Foot & Ankle Orthopaedics最新文献

{"title":"Return to Physical Activity and Footwear Modifications After First Metatarsophalangeal Joint Arthrodesis, Including Alpine Sports: A Retrospective Case Series.","authors":"Stefan C Garcia, Nathaniel E Zona, Kenneth J Hunt, Marissa D Jamieson","doi":"10.1177/24730114261433961","DOIUrl":"https://doi.org/10.1177/24730114261433961","url":null,"abstract":"<p><strong>Background: </strong>First metatarsophalangeal (MTP) arthrodesis can effectively alleviate pain and correct deformity of the great toe but may introduce unique limitations to an active patient population, particularly in alpine-specific sports including Nordic and alpine skiing, snowboarding, hiking, trail running and biking. Limited literature evaluates return to these specific activities after first-MTP arthrodesis. This study aims to better define the ability to return to physical activity, with a focus on alpine sports and footwear modifications.</p><p><strong>Methods: </strong>Adults undergoing MTP arthrodesis with ≥1-year follow-up at a single academic institution were retrospectively reviewed. Demographic data, surgical complications, and radiographic union were recorded. A custom sports questionnaire was administered preoperatively and postoperatively across >20 sports, including outdoor and alpine sports, to assess return to activity. Paired <i>t</i> tests compared pre- to postoperative changes in patient-reported outcomes, with significance set to <i>P</i> <.05.</p><p><strong>Results: </strong>The mean age was 58.8 years, and 57.3% were female. Ninety-six percent (43/45) of patients returned to sport by 12 months postoperatively, whereas 24.4% required more than 12 months to reach their maximum activity level. Nordic and alpine skiers and snowboarders were all able to return to the same or higher level of sport, but nearly half (40%) required boot modifications. Similarly, 42% of all patients in this study required some level of shoe modification for their respective sport.</p><p><strong>Conclusion: </strong>First-MTP arthrodesis supports high return-to-sport rates, including demanding alpine activities including skiing, snowboarding, and hiking. Up to 1 year is often required to reach maximum performance. Patients should be counseled on the potential need for footwear modification after surgery. These findings outline guidance for counseling of highly active patient populations. Further studies can help elucidate which factors contribute to the lack of return to sport for specific patients and sports.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261433961"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147767235","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":"Increased Risk of Recurrence in Severe Hallux Valgus Associated With Inability to Passively Correct Deformity Prior to Surgery: A Comparative Study of Transverse vs Chevron Osteotomy Minimally Invasive Surgery Techniques.","authors":"Thomas L Lewis, Clare Watt, Lily Fletcher, Evelyn Murphy, Gabriel Ferraz Ferreira, Andreas Toepfer, Choon Chiet Hong, Peter Lam","doi":"10.1177/24730114261434234","DOIUrl":"https://doi.org/10.1177/24730114261434234","url":null,"abstract":"<p><strong>Background: </strong>The optimal osteotomy technique for severe hallux valgus deformity using minimally invasive surgery remains unknown. This study aimed to explore the clinical and radiographic outcomes between chevron and transverse osteotomies in patients with severe hallux valgus deformity.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted including 131 feet (109 patients) with complete radiographic follow-up who underwent hallux valgus correction using either percutaneous chevron and Akin osteotomy (PECA) (n = 43 patients, 50 feet) or metaphyseal extra-articular transverse and Akin osteotomy (META) (n = 66 patients, 81 feet) techniques. Radiographic parameters including hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured at baseline, 6 weeks, and final follow-up. Patient-reported outcome measures were assessed using the Manchester-Oxford Foot Questionnaire (MOXFQ), visual analog scale (VAS) for pain, and EuroQol 5 dimension-5 level questionnaire. Recurrence was defined as a final HVA exceeding 20°. Complication rates and passive correctability were also analyzed.