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Luis Carlos Becerra - One of the best experts on this subject based on the ideXlab platform.
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Response to Dr. Belthur’s letter to the editor on the article: “Talonavicular Joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy”
Journal of children's orthopaedics, 2009Co-Authors: Camilo Andrés Turriago, Myriam Fernanda Arbeláez, Luis Carlos BecerraAbstract:Dear Editor, We have read the letter by Dr. Mohan V. Belthur and we appreciate his interesting questions about our article entitled Talonavicular Joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy, which was published in the June 2009 issue of the Journal of Children’s Orthopaedics (pp. 179–183). We are happy to answer his questions: We consider a foot valgus deformity to be severe when the deformity is rigid, does not allow the foot to be a stable support structure, and constitutes a lever arm dysfunction. These patients have a “midfoot break” that simulates a soleus insufficiency. We did not consider brace intolerance to be a variable since most of our patients didn’t use braces preoperatively. As a matter of fact, preoperatively many of them had a severe crouch gait and were unable to wear a brace. In the postoperative period all of them used braces and most tolerated them well. We have the same experience: when the foot is well corrected it is much easier to adapt and tolerate a brace. Ankle valgus was diagnosed clinically postoperatively and then confirmed radiographically. We missed the diagnosis during the preoperative evaluation and attributed the valgus deformity only to the foot. We actually recommend ruling out associated ankle valgus deformities with X rays in addition to the clinical examination. Davis et al.’s measurements are useful when evaluating the preoperative foot, but once the head of the talus is surgically deformed for the fusion it is difficult to assess its original limits, and once the fusion is achieved it is even more difficult. For this reason we used the AP and lateral talo-first metatarsal angle to compare the pre- and postoperative alignments of the medial column. We did not use kinematic data for the purposes of this paper since the values of the standard kinematic gait protocols are still not useful for assessing foot deformities. Additionally, the change in kinetics and kinematics of the foot can also depend on proximal surgical procedures, so isolating the single effect of the foot on gait is not always possible; e.g., derotational tibial osteotomies or hindfoot equinus correction will also modify the kinetics and kinematics of the ankle. We used pedobarography at our gait lab, but during the course of the study our laboratory was updated, and we changed from a Novel® to a BTS® pedobarography system with a different capture system and output, so we were unable to compare the information. We had the same bad results reported by others with conventional triple arthrodesis for spastic valgus foot deformities. We improved our results when we used an additional medial approach for the fusion of the Talonavicular Joint, and it was evident that the key to correcting the foot was the proper reduction of this Joint. We began by fusing the Talonavicular Joint, and soon it was obvious that the foot deformity was nicely corrected and the other fusions seemed to be unnecessary. The Talonavicular Joint is the most mobile articulation of the foot, so instability is more likely to occur on it. Subluxation of this articulation is usually evident on weight-bearing AP X rays. When evaluating the foot instability, we try to be sure that the Talonavicular Joint is the only one that is unstable. Testing the foot mobility under anesthesia with the help of the image intensifier can be helpful. Once fusion is obtained, the mobility of the foot should be tested again. We thank Dr. Belthur for his intelligent questions and we hope that we have clarified the issues that he raised. Sincerely, Camilo A. Turriago, MD; Myriam Fernanda Arbelaez, P.T; Luis Carlos Becerra, MD.
