Foot and Ankle Surgery最新文献

{"title":"MRI evaluation of ATFL and CFL ligamentization after anatomical surgical reconstruction with a hamstring graft","authors":"E. Bilichtin ,&nbsp;G. Rougereau ,&nbsp;M.E. Rollet ,&nbsp;A. De Rousiers ,&nbsp;M. Elkaïm ,&nbsp;B. Rousselin ,&nbsp;T. Bauer ,&nbsp;A. Hardy","doi":"10.1016/j.fas.2024.07.003","DOIUrl":"10.1016/j.fas.2024.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Chronic ankle instability is frequent complication following ankle sprains. Anatomical reconstruction of the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) with a gracilis autograft is a validated reconstruction technique. The signal-to-noise quotient ankle (SNQA) score evaluates graft maturation with MRI and has been shown to be reproducible and reliable. The goal of this study was to evaluate the process of ligamentization of the anatomical reconstruction of the ankle using the SNQA. The hypothesis was that the SNQA signal of the ATFL and the CFL would decrease over time.</div></div><div><h3>Methods</h3><div>A prospective cohort of patients who underwent arthroscopic anatomical ATFL-CFL reconstruction was included. All patients underwent a follow-up MRI examination 3, 6. and 12 months after surgery and the SNQA score was determined.</div></div><div><h3>Results</h3><div>Twenty consecutive patients were included. The SNQA score decreased significantly over time for the ATFL (p = 0.001), the CFL (p &lt; 0.001) and for the fibular bone tunnel-graft interface (p = 0.02). The SNQA scores of the ATFL were significantly higher than those of the CFL at 3 months (p = 0.01), 6 months (p = 0.003) and 12 months (p &lt; 0.001), and then those of the fibular tunnel-graft interface at 12 months (p = 0.003). There was no difference in the SNQA score between the CFL and in the fibular graft-bone tunnel interface at any of the follow up periods.</div></div><div><h3>Conclusion</h3><div>There is a process of graft maturation following anatomical ATFL and CFL reconstruction over time, which is faster for the CFL than for the ATFL during the first year.</div></div><div><h3><u>Level of evidence</u></h3><div>II</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 1","pages":"Pages 74-78"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction of progressive collapsing foot deformity classes after isolated arthroscopic subtalar arthrodesis","authors":"Alessio Bernasconi ,&nbsp;Matthieu Lalevée ,&nbsp;Céline Fernando ,&nbsp;Antonio Izzo ,&nbsp;Cesar de Cesar Netto ,&nbsp;François Lintz","doi":"10.1016/j.fas.2024.07.002","DOIUrl":"10.1016/j.fas.2024.07.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Subtalar osteoarthritis in the context of flatfoot (recently renamed Progressive Collapsing Foot Deformity (PCFD)) may be treated through subtalar joint (SJ) arthrodesis with anticipated consequences on three-dimensional bony configuration. This study investigates the correction of PCFD-related deformities achieved after Anterolateral Arthroscopic Subtalar Arthrodesis (ALAPSTA).</div></div><div><h3>Methods</h3><div>In this retrospective study, we evaluated pre- and post-operative (at 6 months) weight bearing computed tomography (WBCT) images of patients diagnosed with PCFD with a degenerated SJ (2 A according to PCFD classification) and/or peritalar subluxation (2D) with or without associated flexible midfoot and/or forefoot deformities (1B, 1 C and 1E) which underwent ALAPSTA as a standalone procedure between 2017 and 2020. Multiple measurements were used to assess and compare pre and post-operative PCFD classes.</div></div><div><h3>Results</h3><div>Thirtythree PCFD (33 patients, median age 62) were included in the study. Preoperative medial facet subluxation was 28.3 % (IQR, 15.1 to 49.3 %). Overall PCFD 3D deformity improved with a reduction of the foot and ankle offset from 9.3 points (IQR, 7.8 to 12) to 4 (IQR, 0.9 to 7) (p &lt; 0.001). Class A-hindfoot valgus (median tibiocalcaneal angle and median calcaneal moment arm improved by 9.4 degrees (p &lt; 0.001) and 11 mm (p &lt; 0.001), respectively), class B-midfoot abduction (median talonavicular coverage angle improved by 20.5 degrees, p &lt; 0.001) and class C-forefoot varus (median sagittal talo-first metatarsal angle improved by 10.2 degrees (p &lt; 0.001)) were significantly corrected after surgery. Class D was difficult to assess due to the fusion procedure. No patient had a pre-operative valgus deformity at the ankle (no class E), and no significant change of the talar tilt was observed (p = 0.12).</div></div><div><h3>Conclusion</h3><div>In this series, ALAPSTA performed as a standalone procedure to treat patients diagnosed with PCFD with a degenerated subtalar joint and/or peritalar subluxation was effective not only at correcting hindfoot alignment but also flexible midfoot abduction and flexible forefoot varus.