Ankle Arthrodesis has been regarded as a good operative treatment for post traumatic and Rheumatoid arthritis of ankle, and Ankle Arthroplasty has been also developed with several types, from 1970, by Lord & Marotte.
Ankle arthroplasty is more functional & less cosmetic troublesome than arthrodesis, and with more developed prosthesis design, more good result will come.
The authors operated 6 cases of Total Ankle arthroplasty for post traumatic and Rheumatoid Arthritis of ankle, which were also indications of arthrodesis, and introduce the results and operative problems of ankle arthroplasty.
Many patients disabled the knees by severe rheumatiod and degenerative arthritis have been treated with total knee replacement arthroplasty since 1970. Total knee arthroplasty(TKA) afforded much improvement in pain relief and function. We analyzed the result in 32 knees who were performed TKA at Department of Orthopaedic Surgery. Ewha Womans University Hospital from May 1987 to July 1992.
The results were as follows.
1) There were 25 females and 3 males, their mean age was 53 years old.
2) Preoperative etiology was degenerative arthritis in 20 cases, rheumatoid arthritis in 8 cases and osteonecrosis in 4 cases.
3) Knee joint function by Hospital for Special Surgery(HSS) knee rating score was increased from 55.3 points preoperatively to 87.0 points postoperatively.
4) The tibiofemoral angle was changed from 7.4 degree varus to 5.5 degree valgus.
5) The prosthesis type used were Press Fit Condylar(PFC) in 18 knees. Anatomic Modular Knee(AMK) in 6 knees, Miller-Galante(MG) in 4 knees and Porous Coated Anatomic(PCA) in 4 knees.
6) Complication was only one case of knee due to concomitant postoperative deep infection and skin necrosis.
, Do-Sang Cho Recently, motion preservation has come to the forefront of emerging technologies in spine surgery. This is the important background information of the emergence of cervical arthroplasty as an alternative to arthrodesis that offers the promise of restoring normal spinal movement and reduces a kinematic strain on adjacent segments. The study was designed to evaluate early surgical outcome and radiological effects of Bryan cervical disc prosthesis.
The authors retrospectively reviewed radiographic and clinical outcomes in 49 patients who received the Bryan Cervical Disc prosthesis, for whom follow-up data were available. Static and dynamic radiographs were measured by computer to determine the angles formed by the endplates of the natural disc preoperatively, those formed by the shells of the implanted prosthesis, the angle of the FSU, and the C2-7 Cobb angle. The range of motion(ROM) was also determined radiographically, whereas clinical outcomes were assessed using Odom's criteria.
A total of 66 Bryan disc were placed in 49 patients. A single-level procedure was performed in 35 patients, a two-level procedure in 14 patients, and a three-level procedure in 3. Radiographic and clinical assessments were made preoperatively. Mean follow-up duration was 29.2 months, ranging from 6 to 36 months. All of the patients were satisfied with the surgical results by Odom's criteria. The postoperative ROM of the implanted level was preserved without significant difference from preoperative ROM of the operated level. 90% of patients with a preoperative lordotic sagittal orientation of the FSU were able to maintain lordosis. The overall sagittal alignment of the cervical spine was preserved in 89.4% of cases at the final follow up. Interestingly, preoperatively kyphotic FSU resulted in lordotic FSU in 57.7% of patients during the late follow up, and preoperatively kyphotic overall cervical alignment resulted in lordosis in 62.5% of the patients postoperatively.
Arthroplasty using the Bryan disc seemed to be safe and provided encouraging clinical and radiologic outcome in our study. Although early and intermediate results are promising, this is also a relatively new approach, long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.
First
Prev
