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  • 1
    In: The Lancet, Elsevier BV, Vol. 403, No. 10431 ( 2024-03), p. 1027-1050
    Type of Medium: Online Resource
    ISSN: 0140-6736
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2024
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    detail.hit.zdb_id: 1476593-7
    SSG: 5,21
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  • 2
    In: Foot & Ankle International, SAGE Publications, Vol. 30, No. 7 ( 2009-07), p. 579-596
    Abstract: Mobile-bearing ankle replacements have become popular outside of the United States over the past two decades. The goal of the present study was to perform a prospective evaluation of the safety and efficacy of a mobile-bearing prosthesis to treat end stage ankle arthritis. We report the results of three separate cohorts of patients: a group of Scandanavian Total Ankle Replacement (STAR) patients and a control group of ankle fusion patients (the Pivotal Study Groups) and another group of STAR total ankle patients (Continued Access Group) whose surgery was performed following the completion of enrollment in the Pivotal Study. Materials and Methods: The Pivotal Study design was a non-inferiority study using ankle fusion as the control. A non-randomized multi-centered design with concurrent fusion controls was used. We report the initial perioperative findings up to 24 months following surgery. For an individual patient to be considered an overall success, all of the following criteria needed to be met: a) a 40-point improvement in total Buechel-Pappas ankle score, b) no device failures, revisions, or removals, c) radiographic success, and d) no major complications. In the Pivotal Study (9/00 to 12/01), 158 ankle replacement and 66 arthrodesis procedures were performed; in the Continued Access Study (4/02 to 10/06), 448 ankle replacements were performed, of which 416 were at minimum 24 months post-surgery at time of the database closure. Results: Major complications and need for secondary surgical intervention were more common in the Pivotal Study arthroplasty group than the Pivotal Study ankle fusion group. In the Continued Access Group, secondary procedures performed on these arthroplasty patients decreased by half when compared with the Pivotal Arthroplasty Group. When the Pivotal Groups were compared, treatment efficacy was higher for the ankle replacement group due to improvement in functional scores. Pain relief was equivalent between fusion and replacement patients. The hypothesis of non-inferiority of ankle replacement was met for overall patient success. Conclusion: By 24 months, ankles treated with STAR ankle replacement (in both the Pivotal and Continued Access Groups) had better function and equivalent pain relief as ankles treated with fusion. Level of Evidence: II, Prospective Controlled Comparative Surgical Trial
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
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  • 3
    Online Resource
    Online Resource
    SAGE Publications ; 2018
    In:  Foot & Ankle International Vol. 39, No. 2 ( 2018-02), p. 135-142
    In: Foot & Ankle International, SAGE Publications, Vol. 39, No. 2 ( 2018-02), p. 135-142
    Abstract: Over the past decade, total ankle arthroplasty (TAA) has become a mainstay in the treatment of end-stage ankle arthritis. Currently in its fourth generation, the Scandanavian Total Ankle Replacement (STAR) is the only 3-piece mobile bearing ankle prosthesis available in the United States. Our current study reports implant survivorship at 15 years and patient outcomes for a subset of these survivors available for study. Methods: Eighty-four TAAs were performed between 1998 and 2000. Metal component survivorship at 15 years was calculated with a Kaplan-Meier curve. Twenty-four (29%) of 84 patients were available for participation with a minimum 15-year follow-up. Any radiographic changes were documented. All additional procedures and complications were recorded. Clinical findings, self-reported performance and pain evaluations, and AOFAS ankle/hindfoot scores were noted. Results: Metal implant survival was 73% at 15 years. Of the 24 patients available for clinical evaluation, 18 of 24 patients (70.7%) had no change in prosthetic alignment from the immediate postoperative radiograph. Only 1 subtalar fusion was required for symptomatic adjacent joint arthritis. Three patients sustained a broken polyethylene component. AOFAS scores improved from an average of 39.6 points preoperatively, to an average of 71.6. More than half (52.4%) of patients with retained implants required an additional surgical procedure; 3 required 2 additional procedures. The average time to subsequent procedure was 10.2 years. Conclusion: Our small cohort demonstrated STAR ankles with retention at 9 years were highly likely to survive to 15 years, and patients continued to have significant improvement in pain relief and minimal decrease in function. At 15 years from TAA, metal survivorship was 73%. As with all ankle replacements, supplementary procedures were common. Level of Evidence: Level IV, case series.
