Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ARTHRODESIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2005

Intramedullary compression arthrodesis of the knee: early experience with a new device and technique.

The irretrievably failed total knee arthroplasty is the primary indication for knee arthrodesis. Because this difficult condition is relatively rare, an intramedullary arthrodesis system was developed which requires minimal surgeon experience for successful use. The new system called the Wichita Fusion Nail was implanted by a single surgeon in 13 consecutive patients: 11 for arthrodesis alone, 1 for stabilization of a supracondylar fracture nonunion, and 1 for arthrodesis coupled with a supracondylar fracture nonunion. All arthrodesis attempts were successful. The average fusion time was 15.2 weeks except for 2 infected delayed arthrodeses. Both fracture nonunions persisted and went on to amputation. The WFN provides a simple arthrodesis system with minimal technique dependence and a high potential for success.

Adult↗
PubMed1985

An approach to Kienböck's disease: triscaphe arthrodesis.

Sixteen patients with Kienböck's disease were treated with triscaphe arthrodesis (fusion of the scaphoid, trapezium, and trapezoid) with or without silicone rubber lunate arthroplasty. This approach removes compressive stress from the diseased lunate and treats the accompanying rotary subluxation of the scaphoid. Five patients were treated with triscaphe arthrodesis together with silicone rubber lunate arthroplasty. Three patients, who were symptomatic, after receiving silicone rubber lunate arthroplasty elsewhere, were treated with triscaphe arthrodesis. Eight patients were treated with triscaphe arthrodesis alone, without silicone rubber lunate arthroplasty. Two of these eight patients later required silicone rubber lunate arthroplasty. Radial styloidectomy and small lunate fragment excision were performed later on one patient. After an average follow-up of 20.5 months, relief of pain was satisfactory in all 16 patients. There was neither nonunion nor surgical infection. We believe that triscaphe arthrodesis with a silicone rubber lunate provides a means for load transference and heavy stress use capability of the hand. Triscaphe arthrodesis alone may suffice to bear the wrist load and can be used in an effort to preserve the diseased lunate. A silicone rubber lunate can easily be added at a later date if necessary.

Adolescent↗
PubMed1998

Wrist arthrodesis after failed wrist implant arthroplasty.

Wrist arthroplasty has not achieved large success to date, and there are patients with failures in their procedures who will need arthrodesis. We review our experience in revising a wrist implant arthroplasty to an arthrodesis with a block graft of fresh-frozen allograft femoral head or iliac crest bone graft. Fixation was achieved with an intramedullary Steinmann pin. Ten patients with 12 failed wrist implants required wrist arthrodesis; 7 had wrist arthrodesis with a bulk allograft femoral head, 4 with an iliac crest bone autograft, and 1 without a bone graft. After an average follow-up period of 5 years, all patients were pain free and fusion had been achieved. Complications included 1 patient with acute carpal tunnel syndrome, 2 patients with nonunions requiring secondary bone grafting procedures, and 2 patients requiring revisions of their intramedullar pins. In both nonunions, iliac crest bone graft was used for the initial arthrodesis. All the patients were satisfied. Arthrodesis after failed wrist implant arthroplasty is a satisfactory procedure, and a fresh-frozen allograft can be used effectively in wrist fusion.

Adult↗
PubMedDate not supplied

The effects on subtalar contact and pressure following talonavicular and midtarsal joint arthrodesis.

Many clinical studies have demonstrated the effectiveness of both isolated talonavicular and complete midtarsal joint arthrodesis as an alternative to triple arthrodesis. However, in many cases, controversy exists as to which procedure to utilize. Evidence of degenerative radiographic changes and stiffness of the subtalar joint have been reported postoperatively. A cadaveric study at two different loading values, utilizing low-range pressure film transducers and digital scanning, was performed to quantify articular contact effects on the subtalar joint following isolated talonavicular joint arthrodesis and complete midtarsal joint arthrodesis as compared to the intact specimen. Statistically significant differences were found at p < .05 in this study regarding maximum contact pressure and in location of the applied pressures. Results of this study suggest complete midtarsal joint arthrodesis may be favored over isolated talonavicular joint arthrodesis, especially in the setting of a flatfoot deformity.

Aged↗
PubMedDate not supplied

Biomechanics of the first ray. Part III. Consequences of Lapidus arthrodesis on peroneus longus function: a three-dimensional kinematic analysis in a cadaver model.