</p><p><strong>Results: </strong>Baseline characteristics were similar between groups, except for significantly higher initial IMA in the PECA group (17.8° vs 15.8°, <i>P</i> = .001). Both techniques achieved significant deformity correction. At final follow-up, the PECA group demonstrated a significantly lower HVA compared to the META group (11.7° vs 14.5°, <i>P</i> = .045), whereas final IMA measurements were similar (5.2° vs 4.9°, <i>P</i> = .642). Recurrence rates were significantly lower in the PECA group (10.0% [95% CI: 4.3%-21.4%] vs 27.2% [95% CI: 18.7%-37.7%], <i>P</i> = .025). Pre-operative passive correctability was significantly higher in the PECA group (68.0% vs 46.9%, <i>P</i> = .020), particularly amongst recurrent cases (80.0% vs 27.3%, <i>P</i> = .047). No significant differences were observed in MOXFQ scores between groups, although VAS pain favored the META group (6.2 [SD 12.3] vs 11.9 [SD 17.5], <i>P</i> = .046). Complication rates were comparable (PECA: 13.2% vs META: 8.6%, <i>P</i> = .40). Complication rates were comparable (PECA: 13.2% vs META: 8.6%, <i>P</i> = .40), with different complication profiles noted between techniques.</p><p><strong>Conclusion: </strong>Both PECA and META techniques provide effective correction of hallux valgus deformity. The higher recurrence rate observed in the META group was associated with a significantly lower rate of pre-operative passive correctability in that cohort.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261434234"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147767173","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":"Short-term Outcomes of Percutaneous Zadek Osteotomy for Insertional Achilles Tendinopathy in Cavus vs Non-Cavus Feet: A Comparative Multi-Center Study.","authors":"Thomas L Lewis, Lily Fletcher, Clare Watt, Robbie Ray, Togay Koç, Ayla Claire Newton, Gabriel Ferraz Ferreira, Tyler A Gonzalez, Peter Lam","doi":"10.1177/24730114261427474","DOIUrl":"https://doi.org/10.1177/24730114261427474","url":null,"abstract":"<p><strong>Background: </strong>There has been increasing interest in the percutaneous dorsal closing-wedge Zadek calcaneal osteotomy (PDCWZO) for the treatment of insertional Achilles tendinopathy (IAT). This study aims to investigate the clinical efficacy and radiographic outcomes of the percutaneous dorsal closing-wedge Zadek calcaneal osteotomy in patients with and without pes cavus foot morphology.</p><p><strong>Methods: </strong>A multicentre observational study of patients undergoing PDCWZO for IAT. Patients were stratified into cavus (calcaneal pitch angle > 20 degrees) and non-cavus (calcaneal pitch angle ≤ 20 degrees) groups. The primary outcome was the X/Y ratio and calcaneal pitch angle. Clinical outcomes were assessed using the Manchester-Oxford Foot Questionnaire (MOXFQ), visual analogue scale (VAS) for pain, and EuroQol-5 dimensions (EQ-5D). Between-group analyses were performed to identify differences in outcomes based on foot morphology.</p><p><strong>Results: </strong>Between April 2022 and December 2024, 67 feet (61 patients; 25 male, 36 female) with mean age 55.0 ± 12.7 years (range: 20.9-77.6) underwent percutaneous Zadek osteotomy with a median clinical follow-up of 0.56 years (IQR: 0.48-0.99) and median radiographic follow-up of 0.36 years (IQR: 0.13-0.49). The cohort included 50 cavus feet and 17 non-cavus feet. Radiographic analysis showed a significant increase in the X/Y ratio in both groups (cavus: 2.44 ± 0.27 to 3.08 ± 0.45, <i>P</i> < .001; non-cavus: 2.43 ± 0.28 to 3.05 ± 0.56, <i>P</i> < .001). Calcaneal pitch angle remained unchanged in both the cavus group (27.1 ± 4.2 degrees to 27.1 ± 4.6 degrees, <i>P</i> = .917) and non-cavus group (17.7 ± 1.7 degrees to 18.8 ± 4.8 degrees, <i>P</i> = .270). Clinical outcomes in all groups demonstrated significant improvement in all MOXFQ domains, VAS Pain and EQ-5D (<i>P</i> < .05). The complication rate was 6.0%.