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Biomedical subjects

Roger A Mann

Publications and source records attributed to Roger A Mann.

9 recordsLinked to original sources
PubMed2004

Ankle arthroplasty with preoperative coronal plane deformity: short-term results.

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 Joint↗
PubMed2004

Perioperative complication rate of total ankle replacement is reduced by surgeon experience.

BACKGROUND: Recent studies suggest the perioperative complication rate of total ankle arthroplasty decreases as a surgeon becomes familiar with the procedure. This study tests the hypothesis that the number of perioperative adverse events will decrease as surgeon experience with total ankle replacement increases. METHODS: Ten surgeons completed retrospective chart and radiographic reviews of their first 10 cases as well as 10 subsequent cases of the Scandinavian Total Ankle Replacement (STAR). Not all surgeons completed 10 cases within the allotted time periods, and two patients were excluded for less than 3-month follow-up, resulting in 187 cases for review. The surgeons performed an average of 12.8 (range, 0-61) STARs between these two time periods. Cases were divided into Early Group if they were among the first five STARs a surgeon performed and Late Group if they were after the first five. RESULTS: The average patient age was 60.4 +/- 12.8 years. The etiology of arthrosis included 96 (51%) of 187 posttraumatic, 49 (26%) idiopathic, and 33 (18%) rheumatoid. Patients in Early Group had a 3.1 times greater chance of having a perioperative adverse event (95% CI 1.6-6.1, p <.001), and a 3.2 times greater chance of having a perioperative wound problem (95% CI 1.5-6.8, p =.002) than patients in Late Group. Patients in Early Group took 1 week longer to heal their wounds than patients in Late Group (4.5 vs. 3.5 weeks, p =.046). CONCLUSIONS: This study shows a decrease in the perioperative adverse event rate commensurate with surgeon experience with STAR. In contrast to other reports, this study was unable to show a decrease in the number of perioperative fractures with increasing surgeon experience. This information is important for planning how best to train surgeons new to total ankle replacement and for patient counseling regarding the potential risks of the procedure.

Ankle Injuries↗
PubMed2004

Functional evaluation of the Scandinavian Total Ankle Replacement.

The purpose of this study was to evaluate the function of the ankle joint during walking before and after Scandinavian Total Ankle Replacement (STAR). Nine patients (six males and three females) with an average age of 65 years, scheduled for unilateral total ankle replacement for osteoarthritis and rheumatoid arthritis, were evaluated both preoperatively and postoperatively in a gait analysis laboratory. Arthroplasty patients showed reduced range of motion at the ankle compared to normal controls. Postoperative arthroplasty subjects had significantly improved external ankle dorsiflexion moment, the moment that affects the plantarflexor muscles, when compared to their preoperative status. The moment in arthroplasty patients was increased, indicating improved function of the ankle joint.

Aged↗
PubMed2004

A review of rheumatoid arthritis affecting the foot and ankle.

Rheumatoid arthritis is a systemic disease that often affects the foot and ankle. Approximately 20% of patients with rheumatoid arthritis present initially with foot and ankle symptoms, and most patients will eventually develop foot and ankle symptoms. Although early intervention includes conservative measures, operative treatment often is needed to adequately treat rheumatoid patients. Treatment of foot and ankle problems in patients with rheumatoid arthritis is directed to maintaining ambulatory capacity. This article reviews the clinical presentation, evaluation, and treatment of rheumatoid arthritis affecting the foot and ankle.

Ankle Joint↗
PubMed2004

Keratotic disorders of the plantar skin.

Keratotic lesions on the plantar aspect of the foot develop beneath an osseous prominence and can result in substantial disability. This occurs because, during normal gait, the metatarsal head area is subjected to more prolonged stress than any other area on the plantar aspect of the foot. In the treatment of this disorder, it is imperative to establish the etiology, among many possibilities, and then address the specific pathology accordingly.

Biomechanical Phenomena↗
PubMed2004

The bunionette deformity.

The bunionette deformity results in pain about the lateral and/or the plantar aspect of the fifth metatarsal head. It is important to carefully assess the deformity anatomically in order to select the proper surgical procedure to correct this painful affliction. Knowledge of pathoanatomy and certain surgical procedures can be used to correct the deformity.

Foot Deformities, Acquired↗
PubMed2002

The history of the STAR total ankle arthroplasty.

The STAR ankle replacement prosthesis has almost a 30-year history. The current FDA study of the device in the United States is very encouraging. The prosthesis does show great promise but needs further study. Further elucidation of the postoperative radiographs and the various areas of lucency and their significance should be studied. The learning curve for implantation is very steep.

Ankle Joint↗