It has long been proposed that first metatarsocuneiform joint (FMCJ) arthrodesis, also known as Lapidus arthrodesis, can realign the first ray and permanently lock the FMCJ to control hypermobility. Left unanswered is the functional consequence of peroneus longus (PL) after such a procedure. In this study, the effects of PL on the medial column of the foot before and after metatarsocuneiform arthrodesis were evaluated. Seven fresh-frozen cadaver specimens with an intact foot and ankle were mounted on a custom-made acrylic frame and loaded to 400 N while midstance motor function was simulated with pneumatic actuators. Three-dimensional radiowave tracking transducers were attached to the first metatarsal, medial cuneiform, navicular, and talus to measure osseous movements while tensile loads of 0% to 100% of PL predicted force was applied. Simulated arthrodesis of the metatarsocuneiform joint and then additionally the intercuneiform 1-2 joint was achieved with titanium pins and then retested to determine any change in effect from PL. Significant frontal plane eversion of the medial cuneiform (p = .016) and dorsiflexion of the talus (p = .045) occurred after Lapidus arthrodesis was achieved. This suggests that arthrodesis at the first metatarsocuneiform joint increases the efficiency of PL stabilizing action on the medial column.

Adult↗
PubMedDate not supplied

Hallux rigidus: the long-term results of dorsal wedge osteotomy and arthrodesis in adults.

A variety of treatments are recommended for hallux rigidus. These include arthrodesis of the first metatarsophalangeal joint and dorsal wedge osteotomy of the proximal phalanx. This latter operation is not commonly performed in adults. A retrospective review of a series of 10 osteotomies and 20 arthrodeses after an average of 12 years for hallux rigidus in the adult was undertaken. Patients were assessed at a follow-up clinic and their foot pressures were analyzed. Although the two groups were not matched, some conclusions could be drawn. Both operations were successful in terms of pain relief. Complications were more common after arthrodesis. Callosities were more common after arthrodesis. A greater duration of load occurs toward the fifth metatarsal after arthrodesis. A greater force occurs under the first metatarsal after an osteotomy rather than an arthrodesis. It was concluded that the dorsal wedge osteotomy is an alternative operation for hallux rigidus in the adult, provided that there is some plantarflexion possible at the metatarsophalangeal joint. It is recommended as a procedure to preserve movement at the metatarsophalangeal joint to prevent callosities. If the osteotomy fails to relieve symptoms, then an arthrodesis can be performed as a salvage procedure.

Adolescent↗
PubMed2003

Hindfoot arthrodesis for the adult acquired flat foot.

This article reviews hindfoot arthrodesis for the adult acquired flat foot. Discussion of triple arthrodesis, triple arthrodesis with the addition of a lateral column lengthening procedure, triple arthrodesis with the addition of a plantar flexion first metatarsoncuneiform arthrodesis, and an isolated subtalar arthrodesis are discussed. The indications, surgical techniques, outcome studies, and complications are addressed.

Arthrodesis↗
PubMedDate not supplied

[Shoulder arthrodesis with plate fixation. Special features in cases of resection and defects].

AIM: Shoulder arthrodesis following prosthesis explantation or resection of the acromion has not often been described in the literature. The presented article analyses the special features and problems of these preoperative circumstances in 4 cases and discusses them within the entire group. PATIENTS AND METHOD: Between 06/1987 and 02/2001, a total of 30 shoulder arthrodeses using plate fixation were performed in our clinic and then analysed after an average of 2.7 (0.5 - 8.7) years. Surgery was carried out on 5 (17 %) females and 25 (83 %) males with a mean age of 37 (17 - 82) years. Two patients underwent shoulder arthrodesis as a salvage operation following unsatisfactory arthroplasty, or after trapezius transfer with corresponding reduced bony conditions, respectively. RESULTS: The active extent of movement following arthrodesis was 56 degrees (20 degrees - 90 degrees ) abduction, and 60 degrees (20 degrees - 105 degrees ) anteversion. The most frequent complications following arthrodesis included pseudarthroses (3/10 %), infections (4/13 %), and fractures of the humerus (4/13 %). The rate of complications was especially high in the cases after explantation of a shoulder prosthesis and resection of the acromion. In two of the four patients, three or five revision operations, respectively, were necessary. Two of the three pseudarthroses of the entire group occurred in these two cases. CONCLUSION: Complications of shoulder arthrodesis after resection of the acromion or the proximal humerus are especially frequent. To avoid pseudarthrosis in such cases, primary spongioplasty is advantageous. A fixation with plates is superior to a simple screw arthrodesis. For postoperative immobilization a plaster cast instead of an orthotic device should be taken into consideration.