</p><p><strong>Conclusion: </strong>At short-term follow-up (median 6.7 months), percutaneous Zadek calcaneal osteotomy demonstrated a low complication rate and was associated with improvements in foot function and pain relief for patients with both cavus and non-cavus feet.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261427474"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147767212","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":"Manual and Visual Assessment of Foot Type and Posture Correlate Poorly With Radiographic Assessment: A Cross-Sectional Study.","authors":"Steve Bayer, Elizabeth Plakseychuk, Kenzo Cotton, Clarissa LeVasseur, Dukens LaBaze, Alexandra Gabrielli, Gillian Kane, Maria A Munsch, Stephen Chen, Christopher Murawski, Conor Murphy, William Anderst, MaCalus V Hogan","doi":"10.1177/24730114261432621","DOIUrl":"https://doi.org/10.1177/24730114261432621","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to assess how well manual and visual assessment of foot type agree with radiographic assessment. We hypothesized that quantitative measures would have better interrater reliability than qualitative measures, and that visual assessment of foot type would be strongly correlated with radiographic assessment.</p><p><strong>Methods: </strong>Bilateral foot photographs, radiographs, and physical examination were acquired on 92 participants to assess Radiographic Arch Type, calcaneal pitch, Meary angle, Arch Index, Photo Arch Type, Radiographic Foot Posture, Foot Posture Index, and Photo Foot Posture by 5 reviewers. Correlations between measures, interrater reliability, and sensitivity/specificity were assessed using calcaneal pitch as the reference standard.</p><p><strong>Results: </strong>Interrater reliability of the photographic and radiographic measures were moderate to good (intraclass correlation coefficient 0.52-0.83). However, agreement between methods was poor, with significant variability in classification (kappa < 0.40). Overall, Radiographic Arch Type had the greatest sensitivity and specificity for identifying planus, normal, and cavus feet. Among nonradiographic parameters, photographs had the greatest sensitivity and specificity for identifying normal feet, the greatest sensitivity for identifying planus feet, and the greatest specificity for identifying cavus feet.</p><p><strong>Conclusion: </strong>Agreement between methods varied widely, suggesting that classification is dependent on methodology and cutoff values selected to discriminate among foot types. Specifically, nonradiographic methods failed to consistently classify foot type compared with calcaneal pitch and Meary angle.</p><p><strong>Level of evidence: </strong>Level II, prospective cohort study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261432621"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147767191","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":"Weightbearing Computed Tomography Reveals Why Heel Varus Is Not Always the Rule in Müller-Weiss Disease.","authors":"John Wong-Chung, Wolfram Grün, Roslyn Cassidy, Erik Jesús Huánuco Casas, Robert Alistair Wilson, Cesar de Cesar Netto","doi":"10.1177/24730114261436393","DOIUrl":"https://doi.org/10.1177/24730114261436393","url":null,"abstract":"<p><strong>Background: </strong>Controversy exists regarding mandatory hindfoot varus in Müller-Weiss disease (MWD).</p><p><strong>Methods: </strong>This retrospective cohort study examined weightbearing computed tomography (WBCT) in 22 feet with MWD. Measurements included hindfoot moment arm (HMA), middle facet subluxation in coronal (MFSC) and sagittal (MFSS) planes, posterior facet uncoverage, and angles between inferior and superior talar surfaces (inftal-suptal) at 33%, 50%, and 67% of the way moving from anterior to posterior along the posterior facet.</p><p><strong>Results: </strong>From the cohort consisting of 14 patients (22 feet, mean age 51.14 ± 13.90 years), based on a neutral zero HMA, 10 feet were designated as varus-offset and 12 as valgus-offset. Mean MFSC in valgus-offset (49.3 ± 6.3%) is significantly greater than in varus-offset feet (28.2 ± 6.1%) (<i>P = .