Another new and interesting article from our Fall 2019 Issue!  Read the abstract below and click on the link for the full article.

Transfemoral Aortic Valve-in-Valve Replacement in Patient with Aortic Root Pseudoaneurysm (Click link for full PDF)

Authors: Mark A. Nolan, P.E., M.Eng1, Stephane Leung Wai Sang, M.D., MSc2

Background: Transcatheter aortic valve replacement (TAVR) was successfully performed to treat aortic regurgitation (AR) in a patient with a failed aortic valve replacement complicated by aortic root pseudoaneurysm.

Case Presentation: A 92-year-old male presented with acute decompensated congestive heart failure secondary to AR of a previously implanted stentless aortic bioprosthesis, complicated by a 2.5 x 1.7 cm pseudoaneurysm of the aortic root.

Conclusions: Complex aortic root and valve disease can be safely and effectively addressed through the use of TAVR in high-risk patients. The presence of a pseudoaneurysm should not preclude successful TAVR.

New article from the MSRJ 2019 Fall issue is now up on the site! Read the abstract or click on the link below for the full article.

Association between Total Knee Arthroplasty and Subtalar Joint Changes: A Cadaver Study (Click link for full PDF article)

Authors: Dominick J. Casciato, B.A.1*, Natalie A. Builes, B.A.2, Luis A. Rodriguez Anaya, DPM1, Bibi N. Singh, DPM1

Background: Total knee arthroplasty (TKA) has become the procedure of choice for those suffering from debilitating degenerative joint disease of the knee; however, new research suggests that functional changes in the rearfoot occur following the procedure to compensate for gait changes. This pilot study investigates subtalar joint (STJ) changes in cadavers with TKAs.

Methods: Four embalmed cadavers with a unilateral TKA were disarticulated at the STJ and the calcaneal articular facets were imaged. The length, width, and area of these facets ipsilateral to the joint replacement were measured using image analysis software and compared to the contralateral side.
Results: All cadavers exhibited evidence of anatomical changes at the STJ. Moreover, a transition to an anatomically unstable STJ was observed.

Conclusions: This study suggests that biomechanical compensation at the STJ may result in anatomical changes in the joint in which form of the joint follows function. Though this pathology may have developed prior to such arthroplasty, the unilateral nature of the facet changes emphasizes the need to further investigate and address gait abnormalities before and after joint replacement to optimize biomechanics in the arthritic knee.