Foot & Ankle Orthopaedics最新文献

{"title":"Exploratory Analysis of Subtle Ankle Malpositioning on Sagittal Tibiofibular Alignment: Implications for Assessing Syndesmotic Malreduction.","authors":"Nicholas J Yee, Mohammad Hossein Chegini-Kord, Ronit Avadhuta, Carl Habib Rai, Ivy Lee, Jaeyoung Kim, Soheil Ashkani-Esfahani, John Y Kwon","doi":"10.1177/24730114261440555","DOIUrl":"10.1177/24730114261440555","url":null,"abstract":"<p><strong>Background: </strong>Accurate radiographic assessment of syndesmotic alignment is critical in the management of ankle injuries. Given limitations in traditional radiographic parameters, sagittal tibiofibular relationship (STFR) has been increasingly utilized. However, subtle variations in lower-limb rotation during imaging may alter STFR measurements, potentially leading to misinterpretation. This cadaveric study investigates the effect of ankle positioning on STFR in a cadaver model with intact syndesmotic ligaments.</p><p><strong>Methods: </strong>Twelve knee-disarticulated cadaver lower limbs with intact syndesmotic ligaments were used. True lateral fluoroscopic images were obtained using the talar dome double-shadow superimposition method, followed by incremental internal rotation (IR), external rotation (ER), abduction (ABD), and adduction (ADD) to simulate minor positional changes. Two foot and ankle fellowship-trained orthopaedic surgeons confirmed image acceptability. STFR was measured using the anterior tibiofibular interval (ATFI), posterior tibiofibular interval (PTFI), tibial/fibular width ratio (TW/FW), and anterior-posterior tibial-fibular distances (AF-AT, PF-PT). Pearson correlation analysis assessed associations between positioning and each measurement.</p><p><strong>Results: </strong>All STFR measurements were significantly correlated with axial plane rotation (<i>P</i> < .001) demonstrating that slight rotational malalignment in limb positioning was associated with apparent changes in tibiofibular alignment. Inter-rater reliability ranged from 0.75 to 0.95 and intrarater reliability from 0.63 to 0.98. ABD/ADD variation showed no significant effect on STFR measurements (all <i>P</i> > .05).</p><p><strong>Conclusion: </strong>Although increasing in utilization to assess syndesmotic alignment, STFR is sensitive to minor rotational deviations in the axial plane. Awareness of this limitation should be considered to avoid misinterpretation of syndesmotic reduction during intraoperative or postoperative imaging.</p><p><strong>Clinical relevance: </strong>Radiographic assessment of syndesmotic alignment is important for guiding intraoperative reduction and postoperative evaluation in ankle injuries. This study suggested that STFR could be relatively sensitive to minor rotational limb malpositioning, which alter apparent tibiofibular positioning. These findings caution that small rotational deviations may significantly change STFR measurements and may lead to misinterpretation of syndesmotic reduction.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261440555"},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to Sport and Functional Outcomes After Minimally Invasive Zadek Osteotomy for Insertional Achilles Tendinopathy in Young Athletes: A Retrospective Case Series.","authors":"Gil Genuth, Peter Stavrou, Chris Brown, Lukas D Iselin","doi":"10.1177/24730114261446302","DOIUrl":"10.1177/24730114261446302","url":null,"abstract":"<p><strong>Background: </strong>Insertional Achilles tendinopathy (IAT) is a common cause of posterior heel pain in active individuals and athletes. Traditional open surgical techniques are effective but associated with notable morbidity and prolonged rehabilitation. Minimally invasive Zadek osteotomy (MIS Zadek) has emerged as a tendon-preserving alternative aimed at reducing soft tissue disruption and facilitating early recovery. This study evaluated clinical and functional outcomes of MIS Zadek in young, athletic patients with IAT.</p><p><strong>Methods: </strong>This retrospective single-centre case series included patients younger than 55 years who underwent MIS Zadek for symptomatic IAT between 2022 and 2024, with a minimum follow-up of 18 months. All patients were physically active before symptom onset. Procedures were performed according to the technique described by Kaplan et al. Primary outcomes included return-to-sport time, Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF), and PROMIS Pain Interference (PI). Secondary outcomes included visual analogue scale (VAS) pain scores, radiographic union, and complications. PROMIS outcomes were evaluated against established minimal clinically important difference thresholds.