We report the long-term clinical and radiological outcomes of a consecutive series of 200 total ankle arthroplasties (TAAs, 184 patients) at a single centre using the Scandinavian Total Ankle Replacement (STAR) implants. Between November 1993 and February 2000, 200 consecutive STAR prostheses were implanted in 184 patients by a single surgeon. Demographic and clinical data were collected prospectively and the last available status was recorded for further survival analysis. All surviving patients underwent regular clinical and radiological review. Pain and function were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scoring system. The principal endpoint of the study was failure of the implant requiring revision of one or all of the components. Kaplan–Meier survival curves were generated with 95% confidence intervals and the rate of failure calculated for each year.Aims
Patients and Methods
Limb salvage for diabetic foot infections often require multiple
procedures. Some patients will eventually end up with below knee
amputation (BKA) when all limb salvage attempts fail. We seek to
study the patients’ ability to return to normal life, functional
status, prosthesis usage and perspectives on multiple limb salvage
procedures that culminated in BKA to review if they would undertake
a similar path if their situation was repeated. A total of 41 patients who underwent BKA between July 2011 and
June 2013 were reviewed. They were divided into primary and creeping
(prior multiple salvage procedures) amputations. The Barthel’s Index
(BI) and the Reintegration to Normal Living Index (RNLI) were used.
A questionnaire was used to identify whether the patient would undergo
the same multiple attempts at limb salvage again if faced with the
same problem.Aims
Patients and Methods
To examine the mid-term outcome and cost utility of the BioPro
metallic hemiarthroplasty for the treatment of hallux rigidius. We reviewed 97 consecutive BioPro metallic hemiarthroplasties
performed in 80 patients for end-stage hallux rigidus, with a minimum
follow-up of five years. There were 19 men and 61 women; their mean
age was 55 years (22 to 74). No patient was lost to follow-up.Aims
Patients and Methods
The incidence of periprosthetic fractures of
the ankle is increasing. However, little is known about the outcome
of treatment and their management remains controversial. The aim
of this study was to assess the impact of periprosthetic fractures
on the functional and radiological outcome of patients with a total
ankle arthroplasty (TAA). A total of 505 TAAs (488 patients) who underwent TAA were retrospectively
evaluated for periprosthetic ankle fracture: these were then classified
according to a recent classification which is orientated towards
treatment. The outcome was evaluated clinically using the American
Orthopedic Foot and Ankle Society (AOFAS) score and a visual analogue
scale for pain, and radiologically. A total of 21 patients with a periprosthetic fracture of the
ankle were identified. There were 13 women and eight men. The mean
age of the patients was 63 years (48 to 74). Thus, the incidence
of fracture was 4.17%. There were 11 intra-operative and ten post-operative fractures,
of which eight were stress fractures and two were traumatic. The
prosthesis was stable in all patients. Five stress fractures were
treated conservatively and the remaining three were treated operatively. A total of 17 patients (81%) were examined clinically and radiologically
at a mean follow-up of 53.5 months (12 to 112). The mean AOFAS score
at follow-up was 79.5 (21 to 100). The mean AOFAS score in those
with an intra-operative fracture was 87.6 (80 to 100) and for those
with a stress fracture, which were mainly because of varus malpositioning,
was 67.3 (21 to 93). Periprosthetic fractures of the ankle do not
necessarily adversely affect the clinical outcome, provided that
a treatment algorithm is implemented with the help of a new classification
system. Cite this article:
We carried out a prospective study over a period of 12 months to measure the exposure to radiation of the hands of a dedicated foot and ankle surgeon. A thermoluminescent dosimeter ring (TLD) was used to measure the cumulative dose of radiation. Fluoroscopy was used in operations on the foot and ankle. The total screening time was 3028 s, with a mean time per procedure of 37.4 s (0.6 to 197). This correlated positively with the number of procedures performed (r = 0.92, p <
0.001), and with the dose of radiation in both the left (r = 0.85, p = 0.0005) and right TLDs (r = 0.59, p = 0.419). There was no significant difference in the dose of radiation between the two hands ( This is a simple and convenient method for evaluating the exposure of a single surgeon to radiation. The radiation detected was well below the annual dose limit set by the International Commission on Radiological Protection.
