Alignment of CCI total ankle replacements in relation to midterm functional outcome and complication incidence.

BACKGROUND: Total ankle arthroplasty is increasingly used as a treatment for end stage ankle arthropathy. The aim of this study was to report the mid-term clinical function and survival results of Ceramic Coated Implant (CCI) ankle replacements and assess the association between the alignment of the CCI total ankle replacements and early functional outcome and complication incidence. METHODS: Data of 61 patients, who received 65 CCI implants between 2010 and 2016, were obtained from a prospectively documented database. Mean follow-up time was 85.2 months (range 27-99 months). Clinical function was assessed with AOFAS questionnaire and passive range of motion (ROM). Survival analysis and elaborate radiographic analysis was performed. Furthermore, complications and reoperations were recorded for all patients. RESULTS: Progression in ROM was most seen in the first 10 months from 21.8 degrees of passive range of motion preoperative to 27.6 degrees postoperative (p < 0.001), while the mean AOFAS gradually increased during follow-up postoperative from a mean of 40.9 points preoperative to an average of 82.5 but shows a small decline towards the end of follow-up (p < 0.001). During follow-up we recorded 8 failures (12.3%) resulting in a Kaplan-Meier survival analysis of 87.7% with a median follow-up of 85.2 months. CONCLUSION: We observed excellent clinical results and survival after TAA with the CCI implant with only a low mid-term complication rate. LEVEL OF EVIDENCE: Level III, prospective cohort study.

Fibroma of tendon sheath located within Kager's triangle.

The formation of a fibroma of the tendon sheath, a rare, slow-growing, benign tumor, usually occurs in the upper extremities of young adult males. We present an extremely rare case of a fibroma of the tendon sheath arising adjacent to the Achilles tendon within Kager's triangle in a 41-year-old female. The patient presented with progressive pain localized to the posterior aspect of the left ankle. Complete excision and histopathologic analysis of the fibroma were performed. The patient experienced an uneventful recovery after the intervention and had no evidence of recurrence after 3 months of follow-up. Fibroma of the tendon sheath should be included in the differential diagnosis when a patient presents with a painful soft tissue mass in Kager's triangle.