</p><p><strong>Results: </strong>Fifteen athletic patients (mean age, 37.2 ± 9.1 years; 10 males, 5 females) with no relevant comorbidities were included with a minimum 18-month follow-up. All patients returned to their preinjury level of sport at a mean of 4.2 ± 1.1 months. Radiographic union was achieved in all cases at a mean of 10.2 ± 2.1 weeks. PROMIS Physical Function improved from 39.6 ± 5.8 preoperatively to 52.4 ± 6.1 at 3 months and 59.1 ± 5.0 at final follow-up (<i>P</i> < .001), whereas PROMIS Pain Interference decreased from 63.9 ± 6.4 to 51.2 ± 6.0 and 45.1 ± 5.0, respectively (<i>P</i> < .001). VAS pain scores improved from 7.1 ± 1.2 to 1.8 ± 1.1 at final follow-up (mean change -5.3, 95% CI -6.0 to -4.6; <i>P</i> < .001). Two minor complications (13%) were observed.</p><p><strong>Conclusion: </strong>MIS Zadek was associated with meaningful pain relief, functional improvement, and return to sport in athletic patients with IAT in this cohort. These findings suggest that it may represent a viable tendon-preserving surgical option. Prospective comparative studies are needed to further evaluate its role relative to alternative treatments.</p><p><strong>Level of evidence: </strong>Level IV, therapeutic case series.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261446302"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peppering Injection for Plantar Heel Pain: A Double-Blind Randomized Feasibility Study (a Short Report).","authors":"Michael A Jones, Garrett S Bullock, Kerry A Danelson, David W Robinson, Dekarlos M Dial, David R Sinacore","doi":"10.1177/24730114261441626","DOIUrl":"10.1177/24730114261441626","url":null,"abstract":"<p><strong>Background: </strong>Plantar heel pain affects up to 10% of individuals and often limits activity. Corticosteroid injections provide short-term relief, though emerging evidence suggests that benefits may derive from mechanical stimulation rather than pharmacologic effect. This pilot study evaluated the feasibility of a double-blind randomized trial comparing corticosteroid vs saline delivered via a standardized infracalcaneal peppering (fenestration) technique. Exploratory outcomes included short-term changes in Foot Function Index (FFI) and visual analog scale (VAS) pain scores.</p><p><strong>Methods: </strong>A total of 495 adults were identified via electronic health record queries, research registries, and targeted outreach; 76 were screened (assessed for eligibility) and 41 were enrolled and randomized (21 corticosteroid; 20 saline). Feasibility metrics included recruitment yield, visit completion, protocol adherence, and data completeness. Exploratory analyses used unadjusted linear mixed effects models.</p><p><strong>Results: </strong>Feasibility was demonstrated through adequate recruitment, 76% study completion (31/41), high protocol adherence, and low missingness of scheduled outcome measurements (3%). Baseline characteristics were comparable. Exploratory unadjusted estimates favored saline: FFI change -3.2 points (95% CI: -6.1, -0.4), VAS First-Step Pain change -6.6 mm (95% CI: -10.7, -2.4), and VAS General Pain change -3.0 mm (95% CI: -6.6, 0.7); between-group differences were below published minimal important difference (MID) thresholds (≈7 points for FFI Total; ≈9 mm for VAS).</p><p><strong>Conclusion: </strong>A randomized peppering-injection trial was feasible, and early unadjusted signals are consistent with a mechanically mediated effect independent of corticosteroid pharmacology. Larger, longer-term trials-including non-injection controls-are required to evaluate clinical effectiveness.</p><p><strong>Level of evidence: </strong>Level II, pilot feasibility study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261441626"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All-Inside Endoscopic Zone 1 Flexor Hallucis Longus Transfer: A Cadaveric Feasibility Study.","authors":"Kevin D Martin, Yi Wei, Adam G F Smith, Franco Piscitani, Luke M Martin, Brian Steginsky, Brian Tscholl, Nathaniel A Bates","doi":"10.1177/24730114261442547","DOIUrl":"10.1177/24730114261442547","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic flexor hallucis longus (FHL) tendon transfer addresses chronic Achilles tendon ruptures. Traditional percutaneous plantar incisions gain FHL length but risk neurovascular injury. This study evaluated the feasibility of an all-inside endoscopic FHL zone 1 tenotomy and transfer technique, which avoids plantar incisions by using zone 1 of the FHL tendon. We hypothesized that this technique would (1) provide sufficient tendon length, (2) avoid neurovascular damage, and (3) securely anchor the FHL tendon without tunnel blowout.