Reinhard Schuh

Numerous techniques exist in the literature to treat lateral instability. In this chapter, the authors describe the modified Broström-Gould operation, the Watson-Jones operation, the Chrisman-Snook operation and the lateral ligament plasty with a free peroneus brevis tendon graft in step-by-step instructions. In addition to lateral stabilization, t...

This chapter clearly explains the techniques of arthroscopic removal of tibiotalar osteophytes in anterior impingement (“soccer’s ankle”), cheilectomy and metatarsophalangeal arthrodesis in hallux rigidus and arthrodesis of the ankle joint using screws and nails in osteoarthritis.

This chapter covers all common techniques for the treatment of acute and chronic pathologies of the Achilles tendon. The following techniques are explained in detail: open Achilles tendon suture, minimally invasive Achilles tendon suture, Achilles tendon reconstruction using overturnplasty and VY plasty, flexor hallucis longus tendon augmentation,...

This chapter provides the basic knowledge necessary for successful arthroscopic surgery on the ankle joint. In addition to different forms of patient positioning and joint distraction, all common arthroscopy portals are described in detail, and the process of a standardized diagnostic tour of the ankle joint is explained.

Background: The Broström procedure is an established procedure in cases of primary lateral ankle ligament repair (LALR). To improve postoperative stability an augmentation device, InternalBrace™ (Arthrex, Naples, FL) has been introduced. This study evaluates remodelling of the anterior talofibular ligament (ATFL) in patients undergoing a tape augm...

Purpose The proximal chevron osteotomy and the modified Lapidus arthrodesis are both procedures utilized for deformity correction in patients with severe symptomatic hallux valgus. The aim of the current study was to compare their biomechanical stability when using locking plate fixation. Methods Twelve matched pairs of human anatomical lower leg...

Background Several techniques and approaches for first metatarsophalangeal (MTP1) joint arthroscopy have been reported, where joint accessibility plays a key role. This study aimed to evaluate differences in arthroscopic accessibility of the first metatarsal head (MTH1) comparing non-invasive distraction and maximum plantarflexion in a two-portal a...

Purpose The aim of this study was to determine whether the use of suture tape augmentation would lead to improved clinical outcomes, increased stability, shorter postoperative immobilization and earlier return to activity and sports compared to Broström repair in surgical treatment of chronic lateral ankle instability (CLAI). Materials and Methods...

Background: The tibialis posterior tendon (TPT) is the main dynamic stabilizer of the medial longitudinal arch of the foot. Especially in adult acquired flatfoot deformity (AAFD) the TPT plays a detrimental role. The pathology and function of the tendon have been extensively investigated, but knowledge of its insertional anatomy is paramount for s...

Zusammenfassung Hintergrund Die Tarsometatarsale-I Arthrodese, auch bekannt als modifizierte Lapidus Arthrodese, gehört zu den potentesten Korrekturoperationen der Hallux valgus Chirurgie. Aufgrund der großen Hebelkräfte am TMT-I Gelenk wurden jedoch historisch hohe Raten an postoperativen Pseudarthrosen (bis zu 12%), Dorsalextensionsfehlstellunge...

Zusammenfassung Hintergrund Kleinzeheneingriffe gehören zu den häufigsten durchgeführten Operationen des Fußes. Eine Vielzahl an Pathologien hervorgerufen durch ein Ungleichgewicht der extrinsischen und intrinsischen Muskulatur trifft auf eine noch größere Zahl an chirurgischen Techniken. Die Patientenzufriedenheit und die klinischen Ergebnisse si...

PurposeIntramedullary screw fixation is currently considered the gold standard treatment for Jones fractures in the athlete. Besides biological factors (i.e., poor vascularization), mechanical instability induced by the pull of the peroneus brevis tendon (PBT) contributes to deficient Jones fracture healing. This biomechanical study aimed to simula...

In this Technical Note, we describe arthroscopically assisted tape augmentation of a modified Broström repair for chronic lateral ankle instability. Specifically, this technique involves talar anchor placement under direct arthroscopic visualization combined with a minimally invasive approach for anatomic anterior talofibular ligament repair and Fi...