</i>022). Greater MFSS and posterior facet uncoverage in valgus-offset feet are not statistically significant. Based on inftal-suptal angles, 2 groups of talar configurations are identified, each with increased predisposition towards either varus or valgus offset. In talus configurations with inftal-suptal angles open laterally at all 3 levels, the predominant heel offset is varus (89%), whereas in talus configurations featuring an inftal-suptal angle open medially, the predominant heel offset is valgus (85%) (<i>P</i> = .002). As HMA changes from varus to valgus, inftal-suptal angles change from open laterally to open medially at all 3 levels, reaching greatest significance at the 67% mark (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>To our knowledge, this is the largest WBCT study of MWD to date. In these patients, we identified significantly greater MFSC in valgus-offset feet and different talus configurations, which may explain the more frequent 55% incidence of valgus offset. Because universal heel varus is not always the rule, caution is advised in advocating lateral displacement calcaneal osteotomy for all MWD feet.</p><p><strong>Level of evidence: </strong>Level IV, retrospective cohort study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261436393"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147767244","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":"Non-operative Treatment for Acute Achilles Tendon Rupture: Evaluation of Clinical Results and Tendon Lengthening on Magnetic Resonance Imaging.","authors":"Toshito Yasuda, Kosho Togei, Ken Tanaka, Masatoshi Takashima, Hiroaki Shima, Shuhei Otsuki","doi":"10.1177/24730114261436395","DOIUrl":"https://doi.org/10.1177/24730114261436395","url":null,"abstract":"<p><strong>Background: </strong>In previous clinical studies of Achilles tendon (AT) ruptures, there are few reports measuring the AT length after conventional non-operative treatment without early functional rehabilitation. This study reviewed the outcomes of non-operative treatment for AT ruptures and assessed tendon length using magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>Patients with acute AT rupture who underwent non-operative treatment were included in this retrospective study. In our department, conventional non-operative treatment without early functional rehabilitation is used to avoid excessive tendon lengthening in patients with AT rupture. Patients wore a below-the-knee cast and performed non-weight-bearing walking for 4 weeks. Subsequently, the cast was removed, and an ankle-foot orthosis was applied for 4-6 weeks. The mean follow-up period was 28 months. Clinical outcomes were assessed using the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale and the AT Total Rupture Score (ATRS). The tendon length and morphology were evaluated using MRI.</p><p><strong>Results: </strong>Sixty-four patients (42 men, 22 women; mean age, 44 years) with acute AT rupture underwent non-operative treatment. The mean JSSF score and ATRS were 97 and 91 points, respectively. Among 43 athletes, 36 (83.7%) returned to their pre-injury level of sports participation. Tendon re-rupture occurred in 2 of 64 patients (3.1%). T2-weighted MRI revealed fusiform-shaped tendon thickening and homogeneous low-signal changes in all patients. The mean AT length measured by MRI after treatment was 66.4 mm.</p><p><strong>Conclusion: </strong>Conventional non-operative treatment without early functional rehabilitation has a low re-rupture rate and favorable clinical outcomes, and MRI findings indicated good tendon healing in all patients. In our non-operative treatment, tendon lengthening increased up to 6 months post-injury. Overall, these results indicate that casting and non-weight-bearing for 4 weeks may represent a safe and effective treatment option associated with limited excessive tendon lengthening and re-rupture.</p><p><strong>Level of evidence: </strong>Level IV, retrospective cohort study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261436395"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147767178","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":"Corrigendum to \"Radiographic and Clinical Outcomes in Patients With Charcot Neuroarthropathy Undergoing 1-Stage Screw Arthrodesis: 1-Year Follow-up\".","authors":"","doi":"10.1177/24730114261446659","DOIUrl":"https://doi.org/10.1177/24730114261446659","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/24730114261434007.].