Purpose: To assess patients quality of life, pain, and functional limitations with with endstage ankle arthritis (EAA) and compared this to a similar cohort of patients with endstage hip arthritis (EHA).

Methods: Preoperative data (Short Form SF36) was collected prospectively from patients (n=130) with end stage ankle arthritis and compared to a similar cohort of patients (n=130) with end stage hip arthritis. Patients with ankle arthritis were registered in the Canadian Orthopedic Foot and Ankle Society (COFAS) multi-center study investigating the clinical outcome of ankle arthroplasty and fusion and patients with hip arthritis were randomly selected from the Halifax Joint Replacement Registry Database.

Results: All symptom and functional SF36 subscales for patients with EAA or EHA, were approximately two standard deviations below normal population scores. All differences between ankle and hip SF36 subscales scores were less than 4 points (40% of STD) in both direct and adjusted comparisons. A direct comparison of SF36 scores revealed that patients with EAA had significantly worse mental health according to the SF36 Mental Component Summary Score (MCS) (p= 0.0059), physical limitations with work and daily activities - role physical score (p= < 0.0001), and general health (p= 0.0004). Patients with EHA reported poorer physical function (p= 0.0007) although the Physical Component Summary Score (PCS) for the SF36 was not significant (p= 0.0510). Total Summary SF36, Physical Component Summary (PCS), bodily pain, vitality, role-emotional, social functioning, and mental health subscales were all not significantly different between cohorts (p> 0.05).

Conclusions: Patients with EAA have devastating losses of quality of life, which are comparable to patients with EHA. These findings suggest that increased resources should be directed towards alleviating the severe pain and disability associated with ankle arthritis.

Purpose: The use of allografts for anterior cruciate ligament (ACL) reconstruction has gained increased popularity. The major benefits of allograft for ACL replacement include decreased morbidity, easier patient rehabilitation and include ease of surgical procedure, decreased harvest site morbidity and easier patient rehabilitation. Further, allografts have improved appeal because of better sterilization techniques, improve graft availability and decreased hospital costs.|The objective of this study was to perform mechanical testing on various types of allograft. Specimens for allograft reconstruction of the anterior cruciate ligament included tibialis anterior tendon, tibialis posterior tendon, Achilles tendon and bone patella tendon tissues

Methods: The allografts tested were used for deployment in patients suffering with anterior cruciate ligament disruptions. A total of fifty grafts were analyzed. The breakdown of graft types included 15 tibialis anterior tendon, 15 tibialis posterior tendon, 10 Achilles tendon and 10 bone patella tendon tissues. The test techniques included: cutting the tendons to a set thickness and length. The tendons were then mounted in a cryogrip and frozen with liquid Nitrogen to below zero. They were mounted into a servo-hydraulic testing machine and pre-loaded and pre-conditioned. The specimens were then stretched to failure at a set strain rate.

Results: No difference was found between the mechanical/material properties of the various tendon allografts – these included tensile strength and a high stress linear modulus assessments. The mechanical (structural properties) of the allografts were more dependant on the cross sectional area of the allograft than the type of allograft tissue.The greater the cross-sectional area of the allograft, the greater the strength and stiffness of the graft.

Conclusions: These findings have considerable clinical applicability in choosing an allograft for anterior cruciate ligament reconstruction.