Adolescent↗
PubMed2005

[Dorsal capsulodesis versus triscaphe arthrodesis in patients with scapholunate dissociation. Do the results depend on the diagnosis or the operation?].

BACKGROUND: Dorsal capsulodesis and triscaphe arthrodesis are possible treatment modalities for patients with scapholunate dissociation. In light of overlapping indications for either operation for patients with carpal instability, it is important to compare the postoperative results. METHODS: From 1998 until 2002, we operated on 87 patients suffering from scapholunate dissociation. 52 patients were treated by dorsal capsulodesis after R. Berger and 35 patients were treated by triscaphe arthrodesis as published by Watson. Of these 87 patients, we managed to follow-up 77 patients (47 dorsal capsulodesis und 30 triscaphe arthrodesis) with a physical examination, X-ray of the wrists and Krimmer Score. RESULTS: In terms of grip-strength, range of motion, functional outcome (Krimmer Score), duration of the operation and hospitalisation, the dorsal capsulodesis group performed better (p < 0.05) than the triscaphe arthrodesis group at the time of follow-up. At follow-up, pain reduction was significant in both groups (p < 0.05). Krimmer Score (functional outcome) and the rate of complication was clearly better for the dorsal capsulodesis group as compared to the triscaphe arthrodesis group. CONCLUSION: In case of non-static scapholunate dissociation, dorsal capsulodesis should be the first choice treatment. In case of a young manually working man with static scapholunate dissociation, it should be a case-to-case decision whether performing a triscaphe arthrodesis or a dorsal capsulodesis. With this investigation we wanted to discuss and demonstrate the difficulties with the differential-indication for the two operations. Generally speaking the postoperative results did not depend on the type of scapholunate dissociation (dynamic versus static) but rather on the chosen surgical procedure.

Adolescent↗
PubMedDate not supplied

[Long-term results after mediocarpal and total arthrodesis of the wrist--a matched paired study].

AIM: Indications for total wrist arthrodesis are still a matter of discussion. The aim of this study was to investigate the long-term results (mean 118 +/- 49.5 months) of total wrist arthrodesis (TA) in comparison to mediocarpal arthrodesis (MA). METHOD: A paired study of the TA group and the MA group was performed including 22 patients after posttraumatic wrist arthrosis in each group. Subjective, objective and radiological parameters were assessed. In addition, the modified Mayo wrist score, the DASH score and the SF-36 were utilized. RESULTS: Mean pain did not differ significantly in both groups. Mean wrist function (DASH) was assessed better by MA patients (25.3 +/- 25.8) compared to TA patients (35.5 +/- 25.9; p > 0.1). Mean total wrist motion in the MA group was 66.1 % of the opposite side. The average grip strength of the TA group was 85.5 % +/- 58.4 % and of the MA group 79.9 % +/- 25.4 % of the uninvolved wrist. The Mayo score of the MA group (56.4 +/- 12.4) was significantly higher than in the TA group (65.9 +/- 16.3; p = 0.04). The SF-36 showed no significant difference between both groups. CONCLUSION: In self-assessment, pain was of higher importance then wrist motion. According to our findings the type of arthrodesis did not influence patient satisfaction. Total wrist arthrodesis should not be excluded categorically as a possible alternative to mediocarpal arthrodesis.

Arthralgia↗
PubMed2005

Tibio-talocalcaneal arthrodesis as a primary procedure using a retrograde intramedullary nail: a retrospective study of 26 patients with rheumatoid arthritis.

BACKGROUND: Arthrodesis of the ankle joint using screws or external fixation is often a demanding procedure, notably in patients with rheumatoid arthritis. We investigated whether tibio-talocalcaneal arthrodesis with the use of an intramedullary nail is a safe and simple procedure. PATIENTS AND METHODS: We retrospectively reviewed 25 ankles (25 patients) at median 3 (1-7) years after tibio-talocalcaneal arthrodesis because of rheumatoid arthritis. All had been operated on by retrograde insertion of a retrograde nail. 5 types of nail had been used. Complications, functional outcome scores, and patient satisfaction were determined and the radiographs evaluated for healing. RESULTS: All but 1 ankle had a radiographically healed arthrodesis. We recorded 3 deep infections, all healed--in 2 cases after extraction of the nail--and the arthrodesis healed in all 3 patients. The average functional scores at follow-up were high, considering that the patients suffered from rheumatoid arthritis. 23 patients were satisfied with the outcome. We found a correlation between the functional scores and the general activity of the disease expressed as a Health Assessment Questionnaire score. INTERPRETATION: In patients with rheumatoid arthritis, tibio-talocalcaneal arthrodesis with a retrograde intra-medullary nail results in a high rate of healing, a high rate of patient satisfaction, and relatively few complications.