</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261446659"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147767130","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":"Trends in Surgical Management of Lisfranc Injuries: An Analysis of American Board of Orthopaedic Surgery Part II Candidates.","authors":"Kathryn R Segal, Phillip Schmitt, Janine Molino, Amanda Galambas, Jonathan Liu, Brad Blankenhorn, Raymond Y Hsu","doi":"10.1177/24730114261433594","DOIUrl":"https://doi.org/10.1177/24730114261433594","url":null,"abstract":"<p><strong>Background: </strong>Historically, Lisfranc injuries have most commonly been managed by open reduction and internal fixation (ORIF). Over the past 2 decades, literature has suggested that arthrodesis, an alternative option, may be the superior surgical treatment. It is unclear, however, how much orthopaedic clinical practice has responded to the new evidence.</p><p><strong>Methods: </strong>We performed a retrospective review of the Part II Oral Examination Case List American Board of Orthopaedic Surgery (ABOS) database to identify Lisfranc injuries treated with ORIF or arthrodesis from 1999 to 2022. Cases performed by early-career orthopaedic surgeons were selected using relevant <i>Current Procedural Terminology</i>, <i>International Classification of Diseases, Ninth</i> (<i>ICD-9</i>) and <i>Tenth Revision</i> (<i>ICD-10</i>), codes corresponding to treatment with either arthrodesis or ORIF. Treatment trends were analyzed over time and stratified by surgeon fellowship training, patient age, and patient sex. Injury chronicity and specific timing from injury to surgery were not available.</p><p><strong>Results: </strong>A total of 3068 surgically managed Lisfranc injuries were identified. Of these, 574 (18.7%) were managed with arthrodesis and 2494 (81.3%) with ORIF. The rate of arthrodesis increased over time: from 7.7% (95% CI 6.3-9.3) in 1999-2009 to 20.7% (95% CI 18.5-23.1) in 2010-2017 (<i>P</i> < .0001) and to 37.0% in 2018-2022 (95% CI 33.3-40.9) (<i>P</i> < .0001). The rate of arthrodesis was higher among cases performed by foot and ankle-trained orthopaedists (30.3% vs 7.9% of all other sub-specialties), in female patients (22.4% vs 15.9% in males), and in older patients (27.8% of patients >50 years vs 15.4% of patients ≤50 years).</p><p><strong>Conclusion: </strong>Although still the less utilized approach, arthrodesis for Lisfranc injuries has increased substantially among early-career orthopaedic surgeons in parallel to emerging evidence. This trend is more apparent among foot and ankle specialists.</p><p><strong>Level of evidence: </strong>Level III, therapeutic.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261433594"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147767241","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":"A Comparison of Radiographic Alignment Using Patient-Specific and Standard Instrumentation in Total Ankle Arthroplasty.","authors":"Nicholas Veale, Kristian Efremov, Colin Wood, Matthew Beckles, Riley Smith, Gloria Coden, Mark Slovenkai, Kurt Hofmann","doi":"10.1177/24730114261434006","DOIUrl":"https://doi.org/10.1177/24730114261434006","url":null,"abstract":"<p><strong>Background: </strong>The rate of total ankle arthroplasty (TAA) is projected to continue increasing. Implant malalignment is a significant predictor of complications; however intraoperative evaluation of alignment can be challenging. Patient-specific instrumentation (PSI) was designed to improve implant positioning in TAA. This study compares radiographic alignment and postoperative function in patients who underwent TAA with PSI with an Infinity implant vs standard instrumentation (SI) with a Salto Talaris implant.</p><p><strong>Methods: </strong>We retrospectively reviewed 114 TAA cases using PSI compared with 80 TAA surgeries using SI. Demographics, radiographic alignment, range of motion (ROM), complications, and postoperative American Orthopaedic Foot & Ankle Society (AOFAS) pain, function, and alignment scores were compared at a minimum 1-year follow-up.