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response to dr belthur s letter to the editor on the article Talonavicular Joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy
Journal of Children's Orthopaedics, 2009Co-Authors: Camilo Andrés Turriago, Myriam Fernanda Arbeláez, Luis Carlos BecerraAbstract:Dear Editor, We have read the letter by Dr. Mohan V. Belthur and we appreciate his interesting questions about our article entitled Talonavicular Joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy, which was published in the June 2009 issue of the Journal of Children’s Orthopaedics (pp. 179–183). We are happy to answer his questions: We consider a foot valgus deformity to be severe when the deformity is rigid, does not allow the foot to be a stable support structure, and constitutes a lever arm dysfunction. These patients have a “midfoot break” that simulates a soleus insufficiency. We did not consider brace intolerance to be a variable since most of our patients didn’t use braces preoperatively. As a matter of fact, preoperatively many of them had a severe crouch gait and were unable to wear a brace. In the postoperative period all of them used braces and most tolerated them well. We have the same experience: when the foot is well corrected it is much easier to adapt and tolerate a brace. Ankle valgus was diagnosed clinically postoperatively and then confirmed radiographically. We missed the diagnosis during the preoperative evaluation and attributed the valgus deformity only to the foot. We actually recommend ruling out associated ankle valgus deformities with X rays in addition to the clinical examination. Davis et al.’s measurements are useful when evaluating the preoperative foot, but once the head of the talus is surgically deformed for the fusion it is difficult to assess its original limits, and once the fusion is achieved it is even more difficult. For this reason we used the AP and lateral talo-first metatarsal angle to compare the pre- and postoperative alignments of the medial column. We did not use kinematic data for the purposes of this paper since the values of the standard kinematic gait protocols are still not useful for assessing foot deformities. Additionally, the change in kinetics and kinematics of the foot can also depend on proximal surgical procedures, so isolating the single effect of the foot on gait is not always possible; e.g., derotational tibial osteotomies or hindfoot equinus correction will also modify the kinetics and kinematics of the ankle. We used pedobarography at our gait lab, but during the course of the study our laboratory was updated, and we changed from a Novel® to a BTS® pedobarography system with a different capture system and output, so we were unable to compare the information. We had the same bad results reported by others with conventional triple arthrodesis for spastic valgus foot deformities. We improved our results when we used an additional medial approach for the fusion of the Talonavicular Joint, and it was evident that the key to correcting the foot was the proper reduction of this Joint. We began by fusing the Talonavicular Joint, and soon it was obvious that the foot deformity was nicely corrected and the other fusions seemed to be unnecessary. The Talonavicular Joint is the most mobile articulation of the foot, so instability is more likely to occur on it. Subluxation of this articulation is usually evident on weight-bearing AP X rays. When evaluating the foot instability, we try to be sure that the Talonavicular Joint is the only one that is unstable. Testing the foot mobility under anesthesia with the help of the image intensifier can be helpful. Once fusion is obtained, the mobility of the foot should be tested again. We thank Dr. Belthur for his intelligent questions and we hope that we have clarified the issues that he raised. Sincerely, Camilo A. Turriago, MD; Myriam Fernanda Arbelaez, P.T; Luis Carlos Becerra, MD.
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Talonavicular Joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy
Journal of Children's Orthopaedics, 2009Co-Authors: Camilo Andrés Turriago, Myriam Fernanda Arbeláez, Luis Carlos BecerraAbstract:Purpose The purpose of this report is to review our experience with Talonavicular Joint arthrodesis for the treatment of severe valgus foot deformities in older children and adolescents with cerebral palsy (CP). Methods The clinical, radiographic, and gait parameters results after Talonavicular Joint arthrodesis were retrospectively reviewed in 32 patients (59 feet) with valgus deformities of the foot. The surgery was performed as part of multiple simultaneous surgeries for the treatment of gait disorders. The mean age of the patients was 13.9 years (range 9–20 years) and the mean follow-up was 40 months (range 18.3–66.7 months). Results The clinical and radiographic measurements improved significantly ( P = 0.000). There were no significant changes in gait parameters. Symptoms were relieved in most patients with symptomatic preoperative feet. The most frequent complication was pseudoarthrosis, which occurred in seven feet. We found a high rate of satisfaction of patients (or parents) and most of them recommended the procedure to other patients with the same condition. Conclusion Talonavicular Joint arthrodesis is a reliable technique that provides both functionally and cosmetically good results with a low rate of complications in the treatment of severe pes planus valgus in older children and adolescents with CP. Careful examination should rule out concomitant ankle valgus deformities. A stable fixation of the arthrodesis is recommended.
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Talonavicular Joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy.
Journal of children's orthopaedics, 2009Co-Authors: Camilo Andrés Turriago, Myriam Fernanda Arbeláez, Luis Carlos BecerraAbstract:Purpose The purpose of this report is to review our experience with Talonavicular Joint arthrodesis for the treatment of severe valgus foot deformities in older children and adolescents with cerebral palsy (CP).
William R. Ledoux - One of the best experts on this subject based on the ideXlab platform.
