diagnoses.…”

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confidence: 99%

Subtalar arthrodesis with internal compression for post-traumatic arthritis

Dahm

Kitaoka

1998

The Journal of Bone and Joint Surgery. British volume

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We studied retrospectively the results in 24 patients (25 feet) who had been treated by subtalar arthrodesis with internal compression for post-traumatic arthritis from 1988 to 1992. Fifteen patients were men (16 feet) and nine (9 feet) were women. Their mean age was 43 years (22 to 68), and the average duration of follow-up was four years (2 to 6). A single compression screw was used in all feet and iliac-crest bone grafting in ten.Union was achieved in 24 of the 25 feet (96%). Based on a clinical scale the results were excellent in 10 feet, good in 7, fair in 6, and poor in 2 and on the Angus and Cowell score they were good in 19 feet, fair in 4, and poor in 2. The two poor results were due to nonunion in one patient and reflex sympathetic dystrophy in the other. One reoperation was performed for nonunion. Eighteen patients (18 feet) were satisfied with the results, four were satisfied with reservations, and three were dissatisfied. Progressive ankle and midfoot arthritis did not occur in the absence of pre-existing degenerative changes in these joints.We conclude that isolated subtalar arthrodesis with internal compression was effective treatment for posttraumatic subtalar arthritis. Iliac-crest bone grafting was not routinely required.

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“…Outcomes after triple arthrodesis have been well described 27, [29][30][31][32][33][34][35][36] . Graves et al reported on a series of eighteen feet in seventeen patients who had undergone triple arthrodesis 30 .…”

Section: Outcomes and Complicationsmentioning

confidence: 99%

“…Graves et al reported on a series of eighteen feet in seventeen patients who had undergone triple arthrodesis 30 . At an average of 3.5 years, pain was decreased in all patients, although eleven feet were the source of residual discomfort.…”

Section: Outcomes and Complicationsmentioning

confidence: 99%

Arthrodesis Techniques in the Management of Stage-Ii and Iii Acquired Adult Flatfoot Deformity

Johnson

2005

The Journal of Bone and Joint Surgery-American Volume

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Triple arthrodesis in older adults. Results after long-term follow-up.

Cited by 225 publications

References 8 publications

Six DOF in vivo kinematics of the ankle joint complex: Application of a combined dual‐orthogonal fluoroscopic and magnetic resonance imaging technique

Six DOF in vivo kinematics of the ankle joint complex: Application of a combined dual‐orthogonal fluoroscopic and magnetic resonance imaging technique

Subtalar arthrodesis with internal compression for post-traumatic arthritis

Arthrodesis Techniques in the Management of Stage-Ii and Iii Acquired Adult Flatfoot Deformity

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