</p><p><strong>Methods: </strong>Ten cadaveric all-inside endoscopic zone 1 FHL tendon transfers were performed without fluoroscopic guidance. Specimens were independently assessed post hoc by 2 board-certified orthopaedic foot and ankle surgeons. Tendon length, anchor placement, tunnel integrity, and neurovascular bundle preservation were analyzed.</p><p><strong>Results: </strong>No neurovascular injuries or calcaneal tunnel blowouts occurred. Mean FHL tendon length for tunnel fixation was 17.5 (3.7) mm; 2 specimens had FiberLoop suture visible above the biotenodesis screw.</p><p><strong>Conclusion: </strong>Our study supports the feasibility, reproducibility and preliminary safety of an all-inside FHL zone 1 tenotomy and endoscopic transfer. These cadaveric findings support further clinical investigation of this technique for Achilles rupture repair.</p><p><strong>Clinical relevance: </strong>This cadaveric study provides anatomical evidence that an all-inside endoscopic zone 1 FHL tendon transfer can be performed without neurovascular injury or tunnel blowout, offering preliminary support for future clinical investigation of this technique as a minimally invasive approach to Achilles tendon repair.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261442547"},"PeriodicalIF":0.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open vs Endoscopic Surgical Treatment for Haglund Deformity: A Systematic Review, Meta-analysis, and Meta-regression.","authors":"Alex Guedes, Enilton de Santana Ribeiro de Mattos, Eduardo Silva Reis Barreto, César Romero Antunes Júnior","doi":"10.1177/24730114261435962","DOIUrl":"10.1177/24730114261435962","url":null,"abstract":"<p><strong>Background: </strong>Haglund deformity, characterized by a bony prominence at the posterosuperior aspect of the calcaneus, is a frequent cause of posterior heel pain and Achilles tendinopathy. When conservative treatment fails, surgical resection is indicated. This systematic review and meta-analysis aimed to compare clinical and functional outcomes of open and endoscopic surgery in adults with Haglund deformity.</p><p><strong>Methods: </strong>The review followed PRISMA guidelines, was registered in PROSPERO (CRD420251061639), and included randomized trials or observational cohort studies directly comparing both techniques. The primary outcome was postoperative ankle function (American Orthopaedic Foot & Ankle Society score or the Victorian Institute of Sports Assessment-Achilles questionnaire scores); secondary outcomes included operative time, postoperative pain (visual analog scale), and adverse events. Random effects (restricted maximum likelihood) meta-analyses were performed, and risk of bias was assessed using the ROBINS-I tool.</p><p><strong>Results: </strong>Five cohort studies, totaling 226 patients (127 endoscopic, 99 open), met the inclusion criteria. The meta-analysis showed no significant difference in postoperative ankle function between techniques (standardized mean difference = -0.19, 95% CI -0.72 to 0.35; <i>I</i>² = 66.7%). Operative time was shorter in the open surgery group (mean difference = -11.73 minutes, 95% CI -23.03 to -0.42; <i>I</i>² = 94.6%). No significant differences were observed in postoperative pain or adverse events. All studies had a serious overall risk of bias.</p><p><strong>Conclusion: </strong>The available comparative observational evidence does not demonstrate clear superiority of either technique for the evaluated outcomes. Interpretation of symptom and function outcomes is limited by the measurement properties of the instruments used in the source studies. These findings represent a conservative synthesis of the best comparative evidence currently available and highlight the need for adequately powered randomized clinical trials with standardized outcome measures to more reliably inform surgical decision making.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261435962"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Patient Positioning to Improve Orientation, Ergonomics, and Standardization in Percutaneous Forefoot Surgery: A Technical Tip.","authors":"Andreas Toepfer, Thomas L Lewis, Peter Lam, Primoz Potocnik","doi":"10.1177/24730114261436763","DOIUrl":"10.1177/24730114261436763","url":null,"abstract":"<p><p>Graphical Abstract.