Foot & Ankle Orthopaedics最新文献

{"title":"Preoperative Degenerative Changes at the Tibial Sesamoid-Metatarsal Joint in Hallux Valgus: Association With Postoperative Patient-Reported Outcomes After Modified Lapidus Procedure.","authors":"Sophie Kush, Stone R Streeter, Agnes D Cororaton Jones, Brett Steineman, Scott J Ellis, Matthew S Conti","doi":"10.1177/24730114241256370","DOIUrl":"10.1177/24730114241256370","url":null,"abstract":"<p><strong>Background: </strong>Degenerative changes at the sesamoid-metatarsal joints (SMJs) may be a source of pain following hallux valgus surgery. The aims of this study were to describe degenerative changes at the SMJs on weightbearing computed tomography (WBCT) scans and, secondarily, investigate their association with 1-year patient-reported outcome scores following a modified Lapidus procedure for hallux valgus. We hypothesized that reduced joint space in the SMJs would correlate with worse patient-reported outcomes.</p><p><strong>Methods: </strong>Fifty-seven hallux valgus patients who underwent a modified Lapidus procedure had preoperative and minimum 5-month postoperative WBCT scans, and preoperative and at least 1-year postoperative PROMIS physical function (PF), pain interference, and pain intensity scores were included. Degenerative changes at the SMJs were measured using distance mapping between the sesamoids and first metatarsal head on preoperative and postoperative WBCT scans. The minimum and average distances between the first metatarsal head and tibial sesamoid (tibial-SMJ) for each patient preoperatively and postoperatively were measured. Sesamoid station was measured on WBCT scans using a 0 to 3 grading system. Linear regression was used to investigate the correlations between minimum preoperative and postoperative tibial-SMJ distances and 1-year postoperative PROMIS scores.</p><p><strong>Results: </strong>The median minimum and average tibial-SMJ distances increased from 0.82 mm (interquartile range [IQR] 0.40-1.03 mm) and 1.62 mm (IQR 1.37-1.75 mm) preoperative to 1.09 mm (IQR 0.96-1.23 mm) and 1.73 mm (IQR 1.60-1.91 mm) postoperative (P < .001 and P < .001), respectively. In a subset of patients with complete sesamoid reduction, we found an association between preoperative minimum tibial-SMJ distance and 1-year postoperative PROMIS PF scores (coefficient 7.2, <i>P</i> = .02).</p><p><strong>Conclusion: </strong>Following the modified Lapidus procedure, there was a statistically significant increase in the tibial-SMJ distance. Additionally, in patients with reduced sesamoids postoperatively, reduced preoperative tibial-SMJ distance correlated with worse PROMIS PF scores.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"9 2","pages":"24730114241256370"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261440","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":"Auditing the Representation of Female Athletes in Sports Medicine Research: Achilles Repair.","authors":"Michael Braman, Cooper Root, Ian Harmon, Rachel Long, Lisa Vopat, Bryan Vopat, Ashley Herda","doi":"10.1177/24730114241255360","DOIUrl":"10.1177/24730114241255360","url":null,"abstract":"<p><strong>Background: </strong>Establishing evidence-based recommendations specific to female athletes has been overlooked in sports medicine. Achilles tendon rupture is one of the most common musculoskeletal injuries, occurring in 15 to 55 per 100 000 people annually. Differences in injury rates could be due to hormonal effects, as estrogen receptors have been identified in tendons along with decreased tendon strain based on oral contraceptive use. The primary purpose of this study was to audit the representation of female athletes in the literature regarding Achilles repair.</p><p><strong>Methods: </strong>An electronic search was performed using PubMed to identify articles related to Achilles repair using the protocol by Smith et al. Studies were assessed by population, size, athletic caliber, study impact, research theme, and menstrual status.</p><p><strong>Results: </strong>Female representation across all studies was 1783 of 10 673 subjects (16.7%). Composition of included studies was predominantly mixed-sex cohorts with 131 of 169 (77.5%) included studies. Within mixed-sex cohort studies, the total representation of female athletes was 1654 of 8792 participants (18.9%). Thirty-two studies were male only, constituting 1540 participants, whereas 3 studies were female only composed of 86 athletes. Importantly, the disparity between male and female representation worsened as the athletic caliber of the study population increased, with 5.0% female representation in studies with professional athletes. No study collected data related to menstrual status and its potential relationship to Achilles rupture or postoperative outcomes.