Sprunggelenkprothese bei Valgusarthrose

Valderrábano, Víctor; Frigg, Arno; Leumann, André; Horisberger, Monika

doi:10.1007/s00132-011-1825-3

Cited by 24 publications

(4 citation statements)

References 24 publications

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“…The difference in OA susceptibility and prevalence between knee and ankle joints has been posited to be due to different repair responses of these two joints based on differences in their metabolic, biochemical and biomechanical properties [1–11]. The literature related to the prevalence of symptomatic ankle OA is limited, but available references are in general agreement that ankle OA is rare--occurring at a rate of only 1–4% [12]. Trauma is generally believed to account for as much as 80% of ankle OA [13–16]; whereas trauma is believed to account for only 12% of knee OA [15].…”

Section: Introductionmentioning

confidence: 99%

High prevalence of contralateral ankle abnormalities in association with knee osteoarthritis and malalignment

Kraus

Worrell

Renner

et al. 2013

Osteoarthritis and Cartilage

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Objective To evaluate ankle joint abnormalities in a knee osteoarthritis (OA) cohort. Methods Participants (n=159) with symptomatic and radiographic OA in at least one knee underwent technetium-99m methylene diphosphonate bone scan (scored 0–3) of the ankles and forefeet. Knee radiographs were graded for OA features of joint space narrowing (JSN) and osteophyte (OST). Ankle symptoms and history of ankle injury were assessed by self-report. Knee alignment was measured from a long-limb radiograph. Ankle radiographs were obtained on those who returned for follow-up (n=138) and were graded for ankle tibiotalar JSN and OST. Design Ankle scintigraphic abnormalities were frequent (31% of individuals, one-third bilateral). Ankle symptoms were reported by 23% of individuals and history of ankle injury by 24%. Controlling for gender, age, BMI, and contralateral predictor, ankle scintigraphic abnormalities were associated with: ipsilateral ankle symptoms (P=0.005); contralateral knee JSN (P=0.001), knee OST (P=0.006) and knee malalignment (P=0.08); and history of ankle injury or surgery of either ankle (P<0.0001). At follow-up, scintigraphic abnormalities of the ankle were strongly associated with presence of tibiotalar radiographic OA (P<0.0001). Conclusions Although considered rare, we observed a high prevalence of radiographic features of ankle OA in this knee OA cohort. History of overt ankle injury did not appear to account for the majority of ankle abnormalities. These results are consistent with a probable kinematic association of knee OA pathology and contralateral ankle abnormalities and suggest that interventions targeting mechanical factors may be needed to prevent ankle OA in the setting of knee OA.

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Section: Introductionmentioning

confidence: 99%

High prevalence of contralateral ankle abnormalities in association with knee osteoarthritis and malalignment

Kraus

Worrell

Renner

et al. 2013

Osteoarthritis and Cartilage

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“…Hlezno musí být stabilní bez známek varózní nebo valgózní deviace. Varózní nebo valgózní deviace nad 10-15 stupňů má větší výskyt komplikací, korekce deformity náhradou hlezna většinou není možná a je nutné současně s náhradou hlezna provést různé korekční osteotomie patní kosti, vnitřního nebo zevního kotníku nebo i v distální části tibie (9,13,42).…”

Section: Cysty Kolem Implantátuunclassified

“…operací jsou komplikace menší, jak dokazují i literární údaje(1,7,13,15,19,25). V literatuře jsou počty revizních operací různé od 10 do 40 %(1,5,9,13,15,25,29,38,42,46). Záleží na operační technice, na indikaci a hlavně na době sledování.Přežití implantátů podle Kaplanovy-Meierovy křivky v našem souboru je podobné, jako u jiných větších studií(4,17,40).…”

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Eleven-Year Experience with Total Ankle Arthroplasty

Popelka¹,

Sosna²,

Vavřík³

et al. 2016

Acta Chir. orthop. Traum. Cech.