</p><p><strong>Results: </strong>The PSI cohort demonstrated significantly better radiographic alignment, particularly in tibial component positioning, and reduced frequency of lucencies compared with the SI cohort. However, operative time was significantly longer in the PSI group (mean 119.0 ± 34.5 vs 96.3 ± 26.0 minutes; <i>P</i> < .001). For the coronal alignment of the tibial component, PSI alignment was 1.7° (0.0°-10.2°) and 2.5° (0.0°-9.8°) for SI (<i>P</i> = .002). For the sagittal alignment of the tibial component, alignment was observed to be 2.9° (0.0°-9.9°) for PSI and 6.1° (1.0°-13.0°) for SI (<i>P</i> < .001). The PSI cohort had increased AOFAS alignment scores (mean = 9.7 vs 8.9, <i>P</i> = .002), but AOFAS total scores were similar (mean = 77.7 vs 79.2, <i>P</i> = .539) between cohorts. Similar numbers of patients required revision (1.75% for PSI, 1.25% for SI, <i>P</i> = 1.00) or irrigation and debridement (3.51% for PSI, 3.75% for SI, <i>P</i> = 1.00).</p><p><strong>Conclusion: </strong>In this study, PSI was associated with modest differences in tibial alignment and early radiographic lucencies compared with SI, without clear significant differences in short-term clinical outcomes. Both cohorts had similar postoperative range of motion and AOFAS scores. Given the retrospective design and short follow-up, further investigation is needed to assess long-term clinical impact and implant survivorship.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261434006"},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147767143","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":"Swing-Phase Plantar Stimulation and Gait Parameters in Patients With Diabetic Neuropathy: A Preliminary Study.","authors":"Iris Hoffmann, Justin Luk, Kendal Toy, Juliet Moncho, Jennifer A Skolnik, Sara E Rose-Sauld, Soheil Ashkani-Esfahani, Atta Taseh","doi":"10.1177/24730114261427468","DOIUrl":"https://doi.org/10.1177/24730114261427468","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy (DPN) affects nearly 50% of patients with diabetes mellitus, leading to impaired balance and falls. Vibrotactile stimulation during walking is shown to improve gait performance, although the effects of targeted stimulations in the swing phase of gait are unexplored. This study investigated the effects of swing-phase vibrotactile stimulation on gait parameters in DPN.</p><p><strong>Methods: </strong>We conducted a prospective controlled study with the DPN group (DG) aged 18-75 years diagnosed with DPN and the control group (CG) with no diagnosis of diabetes. Participants completed 3-minute walk and Timed Up and Go tests with and without vibrotactile stimulation provided by smart shoes. The shoes measured gait parameters, including stride length, velocity, strike angle, heel clearance, swing-stance ratio, stride duration, and distance. Analysis included the Mann-Whitney <i>U</i> test, with a significance threshold set at <i>P</i> <.05.</p><p><strong>Results: </strong>A total of 28 individuals were analyzed (CG n = 18; DG: n = 10). DG participants were of higher age and BMI compared with controls (<i>P</i> < .01). At baseline, the DG demonstrated shorter stride length, smaller normalized stride length, lower walking velocity, reduced strike angle, and shorter distance covered in the 3-minute walk (<i>P</i> < .01). Between-group comparisons revealed increased heel clearance in controls (<i>P</i> = .03), which was attenuated after adjusting for age and BMI (<i>P</i> = .17).</p><p><strong>Conclusion: </strong>Our findings did not reveal an immediate effect of swing-phase stimulation on gait parameters in DPN patients. However, temporal gait parameters may require more demanding tasks or longer exposure to yield measurable benefits. Larger, age-matched trials using variability data are warranted to determine efficacy and identify responders in DPN.</p><p><strong>Level of evidence: </strong>Level II, prospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 2","pages":"24730114261427468"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722078","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}