</p><p><strong>Conclusion: </strong>Mixed-sex cohort studies underrepresented female athletes, and male-only cohort studies were more common than female-only studies. These findings indicate a need for increased representation of female athletes as well as acknowledgment of menstrual status in research related to Achilles repair. Future studies should focus on representation of female athletes and data collection related to sex-specific hormones, hormonal contraceptive use, and menstrual status to improve treatment of Achilles tendon ruptures for female athletes.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"9 2","pages":"24730114241255360"},"PeriodicalIF":0.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199549","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":"Displacement after Open vs Saw-Based Minimally Invasive Medial Displacement Calcaneal Osteotomy: A Cadaveric Study.","authors":"Motasem Salameh, Sereen Halayqeh, Arielle Richey Levine, Mostafa M Abousayed, Raymond Hsu, Brad Blankenhorn","doi":"10.1177/24730114241255350","DOIUrl":"10.1177/24730114241255350","url":null,"abstract":"<p><strong>Background: </strong>Medial displacement calcaneal osteotomy (MDCO) is routinely used in hindfoot valgus realignment. Minimally invasive surgery (MIS) calcaneal osteotomies have been reported to be as safe and effective compared to open techniques. The aim of this cadaveric study was to compare the amount of medial tuberosity displacement obtained with fine-cut saw-based MIS vs open MDCO techniques.</p><p><strong>Methods: </strong>Eight matched cadaveric specimens had one side randomly assigned to either open or MIS MDCO. The contralateral limb was then assigned to the alternative osteotomy. The amount of medial displacement provided by the osteotomy was measured manually using a flexible metric ruler and radiographically on standardized axial calcaneal radiographs.</p><p><strong>Results: </strong>Manual measurements showed that a mean displacement of the MIS osteotomy was 7.9 mm compared with 8.7 mm for the open technique (<i>P</i> = .36). Radiograph measurement showed a mean displacement of the MIS osteotomy was 7.1 mm compared with 7.4 mm for the open technique (<i>P</i> = .83). No significant difference was found on manual and radiographic measurement of medial displacement between MIS and open MDCO.</p><p><strong>Conclusion: </strong>In a cadaveric model, we found similar magnitude of calcaneal tuberosity displacement using fine-cut saw-based MIS and open techniques for medial displacement calcaneal osteotomies.</p><p><strong>Level of evidence: </strong>Level V, cadaveric study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"9 2","pages":"24730114241255350"},"PeriodicalIF":0.0,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199556","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":"Prehabilitation for Patients Undergoing Elective Foot and Ankle Surgery: A Contemporary Review.","authors":"Hye Chang Rhim, Jason M Schon, Raylin Xu, David Nolan, Jiyong Ahn, Kelly Short, Lew C Schon","doi":"10.1177/24730114241255136","DOIUrl":"10.1177/24730114241255136","url":null,"abstract":"","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"9 2","pages":"24730114241255136"},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11135079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141177177","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":"Intraosseous Schwannoma of the Phalanx of the Left Third Toe: A Case Report.","authors":"Andrea Iglesias Ruiz, Xavier Llorens Martinez, Raul Figa Barrios, Andrea Rodriguez Fernandez","doi":"10.1177/24730114241255358","DOIUrl":"10.1177/24730114241255358","url":null,"abstract":"","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"9 2","pages":"24730114241255358"},"PeriodicalIF":0.0,"publicationDate":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157391","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":"Association of Radiographic Soft Tissue Thickness With Revision Total Ankle Arthroplasty Following Primary Total Ankle Arthroplasty: A Minimum of 5-year Follow-up.","authors":"Kevin A Wu, Albert T Anastasio, Alexandra N Krez, Katherine M Kutzer, James K DeOrio, Mark E Easley, James A Nunley, Samuel B Adams","doi":"10.1177/24730114241255351","DOIUrl":"10.1177/24730114241255351","url":null,"abstract":"<p><strong>Background: </strong>The incidence of primary total ankle arthroplasty (TAA) is rising, with a corresponding increase in revision surgeries. Despite this, research on risk factors for revision TAA following primary TAA remains limited. Radiographic soft tissue thickness has been explored as a potential predictor for outcomes in hip, knee, and shoulder arthroplasty, but its role in TAA has not been assessed. This study aimed to assess the predictive value of radiographic soft tissue thickness for identifying patients at risk of requiring revision surgery following primary TAA.