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Talonavicular Joint coverage and bone morphology between different foot types
Journal of Orthopaedic Research, 2014Co-Authors: Philip K. Louie, Bruce J. Sangeorzan, Michael J. Fassbind, William R. LedouxAbstract:This study explored three dimensional (3D) Talonavicular Joint (TNJ) coverage/orientation and bone morphology to reveal parameters that could classify and identify predispositions to cavus and planus feet. 3D models of 65 feet from 40 subjects were generated from computed tomography images classified as pes cavus, neutrally aligned, or asymptomatic/symptomatic pes planus. We calculated the talar and navicular overlap (TNJ coverage). We also measured orientation of the navicular, morphological parameters of the talus and navicular, and angular position of the talar head to body. Pes cavus showed significantly less Talonavicular coverage (58 ± 2% talus and 86 ± 2% navicular) compared to asymptomatic pes planus (63 ± 2% and 95 ± 2%) and neutrally aligned feet (98 ± 2% navicular), and significantly more navicular dorsiflexion and adduction relative to the talus (p < 0.0083). The talar head in cavus feet was inverted relative to the body compared to planus feet (p < 0.0083). For symptomatic pes planus, significant abduction was measured for the navicular relative to the talus and the talar head was plantar flexed relative to the body (p < 0.0083). The talar head in planus feet was everted relative to the body compared to neutrally aligned feet. Both intrinsic (bone morphology) and extrinsic (bone position) differences exist in groups of feet described as cavus and planus. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:958–966, 2014.
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Talonavicular Joint coverage and bone morphology between different foot types.
Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 2014Co-Authors: Philip K. Louie, Bruce J. Sangeorzan, Michael J. Fassbind, William R. LedouxAbstract:This study explored three dimensional (3D) Talonavicular Joint (TNJ) coverage/orientation and bone morphology to reveal parameters that could classify and identify predispositions to cavus and planus feet. 3D models of 65 feet from 40 subjects were generated from computed tomography images classified as pes cavus, neutrally aligned, or asymptomatic/symptomatic pes planus. We calculated the talar and navicular overlap (TNJ coverage). We also measured orientation of the navicular, morphological parameters of the talus and navicular, and angular position of the talar head to body. Pes cavus showed significantly less Talonavicular coverage (58 ± 2% talus and 86 ± 2% navicular) compared to asymptomatic pes planus (63 ± 2% and 95 ± 2%) and neutrally aligned feet (98 ± 2% navicular), and significantly more navicular dorsiflexion and adduction relative to the talus (p
Camilo Andrés Turriago - One of the best experts on this subject based on the ideXlab platform.
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Response to Dr. Belthur’s letter to the editor on the article: “Talonavicular Joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy”
Journal of children's orthopaedics, 2009Co-Authors: Camilo Andrés Turriago, Myriam Fernanda Arbeláez, Luis Carlos BecerraAbstract:Dear Editor, We have read the letter by Dr. Mohan V. Belthur and we appreciate his interesting questions about our article entitled Talonavicular Joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy, which was published in the June 2009 issue of the Journal of Children’s Orthopaedics (pp. 179–183). We are happy to answer his questions: We consider a foot valgus deformity to be severe when the deformity is rigid, does not allow the foot to be a stable support structure, and constitutes a lever arm dysfunction. These patients have a “midfoot break” that simulates a soleus insufficiency. We did not consider brace intolerance to be a variable since most of our patients didn’t use braces preoperatively. As a matter of fact, preoperatively many of them had a severe crouch gait and were unable to wear a brace. In the postoperative period all of them used braces and most tolerated them well. We have the same experience: when the foot is well corrected it is much easier to adapt and tolerate a brace. Ankle valgus was diagnosed clinically postoperatively and then confirmed radiographically. We missed the diagnosis during the preoperative evaluation and attributed the valgus deformity only to the foot. We actually recommend ruling out associated ankle valgus deformities with X rays in addition to the clinical examination. Davis et al.’s measurements are useful when evaluating the preoperative foot, but once the head of the talus is surgically deformed for the fusion it is difficult to assess its original limits, and once the fusion is achieved it is even more difficult. For this reason we used the AP and lateral talo-first metatarsal angle to compare the pre- and postoperative alignments of the medial column. We did not use kinematic data for the purposes of this paper since the values of the standard kinematic gait protocols are still not useful for assessing foot deformities. Additionally, the change in kinetics and kinematics of the foot can also depend on proximal surgical procedures, so isolating the single effect of the foot on gait is not always possible; e.g., derotational tibial osteotomies or hindfoot equinus correction will also modify the kinetics and kinematics of the ankle. We used pedobarography at our gait lab, but during the course of the study our laboratory was updated, and we changed from a Novel® to a BTS® pedobarography system with a different capture system and output, so we were unable to compare the information. We had the same bad results reported by others with conventional triple arthrodesis for spastic valgus foot deformities. We improved our results when we used an additional medial approach for the fusion of the Talonavicular Joint, and it was evident that the key to correcting the foot was the proper reduction of this Joint. We began by fusing the Talonavicular Joint, and soon it was obvious that the foot deformity was nicely corrected and the other fusions seemed to be unnecessary. The Talonavicular Joint is the most mobile articulation of the foot, so instability is more likely to occur on it. Subluxation of this articulation is usually evident on weight-bearing AP X rays. When evaluating the foot instability, we try to be sure that the Talonavicular Joint is the only one that is unstable. Testing the foot mobility under anesthesia with the help of the image intensifier can be helpful. Once fusion is obtained, the mobility of the foot should be tested again. We thank Dr. Belthur for his intelligent questions and we hope that we have clarified the issues that he raised. Sincerely, Camilo A. Turriago, MD; Myriam Fernanda Arbelaez, P.T; Luis Carlos Becerra, MD.