Radiographic outcome assessment of ankle arthrodesis (AA) requires accurate measurement techniques. This study aimed to identify the most reliable methods for sagittal tibio-talar alignment measurements with regard to the tibio-talar offset after AA. Lateral weight-bearing radiographs of 38 fused ankles were selected for retrospective review. The s...

Implant choice is a matter of concern in athletes and active patients who sustain a Jones fracture because they are prone to failure including non‐union, screw failure, and refracture. The aim of this study was to compare the biomechanical behaviour of a Jones fracture specific screw (JFXS) with a cannulated headless compression screw (HCS) in a si...

Ankle orthoses are commonly used for prevention of recurrent ankle sprains. While there is some data on their functional performance or restriction of range of motion, there is little knowledge on the quantifiable passive mechanical effectiveness of various devices. This study aimed to determine the prophylactic stabilization effect for commonly pr...

Background: Osteochondral lesions of the talus are frequent pathologies of the ankle joint. Especially through arthroscopy, the treatment is kept as minimally invasive as possible. However, there are some drawbacks as to the reachability because of the high congruency of the ankle joint. Here, either noninvasive distraction or maximal dorsiflexion...

Metatarsal osteotomies represent a surgical treatment option for hallux rigidus. These osteotomies aim to decompress the joint and therefore reduce load transmission at the articular cartilage of the first metatarsophalangeal joint. Actually, there is no consensus if this method should only be performed in early stages of disease. However, if there...

Aims: The traditional transosseus flexor hallucis longus (FHL) tendon transfer for patients with Achilles tendinopathy requires two incisions to harvest a long tendon graft. The use of a bio-tenodesis screw enables a short graft to be used and is less invasive, but lacks supporting evidence about its biomechanical behaviour. We aimed, in this stud...

Objective: To investigate the changes of plantar pressure distribution in patients who underwent either Austin or Scarf osteotomy and underwent a postoperative rehabilitation program. Methods: Between September 2006 and December 2007, 50 participants who suffered from mild to moderate hallux valgus deformity were prospectively included in this s...

Introduction: The peroneus brevis tendon (PBT) inserts into the proximal aspect of the 5th metatarsal. Metatarsal bone fractures are encountered to be the most common fractures in the foot with predominantly fractures at the base of the fifth metatarsal bone. Mechanism of injury and treatment of the proximal 5th metatarsal fractures vary due to th...

Ein umfangreicher Algorithmus erleichtert die Indikationsstellung für die deformitätsbezogenen Operationstechniken zur Behandlung des Hallux-valgus-Komplexes. Der distale Weichteileingriff im Bereich des ersten Metatarsophalangealgelenks wird ebenso beschrieben wie diverse Osteotomien am Metatarsale I (subkapital, diaphysär und proximal). Knöcherne...

Dieses kurze Kapitel befasst sich mit der Behandlung von Zehennagelpathologien. Es werden die Operation des eingewachsenen Zehennagels mit Keilresektion und ebenso die komplette Nagelentfernung bei chronischer Infektion dargestellt.

Der umfassenden Aufklärung der Patienten über Operation, alternative Therapien, Nachbehandlung, zu erwartende Einschränkungen der Mobilität und Schuhauswahl wird ein großer Abschnitt gewidmet. Eingriffspezifische, intraoperativ nicht limitierende Lagerung und korrekte Abdeckung mit der Option einer intraoperativen fluoroskopischen Kontrolle werden...

Verfahren zur Behandlung von Sehnenpathologien im Bereich von Fuß und Sprunggelenk sowie Operationstechniken mit Sehneneingriffen, im Sinne von Transpositionen zur Korrektur von Fehlstellungen, werden dargestellt. Darunter der Flexor-digitorum-longus Transfer bei erworbener Plattfußdeformität und die operative Therpie von Pathologien im Bereich der...

Verfahren zur Behandlung von Krankheitsbildern im Bereich der Kleinzehen finden Berücksichtigung. Sowohl Weichteileingriffe als auch knöcherne Operationsmethoden werden angeführt. Erstere beinhalten unter anderem das Release des Metatarsophalangealgelenks mit Berücksichtigung von Strecksehnen, dorsaler Gelenkkapsel und Kollateralbänder. Zudem werde...

