Complications of En Bloc Osteochondral Talar Allografts and Treatment of Failures: Literature Review and Case Report

We present a review of the published data on the complications and treatments for failed talar allograft transplantation. A case report is presented on a young woman who experienced graft failure and osteonecrosis of her talar allograft transplant. Because of the size of the present osteonecrosis, an ankle arthrodesis was performed as the initial revision procedure. Talar necrosis was removed and revascularized from the ankle fusion with solid fusion was confirmed with computed tomography. Symptomatic adjacent joint pain quickly developed in the hindfoot after the ankle fusion, and 12 months later an ankle fusion conversion to total ankle arthroplasty was performed. The patient has returned to normal activity with significant reduction in pain at most recent follow-up visit. This patient was followed for 7 years from initial osteochondral talar allograft transplantation and for 2 years from conversion of ankle fusion to total ankle arthroplasty. It is important to understand the techniques, indications, and outcomes for the various revision options for talar allograft failure. This case report illustrates how multiple revision options can be used to provide the best outcome for the patient.
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research

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This article reviews the potential role of exosomes in OA regenerative medicine. Special attention is given to mesenchymal stem cells-derived exosomes due to the extensive research on their cartilage repair property and their function as miRNA cargo. More investigations are needed for the effects of exosomes from synovial fluid and chondrocytes in joints. A better understanding of the mechanisms will contribute to a novel and promising therapy for OA patients.
Source: Journal of Orthopaedic Translation - Category: Orthopaedics Source Type: research
Condition:   Management of Knee Osteoarthritis Pain Interventions:   Drug: Intra articular injection Group;   Device: Radiofrequency Group Sponsors:   Cairo University;   Tanta University Completed
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
CONCLUSIONS: These results suggest that after TKA, the trunk movements of knee osteoarthritis patients were approximately equal to those of controls, with improvement in clinical outcomes such as knee extension limitation and pain. PMID: 31796661 [PubMed - as supplied by publisher]
Source: Journal of Back and Musculoskeletal Rehabilitation - Category: Orthopaedics Tags: J Back Musculoskelet Rehabil Source Type: research
Conclusions: The modified LRTI procedure provided significant subjective and objective improvements without severe complications particularly related to the harvesting of the PL tendon. This procedure is a valuable surgical option for trapeziometacarpal osteoarthritis and could be a useful salvage modality if the FCR tendon ruptures during the conventional LRTI procedure. PMID: 31788169 [PubMed - in process]
Source: Clinics in Orthopedic Surgery - Category: Orthopaedics Tags: Clin Orthop Surg Source Type: research
Authors: Üstün I, Solmaz A, Gülçiçek OB, Kara S, Albayrak R Abstract OBJECTIVES: Bariatric surgery is an effective intervention for severe obesity and associated comorbidities. We compared symptoms, joint space and life quality of morbidly obese patients with symptomatic knee osteoarthritis before and after bariatric surgery. METHODS: 34 patients with knee osteoarthritis were evaluated with standing anteroposterior and lateral radiography, medial and lateral joint distances of the knees, Visual Analog Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC) que...
Source: Journal of Musculoskeletal Neuronal Interactions - Category: Neurology Tags: J Musculoskelet Neuronal Interact Source Type: research
Articular cartilage lesions generated by trauma or osteoarthritis are the most common causes of pain and disability in patients.
Source: Journal of Experimental Orthopaedics - Category: Orthopaedics Authors: Tags: Review Source Type: research
ConclusionIn patients with symptomatic KOA, the presence of knee CC did not affect the risk of arthroplasty or disease progression at 5 years.
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: FULL LENGTH Source Type: research
CONCLUSION: Lack of relief of pain or restoration of function or quality of life or the occurrence of surgical complications after TJR were defined as TJR failure by participants. Functional TJR failure seems as or more important than surgical failure. This patient perspective of TJR failure further confirmed their inclusion in core domain set for TJR clinical trials in people undergoing knee or hip replacements. PMID: 31787606 [PubMed - as supplied by publisher]
Source: Journal of Rheumatology - Category: Rheumatology Tags: J Rheumatol Source Type: research
This study is a prospective randomized controlled pilot trial in which 120 patients with mild to moderate KOA will be randomly allocated in equal proportions to a fire acupuncture group or a general acupuncture group. They will receive acupuncture for six sessions over 2  weeks. The primary end point is success rate, which will be calculated based on the change from baseline of the pain and function scores in the Western Ontario and McMaster Universities Osteoarthritis Index at 4 weeks. Secondary end points include the proportion of patients achieving clinical i mprovement based on: (1) the OMERACT-OARSI resp...
Source: Trials - Category: Research Source Type: clinical trials
This study investigated the prognostic value of EIH on pain relief following ET in KOA patients. Materials and Methods: In 24 painful KOA patients (Numerical Rating Scale, 0 to 10 ≥3), EIH was assessed as change in pressure pain threshold after 2-minute “lateral raises” before and after ET in this observational study. In addition, temporal summation of pain, clinical pain scores (Numerical Rating Scale, Knee injury and Osteoarthritis Outcome Score [KOOS], and PainDETECT Questionnaire) were assessed before and after ET. The KOOS-4 is defined by the KOOS subscale scores for Pain, Symptoms, Activities of Dai...
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Original Articles Source Type: research
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