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response to dr belthur s letter to the editor on the article Talonavicular Joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy
Journal of Children's Orthopaedics, 2009Co-Authors: Camilo Andrés Turriago, Myriam Fernanda Arbeláez, Luis Carlos BecerraAbstract:Dear Editor, We have read the letter by Dr. Mohan V. Belthur and we appreciate his interesting questions about our article entitled Talonavicular Joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy, which was published in the June 2009 issue of the Journal of Children’s Orthopaedics (pp. 179–183). We are happy to answer his questions: We consider a foot valgus deformity to be severe when the deformity is rigid, does not allow the foot to be a stable support structure, and constitutes a lever arm dysfunction. These patients have a “midfoot break” that simulates a soleus insufficiency. We did not consider brace intolerance to be a variable since most of our patients didn’t use braces preoperatively. As a matter of fact, preoperatively many of them had a severe crouch gait and were unable to wear a brace. In the postoperative period all of them used braces and most tolerated them well. We have the same experience: when the foot is well corrected it is much easier to adapt and tolerate a brace. Ankle valgus was diagnosed clinically postoperatively and then confirmed radiographically. We missed the diagnosis during the preoperative evaluation and attributed the valgus deformity only to the foot. We actually recommend ruling out associated ankle valgus deformities with X rays in addition to the clinical examination. Davis et al.’s measurements are useful when evaluating the preoperative foot, but once the head of the talus is surgically deformed for the fusion it is difficult to assess its original limits, and once the fusion is achieved it is even more difficult. For this reason we used the AP and lateral talo-first metatarsal angle to compare the pre- and postoperative alignments of the medial column. We did not use kinematic data for the purposes of this paper since the values of the standard kinematic gait protocols are still not useful for assessing foot deformities. Additionally, the change in kinetics and kinematics of the foot can also depend on proximal surgical procedures, so isolating the single effect of the foot on gait is not always possible; e.g., derotational tibial osteotomies or hindfoot equinus correction will also modify the kinetics and kinematics of the ankle. We used pedobarography at our gait lab, but during the course of the study our laboratory was updated, and we changed from a Novel® to a BTS® pedobarography system with a different capture system and output, so we were unable to compare the information. We had the same bad results reported by others with conventional triple arthrodesis for spastic valgus foot deformities. We improved our results when we used an additional medial approach for the fusion of the Talonavicular Joint, and it was evident that the key to correcting the foot was the proper reduction of this Joint. We began by fusing the Talonavicular Joint, and soon it was obvious that the foot deformity was nicely corrected and the other fusions seemed to be unnecessary. The Talonavicular Joint is the most mobile articulation of the foot, so instability is more likely to occur on it. Subluxation of this articulation is usually evident on weight-bearing AP X rays. When evaluating the foot instability, we try to be sure that the Talonavicular Joint is the only one that is unstable. Testing the foot mobility under anesthesia with the help of the image intensifier can be helpful. Once fusion is obtained, the mobility of the foot should be tested again. We thank Dr. Belthur for his intelligent questions and we hope that we have clarified the issues that he raised. Sincerely, Camilo A. Turriago, MD; Myriam Fernanda Arbelaez, P.T; Luis Carlos Becerra, MD.