Arthrodesen, Korrekturosteotomien und Resektionsarthroplastiken im Bereich der Fußwurzel sowie der zweiten bis fünften Mittelfußknochen werden besprochen. Dies umfasst die Arthrodese des ersten Tarsometatarsalgelenks und der Lisfranc-Gelenklinie, sowohl in situ als auch als korrigierendes Verfahren. Ferner werden distale und proximale Korrekturoste...

Dieses Kapitel umfasst die Amputationen am Fuß bis hin zur Exartikulation im oberen Sprunggelenk. Dabei werden Grenzzonenamputationen ebenso wie Resektion einzelner Strahlen dargestellt. Eigene Abschnitte sind der Amputation in Höhe der TMT-Gelenke und den transmetatarsalen Amputationen gewidmet. Die Amputation in der Chopart-Gelenkreihe und die Sy...

Dieses Kapitel befasst sich mit Nervenengpasssyndromen im Fuß- und Sprungelenkbereich. Die operative Therapie des Tarsaltunnelsyndroms wird differenziert für das vordere und untere, auch mit dem Bild einer Baxter-Neuralgie, dargestellt. Der Morton-Neuralgie wird ein eigener Abschnitt gewidmet.

Mehrere Varianten der OSG-Arthrodese mit verschiedenen Zugängen und Osteosynthesen finden umfangreich Berücksichtigung. Die Grundlagen der Totalendoprothese werden dargestellt. Die Behandlung fortgeschrittener osteochondraler Läsionen mit Malleolarosteotomie und osteochondralen Grafts sowie additive supramalleoläre Umstellungsosteotomien werden det...

Dieses Buch beschreibt die operative Behandlung der Erkrankungen des Fußes, denen der in Praxis und Klinik tätige chirurgische Orthopäde und Unfallchirurg häufiger begegnet. Die kleine und zum Teil auch große Fußchirurgie wird mit klar strukturierten Texten und mit aussagekräftigen Zeichnungen step-by-step dargestellt. Für die 2. Auflage wurde Altb...

Background In the current study, we investigated midterm results of a new rotating hinge total knee arthroplasty (EnduRo prosthesis), which uses a new bearing material (CFR PEEK). Methods We prospectively analysed data of 50 patients with a minimum follow-up of 5 years. In 24 (48%) patients, a primary implantation was performed and 26 (52%) were r...

Purpose: The purpose of this study was to evaluate the difference in accessibility of the talar dome during ankle arthroscopy between noninvasive distraction and maximum plantar flexion without distraction. Methods: For this study, 20 matched pairs (n = 40) of anatomic ankle specimens were used. Two groups (distraction or maximum plantar flexion...

Background: Although standard fixation of proximal interphalangeal (PIP) arthrodesis by K-wire is relatively inexpensive and well established, it does have some drawbacks, making newer fixation devices interesting. The aim of this study was to clinically and radiologically assess the operative correction of the lesser toe deformation in the form o...

This study aimed to analyze precisely the dimensions, shapes, and variations of the insertional footprints of the tibialis anterior tendon (TAT) at the medial cuneiform (MC) and first metatarsal (MT1) base. Forty-one formalin-fixed human cadaveric specimens were dissected. After preparation of the TAT footprint, standardized photographs were made a...

PurposeThe aim of this study was to determine the reliability and validity of preoperative magnetic resonance imaging (MRI) scans for the detection of additional pathologies in patients with chronic ankle instability (CAI) compared to arthroscopic findings. Methods Preoperative MRI images of 30 patients were evaluated regarding articular and periar...

Dieses Kapitel umfasst sämtliche gängigen Techniken zur Behandlung von akuten und chronischen Pathologien der Achillessehne. Detailliert erläutert werden die folgenden Techniken: Offene Achillessehnennaht, minimalinvasive Achillessehnennaht, Achillessehnenrekonstruktion mittels Umkippplastik und VY-Plastik, Flexor-hallucis-longus-Sehnen-Augmentatio...

