How well can skin marker analysis detect the kinematics of a total ankle arthroplasty? - a comparison to videofluoroscopy

ISSN:1757-114

Hallux rigidus: Wird das Kunstgelenk neuer Goldstandard?

Die Arthrodese gilt ohne Zweifel seit vielen Jahren als Goldstandard für die Behandlung einer schweren Arthrose des Grosszehengrundgelenkes (MP1Gelenk). Neuerdings versprechen jedoch Biomaterialien, als Gelenkersatz implantiert, mindestens so gute Ergebnisse bei gleichzeitigem Erhalt der Beweglichkeit. Motiviert durch die Resultate einer seriös durchgeführten internationalen, multizentrischen Studie1 tendieren immer mehr Chirurgen dazu, diesem Weg zu folgen. Nun stellt sich auch uns die Frage: Ist das mit gutem Gewissen vertretbar

Surgical repair of acute Achilles tendon rupture using a "mini-open" technique

For active patients, surgery is usually the preferred treatment for an acute Achilles tendon rupture. Classical open techniques require a long tendon exposure, which can result in damage to its blood supply and gliding structures. Adhesions may form, which impair the final functional result. Closed surgical techniques do not allow for a perfect adaptation of the tendon stumps and have a higher rate of rerupture. The "mini-open" technique has advantages over both of these techniques. Percutaneously introduced threads prevent adhesions along the tendon. The rupture is exposed through a minimal incision and is carefully sutured with fine threads to allow a direct healing process without the formation of intermediate scar tissue. The minimally invasive approach and the introduction of percutaneous threads considerably reduce the time spent in surgery. An aggressive rehabilitation program can be initiated 1 week after surgery and allows good early functional results

Which Are the Most Frequently Used Outcome Instruments in Studies on Total Ankle Arthroplasty?

The number of studies reporting on outcomes after total ankle arthroplasty is continuously increasing. As the use of valid outcome measures represents the cornerstone for successful clinical research, we aimed to identify the most frequently used outcome instruments in ankle arthroplasty studies and to analyze the evidence to support their use in terms of different quality criteria. A systematic review of the literature identified 15 outcome instruments reported in 79 original studies. The most commonly used measures were the American Orthopaedic Foot and Ankle Society hindfoot score (n = 41), the Kofoed ankle score (n = 21), a visual analog scale assessing pain (n = 15), and the generic SF-36 (n = 6). Eight additional instruments were used only once or twice. The American Orthopaedic Foot and Ankle Society and Kofoed instruments include a clinical examination and score up to 100 points. Evidence to support their use in terms of validity, reliability, responsiveness, and interpretability is limited, raising the question whether their use is justified. Self-reported questionnaires related to ankle osteoarthritis or arthroplasty are rather disregarded in the current literature, and only the Foot Function Index is associated with evidence in terms of the above-mentioned quality criteria. Future research is warranted to improve the outcome assessment after total ankle arthroplasty

Limited open repair of Achilles tendon ruptures: a technique with a new instrument and findings of a prospective multicenter study

Controversy persists regarding the ideal surgical technique for repair of a ruptured Achilles tendon. We propose a limited open procedure with use of an instrument that provides the advantage of an open repair but avoids the soft-tissue problems with which open repair has been associated