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Talonavicular Joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy
Journal of Children's Orthopaedics, 2009Co-Authors: Camilo Andrés Turriago, Myriam Fernanda Arbeláez, Luis Carlos BecerraAbstract:Purpose The purpose of this report is to review our experience with Talonavicular Joint arthrodesis for the treatment of severe valgus foot deformities in older children and adolescents with cerebral palsy (CP). Methods The clinical, radiographic, and gait parameters results after Talonavicular Joint arthrodesis were retrospectively reviewed in 32 patients (59 feet) with valgus deformities of the foot. The surgery was performed as part of multiple simultaneous surgeries for the treatment of gait disorders. The mean age of the patients was 13.9 years (range 9–20 years) and the mean follow-up was 40 months (range 18.3–66.7 months). Results The clinical and radiographic measurements improved significantly ( P = 0.000). There were no significant changes in gait parameters. Symptoms were relieved in most patients with symptomatic preoperative feet. The most frequent complication was pseudoarthrosis, which occurred in seven feet. We found a high rate of satisfaction of patients (or parents) and most of them recommended the procedure to other patients with the same condition. Conclusion Talonavicular Joint arthrodesis is a reliable technique that provides both functionally and cosmetically good results with a low rate of complications in the treatment of severe pes planus valgus in older children and adolescents with CP. Careful examination should rule out concomitant ankle valgus deformities. A stable fixation of the arthrodesis is recommended.
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Talonavicular Joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy.
Journal of children's orthopaedics, 2009Co-Authors: Camilo Andrés Turriago, Myriam Fernanda Arbeláez, Luis Carlos BecerraAbstract:Purpose The purpose of this report is to review our experience with Talonavicular Joint arthrodesis for the treatment of severe valgus foot deformities in older children and adolescents with cerebral palsy (CP).
C.s. Kumar - One of the best experts on this subject based on the ideXlab platform.
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An anatomical study comparing two surgical approaches for isolated Talonavicular fusion
2018Co-Authors: Z. Higgs, Quentin A. Fogg, C.s. KumarAbstract:Isolated Talonavicular arthrodesis is a common procedure particularly for posttraumatic arthritis and rheumatoid arthritis. Two surgical approaches are commonly used: the medial approach and the dorsal approach. It is recognized that access to the lateral aspect of the Talonavicular Joint can be limited when using the medial approach and it is our experience that using the dorsal approach addresses this issue. We performed an anatomical study using cadaver specimens, to compare the amount of articular surface that can be accessed, and therefore prepared for arthodesis , by each surgical approach. Medial and dorsal approaches to the Talonavicular Joint were performed on each of 10 cadaveric specimens. Distraction of the Joint was performed as standard for preparation of articular surfaces during Talonavicular arthrodesis. The accessible area of articular surface was marked for each of the two approaches. Disarticulation was performed and the marked surface area was quantified using a digital Microscribe allowing a three dimensional virtual model of the articular surfaces to be assessed. This study will provide quantifiable measurements of the articular surface accessible by the medial and dorsal approaches to the Talonavicular Joint. These data may provide support for the use of the dorsal approach for Talonavicular arthrodesis .
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An Anatomical Study Comparing Two Surgical Approaches for Isolated Talonavicular Arthrodesis
Foot & ankle international, 2014Co-Authors: Z. Higgs, Quentin A. Fogg, Bilal Jamal, C.s. KumarAbstract:Background:Two operative approaches are commonly used for isolated Talonavicular arthrodesis: the medial and the dorsal approach. It is recognized that access to the lateral aspect of the Talonavicular Joint can be limited when using the medial approach, and it is our experience that using the dorsal approach addresses this issue. We performed an anatomical study using cadaver specimens, to compare the amount of articular surface that can be accessed by each operative approach.Methods:Medial and dorsal approaches to the Talonavicular Joint were performed on each of 11 cadaveric specimens (10 fresh frozen, 1 embalmed). Distraction of the Joint was performed as used intraoperatively and the accessible area of articular surfaces was marked for each of the 2 approaches using a previously reported technique. Disarticulation was performed and the marked surface area was quantified using an immersion digital microscribe, allowing a 3-dimensional virtual model of the articular surfaces to be assessed.Results:The ...