Adult↗
PubMed1997

An experimental study of small-joint compression arthrodesis.

Arthrodesis of the interphalangeal and metacarpophalangeal joints is a technically demanding procedure with significant failure rates. A method of compression arthrodesis that was developed by one of the authors (RWB) using a compression clamp and crossed Kirschner wires is reported. This technique has been used without complication in the successful arthrodesis of 125 consecutive interphalangeal and metacarpophalangeal fusions by two of the authors (RWB and JAIG). An in vivo model of small-joint arthrodesis was then developed using the rabbit humeroulnar joint to compare this method of compression clamp arthrodesis with the tension band technique. Biomechanical testing at both 2 and 8 weeks postoperatively showed compression clamp arthrodesis to compare favorably with the tension band technique.

Animals↗
PubMed1999

Subtalar repositional arthrodesis for adult acquired flatfoot.

Arthrodesis of the subtalar joint is well recognized treatment option for moderate or severe flatfoot associated with adult acquired flatfoot secondary to posterior tibial tendon dysfunction. The success of the subtalar arthrodesis is dependent on restoration of normal bony relationships in the hindfoot and midfoot. For this reason, a distinction is made between a repositional arthrodesis and the traditional in situ type of arthrodesis. An in vitro study of the adult acquired flatfoot identifies an anteroposterior subluxation of the subtalar articulation that can be corrected durably and reliably through a repositional talocalcaneal arthrodesis. Intraoperative reduction techniques are useful in obtaining reduction of the peritalar subluxation. There are certain clinical features that help identify patients with flatfoot deformities who are good candidates for subtalar fusion. As the pathoanatomy of the flatfoot deformity is better elucidated, treatment techniques are modified to better address the key elements of the deformity. A repositional subtalar arthrodesis was shown to produce excellent correction in a moderate to severe in vitro flatfoot example in the authors' clinical series.

Adult↗
PubMed2000

Calcaneocuboid distraction arthrodesis for posterior tibial tendon dysfunction and flatfoot: a cadaveric study.

Nine fresh-frozen foot specimens were studied to determine the mechanical behavior of the foot using calcaneocuboid distraction arthrodesis, an operation designed for treatment of posterior tibial tendon dysfunction with flatfoot deformity. Flatfoot deformity was created in cadaveric specimens, and to simulate toe-off phase of gait, loads were applied to the plantar surface of the foot and six tendons. Three-dimensional tarsal bone positions were determined with a magnetic tracking system. With ligament sectioning, flatfoot deformity was observed and average arch height decreased 53 +/- 3.5 mm. Height arch increased after calcaneocuboid distraction arthrodesis an average of 3.2 +/- 3.6 mm and was less than normal arch at an average of 2.1 +/- 2.4 mm. Metatarsotalar alignment compared with flatfoot improved after calcaneocuboid distraction arthrodesis in adduction and inversion to the extent that these were not significantly different from intact foot positions. Calcaneotalar position improved after calcaneocuboid distraction arthrodesis in adduction and inversion. Calcaneocuboid alignment compared with flatfoot improved after calcaneocuboid distraction arthrodesis in adduction, plantar flexion, and eversion, but compared with an intact foot was overcorrected in all three planes of motion. Arch alignment in simulated toe-off phase of gait in cadaveric feet was improved significantly with calcaneocuboid distraction arthrodesis but was not reduced anatomically.

Aged↗
PubMed2006

Factors associated with outcome after subtalar arthrodesis.