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
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  • 4
    Online Resource
    Online Resource
    SAGE Publications ; 2011
    In:  Foot & Ankle International Vol. 32, No. 5 ( 2011-05), p. 473-484
    In: Foot & Ankle International, SAGE Publications, Vol. 32, No. 5 ( 2011-05), p. 473-484
    Abstract: There has been a resurgence of interest in total ankle replacement (TAR) due to improved results with newer prostheses. However, long-term survivorship data has been limited. The STAR™ Ankle prosthesis is the first three-part prosthesis approved for use in the United States. Materials and Methods: Eighty-four total ankle replacements were performed in 80 patients using the STAR™ Ankle prosthesis and followed prospectively. Postoperatively, patients were evaluated with the AOFAS score for pain and function, and serial radiographs were evaluated for stability and alignment of the prosthesis. Implant failure, secondary procedures, and complications were recorded. Results: Ninety-one percent of prostheses remain implanted at an average followup of 9.1 years. The probability of implant survival was 96% at 5 years and 90% at 10 years. An average 39-point improvement in the AOFAS ankle-hindfoot score was noted, from a mean of 43 to a mean of 82 points. We noted a statistically significant increase in both average pain and function sub-scores. Postoperative range of motion averaged 4.5 degrees of dorsiflexion and 35 degrees of plantarflexion. Ninety-two percent of the patients were satisfied with their outcome. Ten patients (13%) developed concerning osteolytic lesions. Change in prosthetic alignment and adjacent joint arthritis were similar to previous reports. We report 21 complications, which included 14 additional surgical procedures. Conclusion: The first U.S. prospective long-term survivorship data with the STAR™ Ankle prosthesis found it to be an excellent long-term option for the treatment of ankle arthritis. Level of Evidence: IV, Case Series
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
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  • 5
    Online Resource
    Online Resource
    SAGE Publications ; 2011
    In:  Foot & Ankle International Vol. 32, No. 7 ( 2011-07), p. 659-664
    In: Foot & Ankle International, SAGE Publications, Vol. 32, No. 7 ( 2011-07), p. 659-664
    Abstract: 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 underwent ankle replacement utilizing the STAR™ prosthesis from 2000 to 2009 to evaluate the outcome of those with moderate (10 to 19 degrees) and severe (20 degrees or greater) coronal plane deformity. Materials and Methods: Out of 130 consecutive patients, 43 patients had at least 10 degrees of preoperative coronal plane deformity. Twenty-five ankles had 10 to 19 degrees degrees of deformity and 18 ankles had 20 degrees or greater deformity. Average age was 66 years. Average length of followup was 41 (range, 12 to 98) months. Results: Average talar preoperative deformity was 17.9 (range, 10 to 29) degrees, while average initial talar postoperative deformity was 3.5 (range, 0 to 12) degrees. Average final talar postoperative deformity was 4.7 (range, 0 to 14) degrees. Preoperative and final correction of deformity was statistically significant ( p 〈 0.01), but there was no significant difference between initial and final postoperative correction. Overall, recurrence of the preoperative coronal plane deformity occurred in six of 43 patients (14%). All three patients who had deformities over 25 degrees developed recurrences. Correction of the coronal plane deformities was achieved by using intraoperative soft-tissue balancing, including deltoid ligament release in 12 patients and lateral ligament reconstruction in one patient. Deltoid ligament release was found to be necessary for all patients with greater than 18 degrees of varus plane deformity. Conclusion: Correction of moderate to severe coronal plane deformity with the STAR™ prosthesis was achievable with only soft-tissue balancing procedures with predictable results especially for deformities less than 25 degrees. Level of Evidence: IV, Retrospective Case Series
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
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  • 6
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2003
    In:  The Journal of Bone and Joint Surgery-American Volume Vol. 85, No. 5 ( 2003-05), p. 938-955
    In: The Journal of Bone and Joint Surgery-American Volume, Ovid Technologies (Wolters Kluwer Health), Vol. 85, No. 5 ( 2003-05), p. 938-955
    Type of Medium: Online Resource
    ISSN: 0021-9355
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2003
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  • 7
    In: Nature, Springer Science and Business Media LLC, Vol. 615, No. 7954 ( 2023-03-30), p. 874-883
    Abstract: Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being 1–6 . Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was 〈 1.1 kg m –2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
    Type of Medium: Online Resource
    ISSN: 0028-0836 , 1476-4687
    RVK:
    RVK:
    RVK:
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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    SSG: 11
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  • 8
    In: Foot & Ankle International, SAGE Publications, Vol. 21, No. 10 ( 2000-10), p. 804-808
    Abstract: The purpose of this multicenter retrospective study of 55 patients (56 ankles) who underwent simultaneous tibiotalocalcaneal arthrodesis with severe disease involving the ankle and subtalar joints was to determine improvement of pain and function. The surgical indications included osteoarthritis, posttraumatic injury, failed previous surgery, talar avascular necrosis, osteoarthritis, and rheumatoid arthritis involving the ankle and subtalar joints. The average age at the time of the operation was 53 years. The average time of follow-up was 26 months after the operation. Fusion was achieved in 48 ankles, with an average time of fusion of 19 weeks. Forty-eight of the 55 patients were satisfied with the procedure. The average leg length discrepancy was 1.4 cm. The average amount of dorsiflexion was 2 degrees and plantar flexion was 5 degrees. Following surgery, 42 patients complained of pain, 40 patients required shoe modification or an orthotic device, and 34 patients had a limp. Fourteen patients described their activity as unlimited. Based on the AOFAS evaluation, the patients scored an average of 66 on the ankle-hind foot scale following surgery. The most common complications were nonunion (8 ankles) and wound infection (6 ankles). This study demonstrates that tibiotalocalcaneal arthrodesis is an effective salvage procedure for patients with disease both involving the ankle and subtalar joints.
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2000
    detail.hit.zdb_id: 2129503-7
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  • 9
    Online Resource
    Online Resource
    SAGE Publications ; 1989
    In:  Foot & Ankle Vol. 10, No. 1 ( 1989-08), p. 8-11
    In: Foot & Ankle, SAGE Publications, Vol. 10, No. 1 ( 1989-08), p. 8-11
    Abstract: To evaluate the effect of fusion of the first metatarsophalangeal joint on the first intermetatarsal angle, a series of 62 consecutive first metatarsophalangeal fusions was reviewed. Of these, 47 had sufficient data to be included in this study. The results of this study showed that the change in the first intermetatarsal angle following a first metatarsophalangeal joint arthrodesis is directly proportional to the preoperative first intermetatarsal angle. Therefore, when a first metatarsophalangeal joint arthrodesis is performed on a patient with a wide intermetatarsal angle, a concomitant proximal first metatarsal osteotomy is usually not indicated.
    Type of Medium: Online Resource
    ISSN: 0198-0211
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1989
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  • 10
    In: Clinical Orthopaedics and Related Research, Ovid Technologies (Wolters Kluwer Health), Vol. 348 ( 1998-03), p. 180???185-
    Type of Medium: Online Resource
    ISSN: 0009-921X
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1998
    detail.hit.zdb_id: 2018318-5
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