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Thomas L Wickiewicz - One of the best experts on this subject based on the ideXlab platform.

  • The Coronal Plane High Tibial Osteotomy. Part 1: A Clinical and Radiographic Analysis of Intermediate Term Outcomes
    HSS Journal, 2007
    Co-Authors: Keith M Baumgarten, Stephen Fealy, Stephen Lyman, Thomas L Wickiewicz
    Abstract:

    The Coronal Plane high tibial osteotomy is a novel technique that is used to treat tibiofemoral malalignment. The authors hypothesize that the Coronal Plane high tibial osteotomy is (1) efficacious in treating both varus and valgus tibiofemoral malalignment; (2) does not alter the slope of the proximal tibia; and (3) does not alter the relationship between the patella and tibial tubercle. A retrospective review of 25 patients with tibiofemoral malalignment (19 varus/6 valgus) treated with a Coronal Plane osteotomy with a minimum of 2-year follow-up was performed. A Kaplan–Meyer survival curve was performed using knee arthroplasty and a Hospital for Special Surgery (HSS) knee score

  • the Coronal Plane high tibial osteotomy part ii a comparison of axial rotation with the opening wedge high tibial osteotomy
    HSS Journal, 2007
    Co-Authors: Keith M Baumgarten, Kate Meyers, Stephen Fealy, Timothy M Wright, Thomas L Wickiewicz
    Abstract:

    The amount of axial rotation in the tibia caused by high tibial osteotomy is relatively unknown. The authors hypothesize that the Coronal Plane high tibial osteotomy, a novel technique used to treat varus malalignment, alters the axial rotation of the tibia less than the opening wedge high tibial osteotomy. Eight, embalmed, stripped cadaveric tibia–fibula constructs with intact interosseous membranes were randomized to either opening wedge or Coronal Plane high tibial osteotomies. Sequential valgus corrections of 5°, 10°, and 15° were performed. The Qualisys Track Manager motion capture system was used to measure axial rotation. Student’s t test was used to compare axial rotation between the two groups. A p value of 0.05 was determined to be significant. The Coronal Plane technique produced rotations about the tibial axis that were statistically significantly smaller than those of the opening wedge technique for all correction angles (1.2° internal rotation (IR) vs 16° external rotation (ER), respectively, at 5° correction; p = 0.02) (3.5° IR vs 21.2° ER at 10° correction; p = 0.04) (4.5° IR vs 23.0° ER at 15° correction; p = 0.01). The Coronal Plane high tibial osteotomy alters axial rotation of the tibia significantly less than the opening wedge high tibial osteotomy.

Roger A. Mann - One of the best experts on this subject based on the ideXlab platform.

  • Correction of Moderate to Severe Coronal Plane Deformity with the STAR™ Ankle Prosthesis
    Foot & ankle international, 2011
    Co-Authors: Sudheer Reddy, Roger A. Mann, Jeffrey A. Mann, Devin R. Mangold
    Abstract:

    Background:Prior studies have demonstrated a correlation between the degree of preoperative Coronal Plane deformity and failure following ankle replacement. We reviewed all of our patients who unde...

  • TOTAL ANKLE REPLACEMENT IN PATIENTS WITH A PRE-OPERATIVE Coronal Plane DEFORMITY: SHORT-TERM RESULTS
    2005
    Co-Authors: Andrew Haskell, Roger A. Mann
    Abstract:

    Introduction and Aims: Many patients having total ankle replacement require correction of a Coronal Plane deformity. This study examines the pre-operative characteristics and short-term results of patients with a Coronal Plane deformity having total ankle replacement. It tests the hypotheses that the pre-operative deformity will be corrected and maintained at two years. Method: Eighteen of 86 patients who underwent Scandinavian Total Ankle Replacement between February 1998 and April 2001 had a pre-operative Coronal Plane deformity ≥ 10° and at least two-year follow-up. The goal of intraoperative alignment was to place all components perpendicular to the plumb line of the body, and to have this position maintained by appropriate ligament balancing. The mean patient age was 62.2±13.2 years. The etiology of arthrosis included eight post-traumatic, five idiopathic, one rheumatoid, and four other. There were 10 men and eight women. Valgus measurements are > 90°. Congruent ankles have pre-operative talar and tibial alignment within 10 degrees. Results: Ligament balancing consisting of lateral ligament reconstruction was performed in six patients and superficial deltoid release was performed in three patients. The eight ankles with pre-operative varus-congruent alignment improved both the talar and tibial alignment immediately post-operatively and at two-year follow-up (p Ankles with an incongruent pre-operative deformity had a greater loss of correction of the talus between the immediate pre-operative period and two-year follow-up than patients with a congruent pre-operative deformity (3.9±2.8 degrees vs. 1.3±1.0 degrees loss of correction, p Conclusion: In patients with a pre-operative Coronal Plane deformity ≥ 10 degrees, alignment after ankle replacement improves toward a neutral axis in the postoperative period and at two-year follow-up. Ankles with incongruent pre-operative deformities have a greater loss of correction over the first two years than ankles with congruent pre-operative deformities.

  • Ankle arthroplasty with preoperative Coronal Plane deformity: short-term results.
    Clinical orthopaedics and related research, 2004
    Co-Authors: Andrew Haskell, Roger A. Mann
    Abstract:

    The treatment of Coronal Plane deformity during total ankle arthroplasty is understood poorly. This study tests the hypotheses that preoperative Coronal Plane malalignment and incongruence of the ankle can be corrected and maintained for 2 years with total ankle replacement, and that factors can be identified that place ankles at risk of having progressive edge-loading develop. Of 86 consecutive patients who had total ankle replacement, 35 had preoperative Coronal Plane alignment > or =10 degrees. Lateral ligament reconstruction was done in seven patients and superficial deltoid release was done in four patients at the time of ankle replacement. Ankles with talar and tibial deformities improved talar and tibial alignment toward a neutral weightbearing axis postoperatively. Ankles with only a talar deformity improved the talar alignment toward a neutral weightbearing axis postoperatively. No changes in alignment were shown during the subsequent 2 years. Postoperative ankle articulations were congruent. Patients with preoperative incongruent joints are 10 times more likely to have progressive edge-loading develop than patients with congruent joints. Surgeons must be attentive to Coronal Plane alignment during and after ankle replacement. Longer followup is needed to assess the longevity of the correction and the impact of minor malalignment on implant wear.

  • Ankle arthroplasty with preoperative Coronal Plane deformity: Short-term results : Total ankle arthroplasty
    Clinical Orthopaedics and Related Research, 2004
    Co-Authors: Andrew Haskell, Roger A. Mann
    Abstract:

    The treatment of Coronal Plane deformity during total ankle arthroplasty is understood poorly. This study tests the hypotheses that preoperative Coronal Plane malalignment and incongruence of the ankle can be corrected and maintained for 2 years with total ankle replacement, and that factors can be identified that place ankles at risk of having progressive edge-loading develop. Of 86 consecutive patients who had total ankle replacement, 35 had preoperative Coronal Plane alignment ≥ 10°. Lateral ligament reconstruction was done in seven patients and superficial deltoid release was done in four patients at the time of ankle replacement. Ankles with talar and tibial deformities improved talar and tibial alignment toward a neutral weightbearing axis postoperatively. Ankles with only a talar deformity improved the talar alignment toward a neutral weightbearing axis postoperatively. No changes in alignment were shown during the subsequent 2 years. Postoperative ankle articulations were congruent. Patients with preoperative incongruent joints are 10 times more likely to have progressive edge-loading develop than patients with congruent joints. Surgeons must be attentive to Coronal Plane alignment during and after ankle replacement. Longer followup is needed to assess the longevity of the correction and the impact of minor malalignment on implant wear.

