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Clinics in Podiatric Medicine and Surgery
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Revision surgery for failed total ankle replacement is a challenge to the revision surgeon. Deformity, presence of infection, segmental bone defects, patient comorbidities, and soft tissue compromise all are significant considerations when determining appropriate procedures. Revision total ankle replacement, explant and fusion with or without lengthening, use of a trabecular metal cage, placement of an antibiotic cement spacer, grafting, and amputation all are viable options to treat patients wi...
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#1Erin Nelson (Des Moines University)
#2Nephi E.H. Jones (UnityPoint Health)
Last. Mary Brandt (Des Moines University)
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This article reviews the basic anatomy and physiology of tendon healing and ways to use biologics with tendon surgery. Many different products have been used, and this article reviews the literature to distinguish what is still recommended or proven effective through research.
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#1Mitchell J. Thompson (Gundersen Health System)H-Index: 1
#2Thomas S. Roukis (Gundersen Health System)H-Index: 28
Last. Thomas S. Roukis (Gundersen Health System)H-Index: 11
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Osteochondral lesion of the talar dome (OCLT) can be a devastating injury that affects mobility. Etiology of these lesions is debated but trauma seems the most supported etiology. Diagnosis of lesions is based on imaging. Conservative management, including weight-bearing restrictions, physical therapy, and supportive measures, often is first-line treatment. Nonsurgical modalities have mixed results and surgical measures often are necessitated for symptom relief. Surgical treatments vary in invas...
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A malaligned ankle arthrodesis is a painful and complicated pathology. Deformities may be present in the frontal, sagittal, or transverse plane or a combination of planes. Thorough preoperative evaluation of the deformity and the patient as a whole is crucial to successful revision. Surgical site for revision should be based on center of rotation of angulation, when possible. Revision commonly is performed through opening wedge osteotomy. Closing wedge and focal dome osteotomies, however, are ex...
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#1Sean T. GrambartH-Index: 4
#1Sean T. Grambart (Des Moines University)
Last. Travis Drew Anderson (Des Moines University)
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Union rates vary for arthrodesis sites and bone healing in foot and ankle surgery. The ultimate goal is to achieve complete bone healing within a reasonable time. There are many factors that surgeons cannot control, such as the patient's compliance and ability to heal. However, surgeons can control osseous preparation, stable fixation, preservation of soft tissue, and the osseous fusion initial healing environment. Modification of the healing environment can be achieved with the use of bone graf...
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#1Sean T. Grambart (Des Moines University)
#1Sean T. GrambartH-Index: 4
Last. Joseph R. Brown (Des Moines University)
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Although most primary lateral ankle ligament repairs have a high success rate, as with any surgery, failures and the need for revision can occur. Nonanatomic lateral ankle ligament repairs have fallen out of favor because of the increased stiffness and resultant change in mechanics of the functioning tendon that is normally used. Allograft anatomic lateral ankle ligament reconstruction for revision surgery has gained popularity over the last few years. This article discusses the factors that can...
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#1Eric A. Barp (UnityPoint Health)H-Index: 3
#2Nephi E.H. Jones (UnityPoint Health)
Last. Ryan D. Prusa (UnityPoint Health)
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Revision surgeries, as well as conversions from implants to arthrodesis, can present unique challenges to the foot and ankle surgeon. Proper perioperative planning assists in optimizing the outcome of the procedure. In general, some amount of bone loss and/or shortening of the first metatarsal takes place, leading to the need for augmenting the site with bone graft or a synthetic substitute. Fixation also plays a key role in obtaining a successful conversion. A solid construct combined with bone...
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Nonunion of the tarsometatarsal arthrodesis site is a challenging revision surgery. Trephine technique provides an excellent option for revision tarsometatarsal joint arthrodesis. The authors have found the trephine approach to be the procedure of choice in correction of a nonunion. When the trephine approach is indicated, it offers many advantages including minimal soft tissue dissection, quicker joint preparation, and the minimal shortening of the arthrodesis site. This article describes in de...
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Lapidus arthrodesis is becoming more of a common procedure for treatment of hallux valgus deformities. Like other procedures, complications are possible. The common complications associated with Lapidus arthrodesis procedures include nonunion and malunion. Malunion is typically broken down into recurrence, elevated first ray, shortened first ray, or plantarflexed first ray. This article discusses these common complications after Lapidus arthrodesis.
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Top fields of study
Surgery
Physical therapy
Ankle
Deformity
Orthopedic surgery
Medicine