</p><p><strong>Methods: </strong>A retrospective study was conducted on 323 patients who underwent primary TAA between 2003 and 2019. Radiographic measurements of soft tissue thickness were obtained from preoperative radiographs. Two novel radiographic measures of soft tissue thickness were developed and assessed (tibial tissue thickness and talus tissue thickness). Clinical variables including age, gender, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, diabetes, smoking status, primary diagnosis, and implant type were recorded. Logistic regression analysis was used to assess the predictive value of soft tissue thickness and BMI for revision TAA.</p><p><strong>Results: </strong>The rate of revision surgery was 4.3% (14 of 323 patients). Patients requiring revision had significantly greater tibial tissue (3.54 vs 2.48 cm; <i>P</i> = .02) and talus tissue (2.79 vs 2.42 cm; <i>P</i> = .02) thickness compared with those not requiring revision. Both the tibial tissue thickness (odds ratio 1.16 [1.12-1.20]; <i>P</i> < .01) and the talus tissue thickness (odds ratio: 1.10 [1.05-1.15]; <i>P</i> < .01) measurements were significant predictors of revision TAA in multivariable logistic regression models. However, BMI was not a significant predictor of revision TAA. The two metrics demonstrated excellent interrater reliability.</p><p><strong>Conclusion: </strong>Greater soft tissue thickness was a better predictor of revision TAA compared with BMI. These findings suggest that radiographic soft tissue thickness may be a valuable tool for assessing the risk of the need for revision TAA following primary TAA. Further research is needed to validate and explore the potential impact on clinical practice.</p><p><strong>Level of evidence: </strong>Level III, comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"9 2","pages":"24730114241255351"},"PeriodicalIF":0.0,"publicationDate":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157219","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":"Effect of Distal Tibiofibular Destabilization and Syndesmosis Compression on the Flexibility Kinematics of the Ankle Bones: An In Vitro Human Cadaveric Model.","authors":"Walter C Hembree, Daina M Brooks, Byron Rosenthal, Carlynn Winters, Jordan B Pasternack, Bryan W Cunningham","doi":"10.1177/24730114241255356","DOIUrl":"10.1177/24730114241255356","url":null,"abstract":"<p><strong>Background: </strong>Overcompression of the distal tibiofibular syndesmosis during open reduction and internal fixation of ankle fracture may affect multidirectional flexibility of the ankle bones.</p><p><strong>Methods: </strong>Ten cadaveric lower limbs (78.3±13.0 years, 4 female, 6 male) underwent biomechanical testing in sagittal, coronal, and axial rotation with degrees of motion quantified. The intact force (100%) was the force needed to compress the syndesmosis just beyond the intact position, and overcompression was defined as 150% of the intact force. After intact testing, the anterior inferior tibiofibular ligament (AITFL), interosseus membrane (IOM), and posterior inferior tibiofibular ligament (PITFL) were sectioned and testing was repeated. The IOM and AITFL were reconstructed in sequence and tested at 100% and 150% compression.</p><p><strong>Results: </strong>Overcompression of the syndesmosis did not significantly reduce ROM of the ankle bones for any loading modality (<i>P</i> > .05). IOM+AITFL reconstruction restored distal tibiofibular axial rotation to the intact condition. Axial rotation motion was significantly lower with AITFL fixation compared with IOM fixation alone (<i>P</i> < .05). The proximal tibiofibular syndesmosis demonstrated significantly higher motion in axial rotation with all distal reconstruction conditions.</p><p><strong>Conclusion: </strong>As assessed by direct visualization, overcompression of the distal tibiofibular syndesmosis did not reduce ROM of the ankle bones. Distal tibiofibular axial rotation was significantly lower with IOM+AITFL fixation compared with IOM augmentation alone. Distal tibiofibular axial rotation did not differ significantly from the intact condition after combined IOM+AITFL fixation. Dynamic fixation of the distal tibiofibular syndesmosis resulted in increased axial rotation at the proximal tibiofibular syndesmosis.