Keith M Baumgarten - One of the best experts on this subject based on the ideXlab platform.

  • The Coronal Plane High Tibial Osteotomy. Part 1: A Clinical and Radiographic Analysis of Intermediate Term Outcomes
    HSS Journal, 2007
    Co-Authors: Keith M Baumgarten, Stephen Fealy, Stephen Lyman, Thomas L Wickiewicz
    Abstract:

    The Coronal Plane high tibial osteotomy is a novel technique that is used to treat tibiofemoral malalignment. The authors hypothesize that the Coronal Plane high tibial osteotomy is (1) efficacious in treating both varus and valgus tibiofemoral malalignment; (2) does not alter the slope of the proximal tibia; and (3) does not alter the relationship between the patella and tibial tubercle. A retrospective review of 25 patients with tibiofemoral malalignment (19 varus/6 valgus) treated with a Coronal Plane osteotomy with a minimum of 2-year follow-up was performed. A Kaplan–Meyer survival curve was performed using knee arthroplasty and a Hospital for Special Surgery (HSS) knee score

  • the Coronal Plane high tibial osteotomy part ii a comparison of axial rotation with the opening wedge high tibial osteotomy
    HSS Journal, 2007
    Co-Authors: Keith M Baumgarten, Kate Meyers, Stephen Fealy, Timothy M Wright, Thomas L Wickiewicz
    Abstract:

    The amount of axial rotation in the tibia caused by high tibial osteotomy is relatively unknown. The authors hypothesize that the Coronal Plane high tibial osteotomy, a novel technique used to treat varus malalignment, alters the axial rotation of the tibia less than the opening wedge high tibial osteotomy. Eight, embalmed, stripped cadaveric tibia–fibula constructs with intact interosseous membranes were randomized to either opening wedge or Coronal Plane high tibial osteotomies. Sequential valgus corrections of 5°, 10°, and 15° were performed. The Qualisys Track Manager motion capture system was used to measure axial rotation. Student’s t test was used to compare axial rotation between the two groups. A p value of 0.05 was determined to be significant. The Coronal Plane technique produced rotations about the tibial axis that were statistically significantly smaller than those of the opening wedge technique for all correction angles (1.2° internal rotation (IR) vs 16° external rotation (ER), respectively, at 5° correction; p = 0.02) (3.5° IR vs 21.2° ER at 10° correction; p = 0.04) (4.5° IR vs 23.0° ER at 15° correction; p = 0.01). The Coronal Plane high tibial osteotomy alters axial rotation of the tibia significantly less than the opening wedge high tibial osteotomy.

Keun-bae Lee - One of the best experts on this subject based on the ideXlab platform.

  • Outcomes of Total Ankle Arthroplasty in Ankles with >20° of Coronal Plane Deformity.
    The Journal of bone and joint surgery. American volume, 2019
    Co-Authors: Gun-woo Lee, Keun-bae Lee
    Abstract:

    BACKGROUND A preoperative severe Coronal Plane deformity of >20° has been considered a contraindication for total ankle arthroplasty. We aimed to evaluate whether outcomes of total ankle arthroplasty in ankles with severe Coronal Plane deformity (20° to 35° of varus or valgus) are comparable with those with moderate deformity (5° to 15° of varus or valgus). METHODS A total of 148 consecutive ankles (142 patients) that underwent primary total ankle arthroplasty using the HINTEGRA prosthesis were included. The overall mean follow-up duration was 74 months (range, 24 to 160 months). We divided all patients into 2 groups according to the preoperative Coronal Plane tibiotalar angle: the severe group (36 patients, 41 ankles) and the moderate group (106 patients, 107 ankles). Clinical and radiographic outcomes were analyzed for intergroup differences, and multivariable regression was used to adjust for baseline characteristics. Patients in each group showed similar characteristics in mean age, sex, mean body mass index, and median follow-up duration. RESULTS At a mean follow-up of 74 months, we found no significant intergroup difference in the Ankle Osteoarthritis Scale pain and disability score, American Orthopaedic Foot & Ankle Society ankle-hindfoot score, Short Form-36 Physical Component Summary score, visual analog scale pain score, or ankle range of motion (p > 0.05). However, the final tibiotalar angle, talar tilt angle, and number of outliers were greater in the severe group (p 0.05). The overall survival probability of the implant was 91.3% (92.3% in the severe group and 90.7% in the moderate group) (p = 0.354). CONCLUSIONS Total ankle arthroplasty in ankles with preoperative severe Coronal Plane deformity showed satisfactory and comparable clinical outcomes without increasing complication rates relative to those with moderate deformity in the intermediate-term follow-up. Our results suggested that total ankle arthroplasty may be considered in ankles with deformity of >20°. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