Die Lagerung des Patienten kann auf einem Standardoperationstisch erfolgen. Ist eine Arthroskopie des anterioren Kompartiments geplant, so ist eine Rückenlagerung adäquat. Um eine spontane Außenrotation des Fußes zu verhindern, kann die ipsilaterale Gesäßhälfte unterpolstert werden. Die Ferse sollte das Tischende überragen, sodass das Sprunggelenk...

Zur Behandlung der lateralen Instabilität existieren in der Literatur zahlreiche Techniken. In diesem Kapitel beschreiben die Autoren in einer Schritt-für-Schritt-Anleitung die modifizierte Operation nach Broström-Gould, die Operation nach Watson-Jones, die Operation nach Chrisman-Snook und die laterale Bandplastik mit freiem Peroneus-brevis-Sehnen...

Chronischer, belastungsassoziierter Schmerz im Bereich des oberen Sprunggelenks durch tibiotalare Osteophyten am anterioren Aspekt des OSG, welche zu einem anterioren Impingementsyndrom führen (sog. «soccer’s ankle» oder «athlete’s ankle»).

PurposeDeformation of the talus in idiopathic congenital clubfeet is a known problem after treatment. However evidence on types of talus deformation and clinical relevance is rare. The aims of this study were first to define different types of talus deformation, and second, to evaluate the impact of these types on long-term results. Methods At a mi...

Background: Accurate measurement of the tibiotalar alignment is important in radiographic outcome assessment of ankle arthrodesis (AA). In studies, various radiological methods have been used to measure the tibiotalar alignment leading to facultative misinterpretation of results. However, to our knowledge, no previous study has investigated the re...

Purpose Current methods of anterior talofibular ligament (ATFL) reconstruction fail to restore the stability of the native ATFL. Therefore, augmented anatomic ATFL reconstruction gained popularity in patients with attenuated tissue and additional stress on the lateral ankle ligament complex. The aim of the present study was to evaluate the biomecha...

The use of inserts and orthopedic shoe adjustment represents an essential component of the conservative therapy of degenerative diseases and deformities of the musculoskeletal system. Inserts can have supportive, bedding and corrective effects and are used in particular for complaints of the feet and ankles. The combination of diverse materials all...

Background: Little is known about the long-term results of surgical correction of hallux valgus deformity, in particular, the recurrence rate and factors leading to recurrence. Methods: Of one hundred and eight patients (115 feet) who underwent a Scarf osteotomy, ninety-three patients (ninety-three feet) were examined at an average duration of f...

Background: Transverse tarsal joint arthrodesis is commonly performed in the operative treatment of hindfoot arthritis and acquired flatfoot deformity. While fixation is typically achieved using screws, failure to obtain and maintain joint compression sometimes occurs, potentially leading to nonunion. External fixation is an alternate method of ac...

Recently, tape augmentation for Broström repair has been introduced in order to improve the primary stability of the reconstructed anterior talofibular ligament (ATFL). The biomechanical effect of tape augmentation suture anchor (SA) repair is not known yet. The aim of the present study was to compare construct stability of the traditional Broström...

Primary bone or soft tissue tumors of the femur sometimes present with severe and extensive bone destruction, leaving few limb-salvage options other than total femur replacement. However, there are few data available regarding total femur replacement and, in particular, regarding implant failures. We asked: (1) What are the revision-free and overal...

A painful episode in the region of the peroneal tendons, within the retromalleolar groove, is a common precipitating event of an acute lateral ankle sprain. A forefoot striking pattern is suspected to cause peroneal tendinosis. The aim of this study is to analyse the role of peroneal tendinosis as a predisposing factor for ankle sprain trauma in ru...

There is no current guideline nor consensus regarding optimal surgical treatment of the midfoot Charcot. Due to the vast diversity of locations, it is difficult to make a general statement. Various different types of screws and plates are currently being used since they have been tested and declared to be most stable. The Midfoot Fusion Bolt is a n...

Due to the pathoanatomical changes in hallux valgus feet, the plantar flexion moment of the first metatarsophalangeal joint is reduced. Therefore, load bearing of the hallux is decreased during push-off. We assessed loading parameters in hallux valgus feet. Based on dorsal-plantar weight bearing radiographs of 61 feet, the intermetatarsal-, hallux...