</p><p><strong>Clinical relevance: </strong>These biomechanical data suggest that inadvertent overcompression of the distal tibiofibular syndesmosis when fixing ankle fractures does not restrict subsequent ankle bone ROM. The AITFL is an important stabilizer of the distal tibiofibular syndesmosis in external rotation.</p><p><strong>Level of evidence: </strong>controlled laboratory study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"9 2","pages":"24730114241255356"},"PeriodicalIF":0.0,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11128177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155083","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":"Functional Morphologic Changes of the Heel Fat Pad and Plantar Fascia in Patients With Heel Pain During Weightbearing and Nonweightbearing.","authors":"Toshihiro Maemichi, Masatomo Matsumoto, Toshiharu Tsutsui, Shota Ichikawa, Takumi Okunuki, Hirofumi Tanaka, Tsukasa Kumai","doi":"10.1177/24730114241247824","DOIUrl":"10.1177/24730114241247824","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the thickness changes of the heel fat pad and the plantar fascia associated with loading and unloading in healthy individuals and patients with heel pain and reveal the differences between them.</p><p><strong>Methods: </strong>The study included adult male participants with (n = 9) and without (n = 26) heel pain. The participants placed their right foot on an evaluation apparatus with a polymethylpentene resin board (PMP), while their left foot was positioned on a weighing scale used to adjust the loading weight. The heel fat pad was differentiated into superficial Microchamber and deep Macrochamber layers. These layers and plantar fascia thickness were measured using an ultrasonographic imaging device at loading phase ranging from 0% to 100% of their body weight and unloading phase from 100% to 0%. Additionally, the study examined the thickness change ratios of the superficial and deep heel fat pad layers when the load increased from 0% (unload) to 100% (full load).</p><p><strong>Results: </strong>In healthy individuals and patients with heel pain, no significant thickness changes were observed in the Microchamber layer of the heel fat pad or the plantar fascia during loading and unloading evaluations. However, significant thickness changes were observed in the Macrochamber layer of the heel fat pad, and the pattern of change differed between the loading and unloading phases. Additionally, patients with heel pain showed differences in the thickness change and thickness change ratios of the microchamber and macrochamber layers of the heel fat pad during both loading and unloading phases. The thickness of the plantar fascia did not show significant differences between both groups.</p><p><strong>Conclusion: </strong>Compared with healthy individuals, in our relatively small study, patients with heel pain had greater deep fat pad compression in loading and less recovery after load removal. This finding suggests that these patients have different intrinsic fat pad function and related morphology than those without heel pain.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"9 2","pages":"24730114241247824"},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11113045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086900","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":"Modified Gracilis Autograft Preparation for Arthroscopic Anterior Talofibular and Calcaneofibular Ligament Anatomic Reconstruction: Technical Tip.","authors":"Bruno C R Olory, Theodorakys Marín Fermín, Pieter D'Hooghe, Emmanouil Papakostas, Khalid Al-Khelaifi, Bashir A Zikria","doi":"10.1177/24730114241242780","DOIUrl":"10.1177/24730114241242780","url":null,"abstract":"<p><p>Visual AbstractThis is a visual representation of the abstract.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"9 2","pages":"24730114241242780"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11102667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065154","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":"The Splint Script: A Technical Tip Regarding Patient Instructions for Splint Immobilization.","authors":"Mari Adams, Jeffrey Byrd, Khalid Hasan","doi":"10.1177/24730114241251799","DOIUrl":"10.1177/24730114241251799","url":null,"abstract":"","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"9 2","pages":"24730114241251799"},"PeriodicalIF":0.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916234","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}