OBJECTIVES: To evaluate radiographic and functional outcomes after subtalar arthrodesis and to identify patient factors associated with poor outcome. DESIGN: Retrospective study. SETTING: Two academic hospitals. PATIENTS: Eighty-eight patients with primary or secondary osteoarthritis treated between 1995 and 2002. INTERVENTION: Primary subtalar arthrodesis. MAIN OUTCOME MEASUREMENTS: Radiographic outcome was assessed by determining union rates. Functional outcome was assessed through self-administered questionnaires (Short Form-36, Short Musculoskeletal Function Assessment, and the AAOS Foot and Ankle Instrument). RESULTS: After adjusting for age and sex smokers were 3.8 times more likely to go on to nonunion than nonsmokers (P < 0.05). As patients aged, there was a higher likelihood of nonunion if they also smoked (P < 0.05). Of patients undergoing subtalar bone block distraction arthrodesis 95% went on to union compared with 65% of patients treated with an in situ subtalar arthrodesis without bone graft (P < 0.05). There was a trend for higher rates of union if a bone graft was used among patients treated with an in situ subtalar arthrodesis. Diabetic patients were 18.7 times more likely to have a malunion (P < 0.05). As a group, patients who have undergone subtalar arthrodesis can expect significantly worse functional outcomes compared with the Canadian and American normative populations. The poorest functional outcomes were observed among patients with diabetes. A trend for poorer outcome in bodily pain and general health (Short Form-36) was seen in workers' compensation patients. CONCLUSIONS: Certain patient variables are associated with poorer outcomes after subtalar fusion. The results of this study will enable surgeons to provide better information to patients in preoperative discussions with respect to patient expectations, outcomes, and the success of surgery.

Adult↗
PubMedDate not supplied

Carpal joint arthrodesis as a treatment for chronic septic carpitis in calves and cattle.

Chronic septic carpitis in 72 calves and adult cattle was treated by arthrodesis of the carpus (n = 24), proximal or distal carpal row resection with arthrodesis (n = 31), or resection of both the proximal and distal carpal bones and radio-metacarpal arthrodesis (n = 17). Painfree arthrodesis permitting full weight-bearing was obtained in 69% of the cases. Arthrodesis without resection of carpal bones was successful in 87% of the cases. With resection of one carpal row, 72% of the cases were treated successfully. Radio-metacarpal arthrodesis with removal of both carpal rows resulted in fusion in 35% of the animals.

Animals↗
PubMed2004

Radiocarpal arthrodesis for osteoarthritis following fractures of the distal radius.

To compare the radioscapholunate (RSL) arthrodesis and radiolunate (RL) arthrodesis as a treatment for radiocarpal osteoarthritis following fractures of the distal radius, nine patients, 23 to 70 years old (average 41) at the time of surgery, were assessed two to 33 years after surgery. The periods between injury and surgery ranged from four months to 30 years. RSL arthrodesis was performed in three cases and RL arthrodesis in six. Post-operative wrist pain disappeared in six and was decreased in the other three. In the RSL group, the total arc of wrist flexion and extension was reduced from 50 degrees pre-operatively to 35 degrees post-operatively. In the RL group, it was increased from 72 degrees to 76 degrees after surgery. Grip strength improved in most patients, from 7 to 18 kg in the RSL group, and from 16 to 27 kg in the RL group. On roentogenogram, three patients showed arthritic changes in the adjacent joints, but there were no symptoms in two of the three patients. We concluded that partial radiocarpal arthrodesis (preferably RL arthrodesis) is a reliable procedure for radiocarpal osteoarthritis following fractures of the distal radius.

Adult↗
PubMed2005

Arthrodesis compared to Mayo resection of the first metatarsophalangeal joint in total rheumatoid forefoot reconstruction.

BACKGROUND: Painful forefoot deformity from rheumatoid arthritis can be treated with resection of the lesser metatarsal heads combined with either resection or arthrodesis of the first metatarsophalangeal (MTP) joint. METHODS: In a prospective, randomized study we compared arthrodesis of first MTP joint with Mayo resection as part of total forefoot reconstruction in patients with painful forefoot deformity from rheumatoid arthritis. The lesser metatarsal heads were resected and extensor tenotomy was done in all patients. Thirty-one patients were randomized to either the arthrodesis or resection group. RESULTS: After a mean followup of 36 (26 to 52) months, the median subjective satisfaction score was 96 points out of 100 in the resection group and 92 points in the arthrodesis group. Significant improvements in pain, handicap, and activity according to Foot Function Index (FFI) were found in both groups (p <0.001 except for handicap in resection group and activity in fusion group were p=0.02). There were no statistically significant differences between the groups in these measures, nor in the patients' willingness to have the procedure again. There were no recurrences of prominences or tenderness under the forefoot in either group and no recurrence of severe hallux valgus in the resection group. The arthrodeses healed in 93%. There was no higher risk for clinically relevant IP joint symptoms after arthrodesis. The operating time was significantly longer in the arthrodesis group but this was not linked to a higher wound infection rate. CONCLUSION: These results indicate that Mayo resection may still be a good choice for the first MTP joint in total forefoot reconstruction in patients with rheumatoid arthritis.

Adult↗