First tarsometatarsal joint (TMTJ) arthrodesis is known as a powerful operative procedure to correct moderate to severe hallux valgus deformity. However, there is little evidence about actual complication rates and angular correctional power. The aims of the present study were to evaluate the (1) angular correction power and (2) complication rates...

This atlas depicts and describes the newest arthroscopic and open techniques for dealing with sports orthopaedic injuries and problems. More than 75 surgical procedures are presented step by step with the aid of superb illustrations. Arthroscopic views, artist drawings, X-rays, and clinical and operative photographs are all included to demonstrate...

Purpose Metatarsalgia is one of the most frequent pathological conditions of the foot and ankle. Numerous studies exist on plantar-pressure characteristics in various types of shoes. However, to the best of our knowledge, plantar-pressure distribution and clinical effects in sandals has not as yet been the the focus of any study. Methods Twenty-...

Resection of a primary sarcoma of the diaphysis of a long bone creates a large defect. The biological options for reconstruction include the use of a vascularised and non-vascularised fibular autograft. The purpose of the present study was to compare these methods of reconstruction. Between 1985 and 2007, 53 patients (26 male and 27 female) underwe...

Background The best treatment for acute rupture of the Achilles tendon is still under debate. Our purpose was to evaluate surgical triple-bundle technique in selected patients with full subcutaneous rupture of Achilles tendon. Methods Sixty-six consecutive patients (56 men, 10 women; age range 20-61 years) with full unilateral rupture of the Achil...

Purpose: Primary malignant bone tumours of the scapula are very rare. Apart from limited small series and some case reports, international literature on flat bone sarcoma is exiguous and not much is known about the oncological outcome. Methods: A retrospective analysis of 29 patients diagnosed with a primary malignant tumour of the scapula was p...

Background: Indication for rotating hinge (RH) total knee arthroplasty (TKA) includes primary and revision cases, with contradictory results. The aim of this study was to report prospective early results of a new modular rotating hinge TKA (EnduRo). For this implant several new design features and a new bearing material (carbon-fiber reinforced po...

The goal of this study was to determine whether obesity affects implant positioning or early functional outcome after minimally invasive total hip replacement. The authors evaluated 119 patients who had undergone minimally invasive total hip replacement via a direct anterior approach. The patients were segregated according to World Health Organizat...

Background: Conventional survival analysis for endoprosthetic complications does not consider competing events adequately. Patients who die of their disease are no longer at risk for complications; therefore, death as a competing event may alter survivorship estimates in the orthopaedic-oncological setting. Questions/purposes: This investigation...

Hallux valgus represents a common pathological condition of the foot and ankle. Modern concepts in the surgical treatment include metatarsal osteotomies. Based on the amount of deformity it can be classified in mild, moderate and severe hallux valgus. Mathematical analysis revealed that proximal osteotomies provide more angular correction than mid-...

Limb salvage surgery has evolved to become the standard method of treating sarcomas of the extremities with acceptable oncologic results. However, little information exists relative to the activity level or ability to participate in sports after tumor reconstructions. The aims of the study were to answer the following questions: (1) Which sports ac...

We report the results of a consecutive series of 12 cases with haemophilic hip arthropathy treated with uncemented total hip arthroplasty (THA). Our hypothesis was that THA results in the haemophilic group would be inferior to those in the nonhaemophilic group. The clinical histories of 12 consecutive THAs in eight patients (all men) with hereditar...

Acquired flatfoot deformity is characterized by flatening oft he longitudinal arch of the foot and a varus alignement of the hindfoot due to insufficiency of the postero-medial soft tissue structures and is divided in four different stages. Stage II represents a flexible flatfoot deformity without active hindfoot inversion due to insufficiency of t...

The proximal chevron osteotomy provides high correctional power. However, relatively high rates of dorsiflexion malunion of up to 17 % are reported for this procedure. This leads to insufficient weight bearing of the first ray and therefore to metatarsalgia. Recent biomechanical and clinical studies pointed out the importance of rigid fixation of p...