  • outcomes of total ankle arthroplasty in ankles with 20 of Coronal Plane deformity
    Journal of Bone and Joint Surgery American Volume, 2019
    Co-Authors: Gun-woo Lee, Keun-bae Lee
    Abstract:

    BACKGROUND A preoperative severe Coronal Plane deformity of >20° has been considered a contraindication for total ankle arthroplasty. We aimed to evaluate whether outcomes of total ankle arthroplasty in ankles with severe Coronal Plane deformity (20° to 35° of varus or valgus) are comparable with those with moderate deformity (5° to 15° of varus or valgus). METHODS A total of 148 consecutive ankles (142 patients) that underwent primary total ankle arthroplasty using the HINTEGRA prosthesis were included. The overall mean follow-up duration was 74 months (range, 24 to 160 months). We divided all patients into 2 groups according to the preoperative Coronal Plane tibiotalar angle: the severe group (36 patients, 41 ankles) and the moderate group (106 patients, 107 ankles). Clinical and radiographic outcomes were analyzed for intergroup differences, and multivariable regression was used to adjust for baseline characteristics. Patients in each group showed similar characteristics in mean age, sex, mean body mass index, and median follow-up duration. RESULTS At a mean follow-up of 74 months, we found no significant intergroup difference in the Ankle Osteoarthritis Scale pain and disability score, American Orthopaedic Foot & Ankle Society ankle-hindfoot score, Short Form-36 Physical Component Summary score, visual analog scale pain score, or ankle range of motion (p > 0.05). However, the final tibiotalar angle, talar tilt angle, and number of outliers were greater in the severe group (p 0.05). The overall survival probability of the implant was 91.3% (92.3% in the severe group and 90.7% in the moderate group) (p = 0.354). CONCLUSIONS Total ankle arthroplasty in ankles with preoperative severe Coronal Plane deformity showed satisfactory and comparable clinical outcomes without increasing complication rates relative to those with moderate deformity in the intermediate-term follow-up. Our results suggested that total ankle arthroplasty may be considered in ankles with deformity of >20°. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Andrew Haskell - One of the best experts on this subject based on the ideXlab platform.

  • TOTAL ANKLE REPLACEMENT IN PATIENTS WITH A PRE-OPERATIVE Coronal Plane DEFORMITY: SHORT-TERM RESULTS
    2005
    Co-Authors: Andrew Haskell, Roger A. Mann
    Abstract:

    Introduction and Aims: Many patients having total ankle replacement require correction of a Coronal Plane deformity. This study examines the pre-operative characteristics and short-term results of patients with a Coronal Plane deformity having total ankle replacement. It tests the hypotheses that the pre-operative deformity will be corrected and maintained at two years. Method: Eighteen of 86 patients who underwent Scandinavian Total Ankle Replacement between February 1998 and April 2001 had a pre-operative Coronal Plane deformity ≥ 10° and at least two-year follow-up. The goal of intraoperative alignment was to place all components perpendicular to the plumb line of the body, and to have this position maintained by appropriate ligament balancing. The mean patient age was 62.2±13.2 years. The etiology of arthrosis included eight post-traumatic, five idiopathic, one rheumatoid, and four other. There were 10 men and eight women. Valgus measurements are > 90°. Congruent ankles have pre-operative talar and tibial alignment within 10 degrees. Results: Ligament balancing consisting of lateral ligament reconstruction was performed in six patients and superficial deltoid release was performed in three patients. The eight ankles with pre-operative varus-congruent alignment improved both the talar and tibial alignment immediately post-operatively and at two-year follow-up (p Ankles with an incongruent pre-operative deformity had a greater loss of correction of the talus between the immediate pre-operative period and two-year follow-up than patients with a congruent pre-operative deformity (3.9±2.8 degrees vs. 1.3±1.0 degrees loss of correction, p Conclusion: In patients with a pre-operative Coronal Plane deformity ≥ 10 degrees, alignment after ankle replacement improves toward a neutral axis in the postoperative period and at two-year follow-up. Ankles with incongruent pre-operative deformities have a greater loss of correction over the first two years than ankles with congruent pre-operative deformities.

  • Ankle arthroplasty with preoperative Coronal Plane deformity: short-term results.
    Clinical orthopaedics and related research, 2004
    Co-Authors: Andrew Haskell, Roger A. Mann
    Abstract:

    The treatment of Coronal Plane deformity during total ankle arthroplasty is understood poorly. This study tests the hypotheses that preoperative Coronal Plane malalignment and incongruence of the ankle can be corrected and maintained for 2 years with total ankle replacement, and that factors can be identified that place ankles at risk of having progressive edge-loading develop. Of 86 consecutive patients who had total ankle replacement, 35 had preoperative Coronal Plane alignment > or =10 degrees. Lateral ligament reconstruction was done in seven patients and superficial deltoid release was done in four patients at the time of ankle replacement. Ankles with talar and tibial deformities improved talar and tibial alignment toward a neutral weightbearing axis postoperatively. Ankles with only a talar deformity improved the talar alignment toward a neutral weightbearing axis postoperatively. No changes in alignment were shown during the subsequent 2 years. Postoperative ankle articulations were congruent. Patients with preoperative incongruent joints are 10 times more likely to have progressive edge-loading develop than patients with congruent joints. Surgeons must be attentive to Coronal Plane alignment during and after ankle replacement. Longer followup is needed to assess the longevity of the correction and the impact of minor malalignment on implant wear.

  • Ankle arthroplasty with preoperative Coronal Plane deformity: Short-term results : Total ankle arthroplasty
    Clinical Orthopaedics and Related Research, 2004
    Co-Authors: Andrew Haskell, Roger A. Mann
    Abstract:

    The treatment of Coronal Plane deformity during total ankle arthroplasty is understood poorly. This study tests the hypotheses that preoperative Coronal Plane malalignment and incongruence of the ankle can be corrected and maintained for 2 years with total ankle replacement, and that factors can be identified that place ankles at risk of having progressive edge-loading develop. Of 86 consecutive patients who had total ankle replacement, 35 had preoperative Coronal Plane alignment ≥ 10°. Lateral ligament reconstruction was done in seven patients and superficial deltoid release was done in four patients at the time of ankle replacement. Ankles with talar and tibial deformities improved talar and tibial alignment toward a neutral weightbearing axis postoperatively. Ankles with only a talar deformity improved the talar alignment toward a neutral weightbearing axis postoperatively. No changes in alignment were shown during the subsequent 2 years. Postoperative ankle articulations were congruent. Patients with preoperative incongruent joints are 10 times more likely to have progressive edge-loading develop than patients with congruent joints. Surgeons must be attentive to Coronal Plane alignment during and after ankle replacement. Longer followup is needed to assess the longevity of the correction and the impact of minor malalignment on implant wear.