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261436763"},"PeriodicalIF":0.0,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Initial Immobilization Method on Outcomes in Unstable Weber B Ankle Fractures: A Retrospective Cohort Study.","authors":"Isabella Rubin, Gianna Guarino, Meghan Lauzé, Antonio Lobao, Abhay Patel","doi":"10.1177/24730114261438476","DOIUrl":"10.1177/24730114261438476","url":null,"abstract":"<p><strong>Background: </strong>Weber B ankle fractures with medial clear space (MCS) widening on stress radiographs are unstable injuries that may require surgical stabilization. Initial emergency department management varies, with patients receiving a cast or splint after reduction, although concerns for soft tissue complications often limit cast use. It remains unclear whether splint or cast immobilization affects clinical or radiographic outcomes.</p><p><strong>Methods: </strong>We retrospectively reviewed 295 patients treated for closed Weber B ankle fractures between January 1, 2017, and February 15, 2025; among them, 96 were determined to have an unstable pattern based on MCS widening on stress radiographs. Inclusion criteria were age ≥18 years, isolated fibular fracture with MCS widening indicating deltoid incompetence, and ankle radiographs at initial, postreduction, and follow-up time points. Patients with bimalleolar or trimalleolar fractures were excluded. We compared MCS values, surgical rates, reduction attempts, and complications across initial immobilization types.</p><p><strong>Results: </strong>Postreduction MCS was significantly smaller in the cast group compared to the splint group (2.79 ± 0.50 vs 3.41 ± 0.83 mm, <i>P</i> < .01). MCS at follow-up remained lower in the cast group and below the 4-mm threshold commonly used to guide surgical decision making (2.73 ± 0.54 vs 4.14 ± 1.10 mm, <i>P</i> < .01). A greater proportion of casted patients maintained reduction at follow-up (n = 72 vs 19, <i>P</i> = .04), reinforcing the association between initial casting and radiographic stability. There were no statistically significant differences in surgical or complication rates between groups.</p><p><strong>Conclusion: </strong>Initial immobilization with a cast in unstable Weber B ankle fractures was associated with improved postreduction and follow-up radiographic alignment measured by MCS. The absence of increased complication rates among cast patients indicates that the superior radiographic stability with casting is not offset by increased complications, although the study may have been underpowered to detect a difference in safety profiles. Future prospective studies can inform the development of standardized immobilization protocols for unstable Weber B fractures.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261438476"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Open Scarf-Akin Osteotomy and Minimally Invasive Chevron and Akin (MICA) Osteotomy for Severe Hallux Valgus Deformity: A Retrospective Study.","authors":"WaiLok Charlix Yeung, Ming Hong Chau, Ka Ki Stephanie Liu","doi":"10.1177/24730114261436758","DOIUrl":"10.1177/24730114261436758","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgery (MIS) for hallux valgus, particularly the minimally invasive chevron and Akin (MICA) technique, is gaining popularity. However, comparative studies between open scarf-Akin osteotomy (SA) and MICA remain limited, particularly for severe cases (ie, hallux valgus angle [HVA] ≥ 40° or intermetatarsal angle [IMA] ≥ 16°). This study aimed to compare the clinical and radiographic outcomes between SA and MICA for severe hallux valgus.</p><p><strong>Methods: </strong>We retrospectively reviewed 56 consecutive feet (SA = 33; MICA = 23) treated between January 2019 and January 2023 at a single institution in Hong Kong. Clinical outcomes were evaluated using the American Orthopaedic Foot & Ankle Society (AOFAS) score, Self-Reported Foot and Ankle Score (SEFAS), and visual analog scale (VAS) for pain. Radiographic parameters included the HVA, IMA, distal metatarsal articular angle (DMAA), first metatarsal pronation, and first metatarsal length.