Biomechanical Design of the Total Ankle Prosthesis

Calderale, P. M.; Garro, Adrienne; Barbiero, R; G, Fasolio; Pipino, F

doi:10.1243/emed_jour_1983_012_020_02

Cited by 47 publications

(22 citation statements)

References 15 publications

(5 reference statements)

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“…[4] and Kofoed [8]. The upper prostheses [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Nowadays, there is no total ankle articulation of the system makes gliding and rotation replacement that shows results that are comparable possible while the lower articulation allows extension to those achieved in hip or knee joint replacement.…”

Section: Fractures Osteochondritis Dissecans and Haemophilicmentioning

confidence: 99%

Total ankle replacement. Review and critical analysis of the current status

Bauer

Eberhardt

Rosenbaum

et al. 1996

Foot and Ankle Surgery

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Section: Fractures Osteochondritis Dissecans and Haemophilicmentioning

confidence: 99%

Total ankle replacement. Review and critical analysis of the current status

Bauer

Eberhardt

Rosenbaum

et al. 1996

Foot and Ankle Surgery

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“…Sufficient bone stock is a prerequisite for durability of total ankle replacements [14]; supporting this idea is the fact that one of the most common reasons for implant failure is talar subsidence resulting from periprosthetic osteolysis from polyethylene wear or direct mechanical insufficiency of the underlying bone stock [19,40]. Therefore, given that the mean patient age at total ankle replacement implantation is between 50 and 60 years, knowledge of a potential age effect on bone quality of the talus is of paramount importance [23,42].…”

Section: Introductionmentioning

confidence: 99%

Bone Microarchitecture of the Talus Changes With Aging

Krause

Rupprecht

Mumme

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Fractures of the talus in the elderly are rare and usually result from high-impact injuries, suggesting only minor age-related bone structure changes. However, total ankle replacement failures with age often result from talar subsidence, suggesting age-related bone loss in the talus. Despite a number of histological analyses of talar microarchitecture, the effects of age and sex on talar microarchitecture changes remain poorly defined.Questions/purposes The aim of this study was to analyze changes or differences in the trabecular microarchitecture of the talus with regard to (1) age and (2) sex. Methods Sixty human tali were harvested from 30 patients at autopsy of three different age groups (20-40, 41-60, 61-80 years). The specimens were analyzed by radiography, micro-CT, and histological analysis. Given that there was no difference between the left and right talus, static histomorphometric parameters were assessed in three regions of interest of the right talus only (body, neck, head; n = 30). Results The talar body, neck, and head were affected differently by age-related changes. The greatest loss of bone volume with age was seen in the talar body (estimate: À0.239; 95% confidence interval [CI], À0.365 to À0.114; p \ 0.001). In the talar neck (estimate: À0.165; 95% CI, À0.307 to À0.023; p = 0.025), bone loss was only moderate and primarily was the result of reduction in trabecular thickness (estimate: À1.288; 95% CI, À2.449 to À0.127; p = 0.031) instead of number (estimate: À0.001; 95% CI, À0.005 to À0.003; p = 0.593). Bone structure changes were independent of sex. Conclusions Age-related bone structure changes predominantly occur in the talar body, which poses a potential risk factor for total ankle replacement loosening. The moderate changes in the talar neck might explain the persistent low incidence of talar neck fractures with age.

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“…Previous designs of TAA focused exclusively on the geometry of the prosthetic components in relation to the morphologic features of the intact articular surface of the talus [5,8,17,28]. A mathematical analysis (Fig.…”

Section: Introductionmentioning

confidence: 99%

Total Ankle Replacement Compatible with Ligament Function Produces Mobility, Good Clinical Scores, and Low Complication Rates: An Early Clinical Assessment

Giannini

Romagnoli

O’Connor

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background A three-part ankle replacement was developed to achieve compatibility with the natural ligaments by allowing fibers on the medial and lateral sides to remain isometric during passive motion. Unlike all current prostheses, the new design uses nonanatomically shaped components on the tibia and talus and a fully conforming interposed meniscal bearing.Questions/purposes Does this new design restore ankle mobility, improve clinical score, and result in low complication and early revision rates? Patients and Methods We reviewed 51 patients in whom 51 prostheses were implanted in a seven-center trial from July 2003 to July 2006. The mean age of the patients at surgery was 61.5 years (range, 35.1-82.5 years). We used the AOFAS score to assess clinical outcome. We used lateral radiographs to assess function. The minimum followup was 24 months (mean, 30 months; range, 24-48 months). Results The mean preoperative AOFAS score of 38.5 increased to 76.9, 79.1, 76.4, and 79.0 at 12, 24, 36, and 48 months, respectively. We observed a correlation between meniscal bearing movement on the tibial component (mean, 3.4 mm; range, 2-12 mm) and range of flexion at the replaced ankle (mean, 27.48; range, 168-538). We revised one arthroplasty in the second postoperative year for lateral impingement, providing a 3-year cumulative survival rate of 97% and performed one other secondary operation for hindfoot pain. Conclusions These data suggest the new prosthesis can provide short-term restoration of ankle mobility, a good clinical score, and low complication and failure rates. Longer followup with larger numbers is required.

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Biomechanical Design of the Total Ankle Prosthesis

Cited by 47 publications

References 15 publications

Total ankle replacement. Review and critical analysis of the current status

Total ankle replacement. Review and critical analysis of the current status

Bone Microarchitecture of the Talus Changes With Aging

Total Ankle Replacement Compatible with Ligament Function Produces Mobility, Good Clinical Scores, and Low Complication Rates: An Early Clinical Assessment

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