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PURPOSE OF THE STUDYTotal joint replacement is one of the options in surgical treatment of advanced ankle arthritis. It allows the ankle to remain mobile but, unfortunately, it does not provide the same longevity as total knee or hip replacements. Therefore, decisions concerning the kind of treatment are very individual and depend on the clinical status and opinion of each patient. MATERIAL AND METHODSA total of 132 total ankle replacements were carried out in the period from 2004 to 2015. The prostheses used included the Ankle Evolutive System (AES) in 52 patients, Mobility Total Ankle System (DePuy) in 24 patients and, recently, Rebalance Total Ankle Replacement implant in 53 patients. Three patients allergic to metal received the Taric prosthesis. Revision arthroplasty using the Hintegra prosthesis was carried out in four patients.The outcome of arthroplasty was evaluated on the American Orthopaedic Foot and Ankle Society (AOFAS) scoring scale. Indications for total ankle arthroplasty included post-traumatic arthritis in 83 patients, rheumatoid arthritis in 37 and primary arthritis in 12 patients. There were 78 women and 54 men, with an average age of 55.6 years at the time of surgery. RESULTSThe average follow-up was 6.1 years (1-11 years). The average AOFAS score of the whole group increased from 33.2 before surgery to 82.5 after it. The primary indication had an important role. Arthroplasty outcomes were poorer in patients with post-traumatic arthritis than in those with rheumatoid arthritis or primary arthritis. In patients with post-traumatic arthritis, the average AOFAS score rose to 78.6 due to restricted motion of the ankle, and some patients continued to have pain when walking. The average AOFAS score in a total of 49 patients who had rheumatoid arthritis or primary arthritis reached a value of 86.4.Post-operative complications were recorded in ten patients (7.6%) in whom part of the wound was healing by second intention. Ossification was also a frequent complication and had to be removed in six patients (4.5%). No early infection was recorded and late infection was treated in three patients.The prosthesis had to be removed and ankle arthrodesis performed in seven patients (5.3%). All had necrosis of the talus with ankle instability. In five, the retrograde nail Medin was used and extensive defects remaining after talar necrosis were filled with massive bone grafts obtained from a bone bank. One patient required tibio-calcaneal arthrodesis with external fixator; surgery in one case involved the use of a Zimmer Trabecular Metal Ankle Fusion Spacer with retrograde nail fixation.The development of cystic radiolucencies adjacent to tibial or talar components presents another post-operative complication. It was recorded mostly in the patients after AES implantation, in whom eight of 52 (15.3%) had these findings. DISCUSSIONTotal ankle arthroplasty is a complicated surgical procedure potentially associated with various technical problems. The occurrence of complications is indirectly related to the experien...

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“…2 ) bei den rheumatischen Erkrankungen besser als bei den primär arthrotischen, Betroffene mit posttraumatischen Situationen profitieren subjektiv oft weniger gut von Endoprothesen. Sowohl die Endoprothetik am OSG (Lockerungen mit Folgeoperationen) als auch die Versteifungen (aufwendige Nachbehandlung, Pseudarthrosen, Anschlussarthrosen) weisen spezifische Komplikationen auf 23 24 25 26 . Zudem sind differentialindikative Überlegungen für die Wahl des operativen Verfahrens bedeutsam (Talusnekrosen, Achsabweichungen, Anspruch, Begleiterkrankungen, Prognose, Compliance, etc.).…”

Section: Introductionunclassified

OSG-Prothesen am arthritischen und arthrotischen Fuß

Rehart

2022

Aktuelle Rheumatologie

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ZusammenfassungBei den endgradigen Zerstörungen am oberen Sprunggelenk kommt heute den operativen Verfahren der endoprothetischen Versorgung und der Versteifung die entscheidende Rolle zu. Die 3 am meisten betroffenen Patientengruppen sind die mit posttraumatischen, arthrotischen und rheumatischen Folgen. Es bestehen fulminante Unterschiede in den pathophysiologischen Abläufen der Gelenkaffektionen bei den primär degenerativen zu den chronisch-entzündlichen Erkrankungen. Letztere unterliegen besonderen lokalen, regionalen und systemischen Veränderungen, die in Bezug auf die Differentialindikation und das gesamte perioperative Management bekannt sein müssen, um Patienten optimal zu versorgen und Komplikationen zu vermeiden. Beim „Rheumatiker“ gesellt sich zu den immunologisch-induzierten Ko-Morbiditäten noch eine sehr gezielte Basismedikation dazu, die in ihren orthopädisch-unfallchirurgischen und den orthopädisch-rheumatologischen Auswirkungen zu bedenken ist. Initial stehen die gesamten Verfahren der konservativen Behandlung am Sprunggelenk und im Verlauf – vor allem bei entzündlich induzierten Synovialitiden – eine Spiegelung mit Schleimhautresektion und anschließender Radiosynoviorthese zur Verfügung. Zuletzt gewinnt die technisch anspruchsvolle endoprothetische Versorgung am oberen Sprunggelenk seit geraumer Zeit wieder mehr an Bedeutung, vielfach wird von fußchirurgischen Experten jedoch eine Fusion des tibio-talaren Gelenkes bei entsprechender Destruktion bevorzugt. In Deutschland werden rund 2000 OSG-TEP-Implantationen p.a. mit den heute üblichen zementfrei eingesetzten 3-Komponenten-Prothesen ausgeführt, die -besonders bei den rheumatischen Erkrankungen- mittelfristig recht gute Ergebnisse aufweisen. Sowohl die TEP-Versorgung als auch die Fusionseingriffe weisen spezifische Vor- und Nachteile sowie Komplikationsmuster auf. Die Indikation zu den Verfahren ist individuell zu stellen. Fußchirurgische und orthopädisch-rheumatologische Spezialisten für die jeweiligen Patientengruppen können den Fachgesellschaftsseiten entnommen werden.

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Sprunggelenkprothese bei Valgusarthrose

Cited by 24 publications

References 24 publications

High prevalence of contralateral ankle abnormalities in association with knee osteoarthritis and malalignment

High prevalence of contralateral ankle abnormalities in association with knee osteoarthritis and malalignment

Eleven-Year Experience with Total Ankle Arthroplasty

OSG-Prothesen am arthritischen und arthrotischen Fuß

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