Purpose: Total ankle arthroplasty provides an alternative to arthrodesis for management of ankle osteoarthritis. The results of the third generation total ankle replacements have been promising. The purpose of the present study was to investigate the clinical and radiographical outcome and implant survival of 16 consecutive patients suffering from...

Response to the comment on Schuh et al.: Angular correction and complications of proximal first metatarsal osteotomies for hallux valgus deformity Dear Prof. Pecina, We greatly appreciate the comments offered by Dr. He and Dr. Peng regarding the recent publication "Angular correction and complications of proximal first metatarsal osteotomies for h...

The ideal treatment for Achilles tendon ruptures is still unknown. Biomechanical were correlated to radiological and clinical parameters to study outcomes. In this retrospective, assessor-blinded multi-centre cohort study, 52 patients with unilateral Achilles tendon rupture were assessed, each at least 3 years after injury. Patients underwent open...

This systematic review aims to illustrate the published results of "minimally invasive" procedures for correction of hallux valgus. Based on former systematic reviews on that topic, the literature search was organised by two independent investigators. MEDLINE was systematically searched for available studies. The keywords used were "hallux valgus",...

Stage II posterior tibial tendon dysfunction (PTTD) can be treated by flexor digitorum longus (FDL) tendon transfer and medial displacement calcaneal osteotomy (MDCO). Numerous authors have studied the clinical and radiographic results of this procedure. However, little is known about the kinematic changes. Therefore, the purpose of this study was...

The clinical histories of 45 consecutively performed TKAs in 32 patients with hereditary bleeding disorders were reviewed retrospectively. The mean follow up was 88.7 (range, 24-232) months. The cumulative probability of infection free-survival was 87.8% after 180months. When removal of component was defined as endpoint, the survival probability wa...

Proximal first metatarsal osteotomies are recommended for the surgical treatment of moderate to severe hallux valgus deformity. This study aimed to compare correction of intermetatarsal and hallux valgus angles and complications of proximal crescentic, Ludloff, proximal opening wedge, proximal closing wedge, proximal chevron and other proximal firs...

Double fusion (i.e., fusion of the subtalar and talonavicular joint) represents a modification of triple arthrodesis preserving integrity of the calcaneocuboidal joint. Our aims were (1) to evaluate dynamic plantar pressure distribution in patients undergoing double arthrodesis, (2) to obtain a comparison of kinematic changes to healthy feet, (3) t...

Background: Instability of the second metatarsophalageal (MTP) joint is a common disorder of the forefoot and can be addressed operatively. The objective of this study was to compare a temporary K-wire fixation (tKW) to a postoperative strapping dressing (SD) after realignment surgery of second MTP instability in combination with correction of cla...

Mutations in the serine palmitoyltransferase subunit 1 (SPTLC1) gene are the most common cause of hereditary sensory neuropathy type 1 (HSN1). Here we report the clinical and molecular consequences of a particular mutation (p.S331Y) in SPTLC1affecting a patient with severe, diffuse muscle wasting and hypotonia, prominent distal sensory disturbances...

Common peroneal nerve palsy is an infrequent pathology mostly related to endogenous or exogenous compression. The exogenous compression is frequently related to trauma: knee fractures or hematoma arisen after a direct blow. Fractures may cause a direct lesion of the nerve; hematoma causes a compression of the nerve at the fibular neck causing pain...

Die Lagerung des Patienten kann auf einem Standardoperationstisch erfolgen. Ist eine Arthroskopie des anterioren Kompartiments geplant, so ist eine Rückenlagerung adäquat. Um eine spontane Außenrotation des Fußes zu verhindern, kann die ipsilaterale Gesäßhälfte unterpolstert werden. Die Ferse sollte das Tischende überragen, sodass das Sprunggelenk...

Frische Achillessehnenrupturen bei Patienten in körperlich gutem Zustand. Das Alter allein sollte keine Kontraindikation sein. Kontraindikationen für eine offene operative Behandlung sind peripheren arteriellen Verschlusskrankheit plus biologisch hohes Alter, schlechte Haut- und Weichteilverhältnisse, nicht bzw. schlecht eingestellter Diabetes mell...