</p><p><strong>Results: </strong>Baseline characteristics were broadly comparable, with deformity severity trending higher in MICA. MICA had shorter total operative time and hospital stay (<i>P</i> = .002 and <i>P</i> < .001), although the SA group had a higher frequency of concomitant lesser-toe procedures (85% vs 61%, <i>P</i> = .056), and MICA showed greater improvements in AOFAS and SEFAS (<i>P</i> = .006 and <i>P</i> = .032). In exploratory 2-predictor sensitivity regression adjusting for concomitant lesser-toe procedure, MICA remained associated with shorter operative time (beta = -40.0 min, 95% CI -66.3 to -13.7; <i>P</i> = .003) and shorter length of stay (beta = -2.35 days, 95% CI -3.52 to -1.17; <i>P</i> < .001). After this adjustment, AOFAS improvement was greater in MICA (beta = +6.40, <i>P</i> = .008), whereas SEFAS and VAS improvements were not statistically different. For pronation, SA achieved superior apparent correction: severe postoperative pronation (Wagner 3) was 0% after SA vs 48% after MICA, and baseline-adjusted ordered logistic regression similarly favored SA (MICA vs SA OR 3.75, 95% CI 1.08-13.03; <i>P</i> = .037).</p><p><strong>Conclusion: </strong>Both procedures reliably corrected severe HV deformity. MICA was associated with shorter total operative time and reduced length of stay. In exploratory covariate-adjusted sensitivity models, MICA maintained advantages in operative time and AOFAS scores, whereas between-group differences in SEFAS and angular radiographic outcomes were attenuated or nonsignificant. In contrast, SA demonstrated stronger correction of apparent first-metatarsal pronation, with no apparent residual severe pronation at follow-up compared with MICA.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261436758"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ankle Arthrodesis Associated With Risk of Progression to Total Knee Arthroplasty Compared to Total Ankle Arthroplasty.","authors":"Gloria Coden, Colin Wood, Andrzej Brzezinski, Matthew Beckles, Shannon Gray, Riley Smith, Kurt Hofmann","doi":"10.1177/24730114261435963","DOIUrl":"10.1177/24730114261435963","url":null,"abstract":"<p><strong>Background: </strong>It is unknown how the increased range of motion and improved gait mechanics provided by total ankle arthroplasty (TAA) affects the progression of knee arthritis compared with ankle arthrodesis (AA). We hypothesized that patients treated with TAA would have a lower incidence of postoperative knee arthritis and total knee arthroplasty (TKA) compared with AA.</p><p><strong>Methods: </strong>We retrospectively reviewed a matched cohort of 3751 AAs and 3751 TAAs performed between January 1, 2007, and December 31, 2021, using a commercial claims database. Patients with a history of preoperative knee arthritis or TKA were excluded. Patients were matched 1:1 for gender, age at time of ankle surgery, indication for ankle surgery, year of ankle surgery, and geographical region. Univariate and multivariate regression analyses were performed. Significance was set at <i>P</i> < .05.</p><p><strong>Results: </strong>Demographics were similar between AA and TAA. AA (absolute risk [AR] = 17.54%, odds ratio [OR] = 1.24, CI = 1.07-1.44), earlier years of ankle surgery, and older age increased the risk of postoperative knee arthritis compared with TAA (AR = 10.10%, absolute risk reduction [ARR] = 7.44%, CI = 5.89%-8.99%). Posttraumatic ankle arthritis, inpatient surgery, and surgery in the West region were protective against developing postoperative knee arthritis. AA (AR = 4.19%, OR = 2.37, CI = 1.65-3.39), earlier year of ankle surgery, males, and other indication for ankle surgery increased the risk of requiring a postoperative TKA compared with TAA (AR = 1.36%, ARR = 2.83%, CI = 2.09%-3.57%). Posttraumatic ankle arthritis and inpatient surgery were protective factors against requiring a TKA.</p><p><strong>Conclusion: </strong>There is a significantly higher incidence of patients who underwent TKA after AA compared with TAA, although the inability to confirm laterality in 38% of cases dilutes the hypothesis of a specific biomechanical association in the study. We recommend that surgeons carefully weigh the risks and benefits of TAA and AA with this in mind, especially in patients with minimal knee arthritis, as a potential strategy to mitigate risk of requiring TKA in the future.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261435963"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: \"Letter Regarding: Modified Sliding Fibular Graft for Aneurysmal Bone Cyst of the Lateral Malleolus: Technique and Two-Case Series\".","authors":"Filipe Marques de Oliveira, Mariana Vendramin Mateussi, Jairo Greco Garcia, Marcelo de Toledo Petrilli, Dan Carai Maia Viola, Reynaldo Jesus-Garcia Filho","doi":"10.1177/24730114261435584","DOIUrl":"10.1177/24730114261435584","url":null,"abstract":"","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261435584"},"PeriodicalIF":0.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147767220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}