Advanced search
1 file | 3.46 MB Add to list

Aseptische Lockerung einer OSG‑Endoprothese : einzeitiger Prothesenwechsel

Author
Organization
Abstract
To revise one or both loosened prosthesis components, to achieve postoperative pain relief, and preserve ankle range of motion. Aseptic loosening of the tibial and/or talar ankle prosthesis components without substantial bone defect of the tibial or talar bone stock. General surgical or anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy (e. g. Charcot arthropathy), substantial nonreconstructable osseous defects with or without cysts on the tibial and/or talar side, non-compliance, patients with primary total ankle replacement (TAR) using intramedullary fixation (stem fixation), patients with severely reduced bone quality, insulin-dependent diabetes mellitus, smoking, unrealistic patient expectations, patients with high activity in sports. Exposure of the ankle joint using the previous incision (anterior or lateral transfibular approach). Mobilization and removal of loosened prosthesis component. Careful debridement of bone stock at bone-prosthesis interface. Determination of prosthesis component size. Implantation of definitive prosthesis components. Wound closure in layers. A soft wound dressing is used. Thromboprophylaxis is recommended. Patient mobilization starts at postoperative day 1 with 15 kg partial weight bearing using a stabilizing walking boot or cast for 6 weeks. Following clinical and radiographic follow-up at 6 weeks, full weight bearing is initiated gradually. Between January 2007 and December 2012 a one-stage revision TAR was performed in 14 patients with a mean age of 52.7 +/- 12.0 years (29.8-70.5 years). The indication for revision surgery was aseptic loosening of one or both prosthesis components. The mean time between the initial TAR and revision surgery was 5.9 +/- 2.9 years (2.0-11.5 years). In 2 patients a tibiotalocalcaneal arthrodesis was performed due to painful aseptic loosening of revision TAR. In all patients a significant pain relief was observed.
Keywords
Articulatio talocruralis, Total ankle replacement, Prosthesis failure, Surgical revision, Arthrodesis, VARUS DEFORMITY, OSTEOTOMY, JOINT, PROSTHESIS, CALCANEUS, SURGERY

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 3.46 MB

Citation

Please use this url to cite or link to this publication:

MLA
Pagenstert, G et al. “Aseptische Lockerung Einer OSG‑Endoprothese : Einzeitiger Prothesenwechsel.” OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE 29.3 (2017): 220–235. Print.
APA
Pagenstert, G., Wimmer, M., Jacxsens, M., Saltzman, C., & Barg, A. (2017). Aseptische Lockerung einer OSG‑Endoprothese : einzeitiger Prothesenwechsel. OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE, 29(3), 220–235.
Chicago author-date
Pagenstert, G, MD Wimmer, Matthijs Jacxsens, CL Saltzman, and A Barg. 2017. “Aseptische Lockerung Einer OSG‑Endoprothese : Einzeitiger Prothesenwechsel.” Operative Orthopadie Und Traumatologie 29 (3): 220–235.
Chicago author-date (all authors)
Pagenstert, G, MD Wimmer, Matthijs Jacxsens, CL Saltzman, and A Barg. 2017. “Aseptische Lockerung Einer OSG‑Endoprothese : Einzeitiger Prothesenwechsel.” Operative Orthopadie Und Traumatologie 29 (3): 220–235.
Vancouver
1.
Pagenstert G, Wimmer M, Jacxsens M, Saltzman C, Barg A. Aseptische Lockerung einer OSG‑Endoprothese : einzeitiger Prothesenwechsel. OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE. 2017;29(3):220–35.
IEEE
[1]
G. Pagenstert, M. Wimmer, M. Jacxsens, C. Saltzman, and A. Barg, “Aseptische Lockerung einer OSG‑Endoprothese : einzeitiger Prothesenwechsel,” OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE, vol. 29, no. 3, pp. 220–235, 2017.
@article{8610715,
  abstract     = {To revise one or both loosened prosthesis components, to achieve postoperative pain relief, and preserve ankle range of motion. 
Aseptic loosening of the tibial and/or talar ankle prosthesis components without substantial bone defect of the tibial or talar bone stock. 
General surgical or anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy (e. g. Charcot arthropathy), substantial nonreconstructable osseous defects with or without cysts on the tibial and/or talar side, non-compliance, patients with primary total ankle replacement (TAR) using intramedullary fixation (stem fixation), patients with severely reduced bone quality, insulin-dependent diabetes mellitus, smoking, unrealistic patient expectations, patients with high activity in sports. 
Exposure of the ankle joint using the previous incision (anterior or lateral transfibular approach). Mobilization and removal of loosened prosthesis component. Careful debridement of bone stock at bone-prosthesis interface. Determination of prosthesis component size. Implantation of definitive prosthesis components. Wound closure in layers. 
A soft wound dressing is used. Thromboprophylaxis is recommended. Patient mobilization starts at postoperative day 1 with 15 kg partial weight bearing using a stabilizing walking boot or cast for 6 weeks. Following clinical and radiographic follow-up at 6 weeks, full weight bearing is initiated gradually. 
Between January 2007 and December 2012 a one-stage revision TAR was performed in 14 patients with a mean age of 52.7 +/- 12.0 years (29.8-70.5 years). The indication for revision surgery was aseptic loosening of one or both prosthesis components. The mean time between the initial TAR and revision surgery was 5.9 +/- 2.9 years (2.0-11.5 years). In 2 patients a tibiotalocalcaneal arthrodesis was performed due to painful aseptic loosening of revision TAR. In all patients a significant pain relief was observed.},
  author       = {Pagenstert, G and Wimmer, MD and Jacxsens, Matthijs and Saltzman, CL and Barg, A},
  issn         = {0934-6694},
  journal      = {OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE},
  keywords     = {Articulatio talocruralis,Total ankle replacement,Prosthesis failure,Surgical revision,Arthrodesis,VARUS DEFORMITY,OSTEOTOMY,JOINT,PROSTHESIS,CALCANEUS,SURGERY},
  language     = {ger},
  number       = {3},
  pages        = {220--235},
  title        = {Aseptische Lockerung einer OSG‑Endoprothese : einzeitiger Prothesenwechsel},
  url          = {http://dx.doi.org/10.1007/s00064-017-0497-5},
  volume       = {29},
  year         = {2017},
}

Altmetric
View in Altmetric
Web of Science
Times cited: