Influence of Geometry and Depth of Resections on Bone Support for Total Ankle Replacement.

MedStar author(s):
Citation: Foot & Ankle International. 38(9):1026-1034, 2017 SepPMID: 28675940Institution: MedStar Union Memorial HospitalForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Ankle Joint/su [Surgery] | *Arthroplasty, Replacement, Ankle | *Talus/su [Surgery] | *Tibia/su [Surgery] | *Tomography, X-Ray Computed/mt [Methods] | Arthroplasty, Replacement, Ankle/mt [Methods] | Humans | Tomography, X-Ray Computed/mo [Mortality]Year: 2017Local holdings: Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 1071-1007
Name of journal: Foot & ankle internationalAbstract: BACKGROUND: Aseptic component loosening is a leading cause of revision for total ankle replacement. Different operative approaches for resecting the tibia and talus impact the bony support for the prostheses due to variations in both bone density and resection area, and may therefore impact loosening performance.CLINICAL RELEVANCE: Biomechanical characteristics of total ankle replacement impacted by bony support of the prostheses, including implant stability and resistance to subsidence, may be improved with round resections as compared to flat-cut resections.CONCLUSION: Bony support in total ankle arthroplasty may be decreased using flat resections compared to round resections at comparable resection depths. Estimated differences are resection-level dependent and different for the distal tibia vs the proximal talus.METHODS: Computed tomography data from 116 subjects were obtained, and solid models of the talus and tibia were generated. Bone density, resection area, and bony support were measured on a series of flat resections for each subject, at multiple resection depths. Similar measurements were performed using a series of subject-specific, anatomic radius-based resections ("round resections") at multiple depths. Results were compared to assess the impact of both resection type (flat vs round) and resection depth (6-16 mm for the tibia, 2-6 mm for the talus) on bony support.RESULTS: Statistically significant decreases in bony support for both the talus and the tibia were obtained for flat resections as compared to round resections. A decrease of 8% to 19% for the tibia was seen for all resection depths; a decrease of 8% to 46% for the talus was seen, with greater decreases seen for shallower flat-cut resections.All authors: Bischoff JE, Saltzman C, Schon LFiscal year: FY2018Digital Object Identifier: Date added to catalog: 2017-07-10
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 28675940 Available 28675940

Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006

BACKGROUND: Aseptic component loosening is a leading cause of revision for total ankle replacement. Different operative approaches for resecting the tibia and talus impact the bony support for the prostheses due to variations in both bone density and resection area, and may therefore impact loosening performance.

CLINICAL RELEVANCE: Biomechanical characteristics of total ankle replacement impacted by bony support of the prostheses, including implant stability and resistance to subsidence, may be improved with round resections as compared to flat-cut resections.

CONCLUSION: Bony support in total ankle arthroplasty may be decreased using flat resections compared to round resections at comparable resection depths. Estimated differences are resection-level dependent and different for the distal tibia vs the proximal talus.

METHODS: Computed tomography data from 116 subjects were obtained, and solid models of the talus and tibia were generated. Bone density, resection area, and bony support were measured on a series of flat resections for each subject, at multiple resection depths. Similar measurements were performed using a series of subject-specific, anatomic radius-based resections ("round resections") at multiple depths. Results were compared to assess the impact of both resection type (flat vs round) and resection depth (6-16 mm for the tibia, 2-6 mm for the talus) on bony support.

RESULTS: Statistically significant decreases in bony support for both the talus and the tibia were obtained for flat resections as compared to round resections. A decrease of 8% to 19% for the tibia was seen for all resection depths; a decrease of 8% to 46% for the talus was seen, with greater decreases seen for shallower flat-cut resections.

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