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AN ANATOMICAL STUDY COMPARING TWO SURGICAL APPROACHES FOR ISOLATED Talonavicular FUSION
Journal of Bone and Joint Surgery-british Volume, 2013Co-Authors: Z. Higgs, Quentin A. Fogg, C.s. KumarAbstract:Isolated Talonavicular arthrodesis is a common procedure particularly for posttraumatic arthritis and rheumatoid arthritis. Two surgical approaches are commonly used: the medial and the dorsal approach. It is recognized that access to the lateral aspect of the Talonavicular Joint can be limited when using the medial approach and it is our experience that using the dorsal approach addresses this issue. We performed an anatomical study using cadaver specimens, to compare the amount of articular surface that can be accessed, and therefore prepared for arthodesis, by each surgical approach. Medial and dorsal approaches to the Talonavicular Joint were performed on each of 11 cadaveric specimens (10 fresh frozen, 1 embalmed). Distraction of the Joint was performed as used intraoperatively for preparation of articular surfaces during Talonavicular arthrodesis. The accessible area of articular surface was marked for each of the two approaches using a previous reported technique. Disarticulation was performed and the marked surface area was quantified using an immersion digital microscribe, allowing a three dimensional virtual model of the articular surfaces to be assessed. The median percentage of accessible total Talonavicular articular surface for the medial and dorsal approaches was 71% and 92% respectively. This difference was significant (Wilcoxon Signed Ranks Test, p This study provides quantifiable measurements of the articular surface accessible by the medial and dorsal approaches to the Talonavicular Joint. These data support for the use of the dorsal approach for Talonavicular arthrodesis.
Sakae Tanaka - One of the best experts on this subject based on the ideXlab platform.
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Excision Arthroplasty With Interpositional Achilles Tendon Autograft: A Novel Approach to Talonavicular Joint Osteoarthritis Associated With Ankle Arthrodesis
Journal of Foot & Ankle Surgery, 2020Co-Authors: Takumi Matsumoto, Taro Kasai, Akihiro Uchio, Naohiro Izawa, Juji Takuo, Sakae TanakaAbstract:Abstract Talonavicular Joint arthritis is a great concern after ankle fusion. Although arthrodesis is the gold standard treatment for this complication, it could initiate a vicious cycle of further adjacent Joint arthritis. An alternative that may delay or eliminate the need for arthrodesis is excision arthroplasty; however, there are only a few reports on its application on a Talonavicular Joint. We report 3 cases of excision arthroplasty with interpositional Achilles tendon autograft for the treatment of end-stage Talonavicular osteoarthritis in low-demand elderly patients. In 1 patient, excision arthroplasty was performed after tibiotalocalcaneal arthrodesis, and in 2 patients, it was performed after tibiotalar arthrodesis, in which the subtalar Joints were also damaged and fused simultaneously on performance of the interpositional arthroplasty of the Talonavicular Joint. In all cases, pain relief and functional activities of daily living improvement were achieved with this procedure. At a minimum follow-up of 1 year, no patient reported adjacent Joint symptoms or flatfoot progression. These cases show that interpositional arthroplasty with Achilles tendon autograft is an effective treatment for end-stage Talonavicular arthritis in patients with fused ankle and subtalar Joints. This procedure was helpful in relieving pain and improving activities of daily living function in low-demand elderly patients with the preservation of movement of the Talonavicular Joint. Autograft was considered to be superior to other grafts with respect to availability, graft rejection, or allergy development. Fused subtalar Joint resolved the concerning issues, such as flatfoot progression and muscular weakness of ankle plantar flexion, associated with this procedure.
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Lateral collapse of the tarsal navicular in patients with rheumatoid arthritis: Implications for pes planovarus deformity.
Modern rheumatology, 2018Co-Authors: Takumi Matsumoto, Yuji Maenohara, Song Ho Chang, Jun Hirose, Takuo Juji, Katsumi Ito, Sakae TanakaAbstract:AbstractObjectives: In patients with rheumatoid arthritis (RA), the Talonavicular Joint is commonly involved and midfoot collapse can lead to progressive flattening of the arch. Despite a general awareness of the important structural role of the Talonavicular Joint in rheumatoid foot disease, details of its destructive pattern have not been elucidated.Methods: We cross-sectionally investigated 176 RA patients (342 feet) and classified their feet into the following five groups according to radiographic findings: arthritis (RA changes with normal navicular shape), Muller–Weiss Disease (MWD) (collapse of the lateral aspect of the tarsal navicular), flat (flattened navicular), ankylosis (ankylosis of the Talonavicular Joint), and normal. We compared medical histories and radiographic measurements among all five groups.Results: The arthritis group comprised 91 feet, 36 in the MWD group, nine in the flat group, 12 in the ankylosis group, and 194 classified as normal. The MWD group demonstrated a trend towards p...