Sprunggelenksupinationstraumen führen in bis zu 90 % der Fälle zu einer Verletzung des Außenbandkomplexes, bei bis zu 30 % hiervon zu einer chronischen lateralen Sprunggelenkinstabilität. Die Indikation zur operativen Rekonstruktion besteht, wenn trotz funktioneller Rehabilitation mit muskelstärkender und propriozeptiver Physiotherapie sportliche A...

Chronischer, belastungsassoziierter Schmerz im Bereich des oberen Sprunggelenks durch tibiotalare Osteophyten am anterioren Aspekt des OSG, welche zu einem anterioren Impingementsyndrom führen (sog. „soccer’s ankle“ oder „athletes ankle“). Bei dieser Pathologie werden repetitive mechanische Belastungen als Auslöser vermutet. Vor allem die wiederhol...

Background: This prospective study examined the clinical and radiological results of the Chevron osteotomy with screw fixation and distal soft tissue release up to an intermetatarsal angle of 19°. Furthermore, the results are presented for patients over the age of 70 years, and whether or not there is a higher complication rate. Material and meth...

Hip resurfacing arthroplasty has gained popularity for treating young and active patients who have arthritis. There are two major data sources for assessing outcome and revision rate after total joint arthroplasty: sample-based clinical trials and national arthroplasty registers. The purpose of this study was to evaluate the outcome of the Birmingh...

The reproducibility of the results of cohort-based clinical studies of arthroplasty procedures by the average orthopaedic surgeon is a major issue involving the quality of the scientific literature. We compared the results of a comprehensive literature analysis with data from national arthroplasty registries to examine the influence of arthroplasty...

Ankle arthrodesis (AAD) and total ankle replacement (TAR) are the major surgical treatment options for severe ankle arthritis. There is an ongoing discussion in the orthopaedic community whether ankle arthrodesis or ankle fusion should be the treatment of choice for end stage osteoarthritis. The purpose of this study was to compare the participatio...

Metatarsalgia is a common pathologic entity. It refers to pain at the MTP joints. Pain in the foot unrelated to the MTP joints (such as Morton’s neuroma) must be distinguished from those disorders, which lead to abnormal pressure distribution, reactive calluses, and pain. Initial treatment options for metatarsalgia include modifications of shoe wea...

Bone defects of the distal end of the humerus require complex reconstructions, for which standard prostheses may be insufficient. We investigated the outcomes of distal humeral reconstruction with use of a modular prosthesis. Fifty-three elbows in fifty-two patients underwent reconstruction with a modular prosthesis (twelve total humeral replacemen...

Total knee arthroplasty (TKA) as a treatment for end-stage osteoarthritis of the knee shows good results in terms of patient satisfaction. For the assessment of outcome and revision rate after total joint arthroplasty, there are two major data sources: clinical studies and national arthroplasty registers. The purpose of this study was to analyse th...

Severe bone loss of the first metatarsal is a significant problem in revisional surgery of the first metatarsophalangeal joint either after failed hallux valgus surgery or failed primary arthrodesis. A short first ray leads to pathologic biomechanics of the forefoot, which is treated with interpositional bone block arthrodesis. A ball-in-socket pre...

Modern concepts in the postoperative treatment of first metatarsal osteotomies include special shoes that should decrease stress in the forefoot region. The purpose of this study was to determine plantar pressure distribution, wearing characteristics and stress-reducing effectiveness of five different types of commonly used postoperative shoes. Add...

Recent pedobarographic studies have demonstrated decreased loading of the great toe region and the first metatarsal head at a short- and intermediate-term followup. The purpose of the present study was to determine if a postoperative rehabilitation program helped to improve weightbearing of the first ray after chevron osteotomy for correction of ha...

Originally developed in Scandinavia, national arthroplasty registers have spread worldwide during the last decade. The value of registers for quality improvement in arthroplasty has frequently been documented. However, for the development of a successful register a few key points should be taken into account. Uncontrolled loss of patients from the...

Cheilectomy is performed as treatment for hallux rigidus. Its aim is the relief of pain and improvement of function. Previous pedobarograhic studies have revealed that osteoarthritis of the first metatarsophalangeal joint leads to a lateralisation of peak forces during the stance phase of gait. This occurs since the big toe does not participate in...