</div></div><div><h3>Level of evidence</h3><div>Level IV, case series</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 1","pages":"Pages 65-73"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The variation of anticoagulation prescribed in foot and ankle surgery in the UK – UK foot and ankle thrombo-embolism audit (UK-FATE)","authors":"Lyndon Mason ,&nbsp;Jitendra Mangwani ,&nbsp;Linzy Houchen-Wolloff ,&nbsp;Aiden Smith ,&nbsp;Lucy Teece ,&nbsp;Sarah Booth ,&nbsp;Karan Malhotra ,&nbsp;UK-FATE Collaborative","doi":"10.1016/j.fas.2024.06.005","DOIUrl":"10.1016/j.fas.2024.06.005","url":null,"abstract":"<div><h3>Introduction</h3><div><strong>Venous thrombo-embolism</strong> (VTE) is a recognised complication of foot and ankle surgery. There are multiple possible anticoagulation treatments available in the UK to mitigate the risk of developing VTE. Our primary objective was to assess the variability of chemical anticoagulation prescribed in patients undergoing foot and ankle procedures.</div></div><div><h3>Methods</h3><div>This was a UK-based national, multicenter, prospective audit spanning a collection duration of 9 months on all foot and ankle procedures, carried out in 68 UK centers between 1st June 2022 and 30th November 2022, with a further 3-month follow up period. All patients who underwent a foot and ankle surgical procedure (including Achilles tendon rupture treatment) were included in this study.</div></div><div><h3>Results</h3><div>Data on a total of 13,569 patients was submitted. Following data cleansing, 11,363 patients were available for further analysis, with anticoagulation data available for 11,099 patients. There were eleven different chemical anticoagulation treatments recorded across the cohort. A total of 3630 (31.95 %) patients received no chemical anticoagulation. The patients receiving chemical anticoagulation medication could be split into 4 main groups. The most common chemical anticoagulation received was <strong>low molecular weight heparin</strong> (LMWH) (6303, 84.4 % of patients receiving chemical anticoagulation). Aspirin was given in 4.1 % (308 patients), a Factor Xa inhibitor in 10 % (744 patients) and other anticoagulants (e.g. Warfarin) in 1.5 % (114 patients). The overall VTE rate in this sub analysis <strong>of patients receiving chemical anticoagulation,</strong> was 1.1 % (83 cases out of 7469). There was no significant difference seen in incidence of VTE between types of anticoagulants, when confounding factors were considered. The duration of post-operative chemical prophylaxis used by participants for most chemical anticoagulants was 6 weeks (64.50 %).</div></div><div><h3>Conclusion</h3><div>There was significant variability of chemical anticoagulants reported in the study, with five different categories of anticoagulants used (including no chemical anticoagulation), and none clearly superior/inferior. The duration of anticoagulation was consistent across types of thromboprophylaxis.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 1","pages":"Pages 38-43"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incisura tangent method to determine the transsyndesmotic axis for syndesmotic fixation","authors":"Toshinari Mashu ,&nbsp;Satoshi Yamaguchi ,&nbsp;Seiji Kimura ,&nbsp;Hirofumi Nakajima ,&nbsp;Manato Horii ,&nbsp;Shotaro Watanabe ,&nbsp;Ryu Ito ,&nbsp;Takahisa Sasho ,&nbsp;Seiji Ohtori","doi":"10.1016/j.fas.2024.06.008","DOIUrl":"10.1016/j.fas.2024.06.008","url":null,"abstract":"<div><h3>Background</h3><div>Clamping along the transsyndesmotic (TS) axis decreases the risk of malreduction when reducing syndesmotic diastasis. We aimed to measure the difference between the TS axis and the axis determined by the newly proposed fluoroscopic incisura tangent (IT) method. The measurements were compared to those between the TS axis and those based on the center–center (CC) and talar dome lateral (TL) methods.</div></div><div><h3>Methods</h3><div>We analyzed computed tomographic images of 43 normal ankles. The IT view was simulated using a digitally reconstructed radiograph, in which the anterior and posterior fibular incisura tubercles overlapped on the internally rotated anteroposterior view. The interaxis angle between the TS and the axes determined by the IT method was measured on the axial computed tomographic image corresponding to the radiographic image. The same procedure was repeated using the CC and TL methods. The measured values were compared between the three methods using a one-factor analysis of variance. Furthermore, the measurements of the anteverted and retroverted incisurae were compared for each fluoroscopic method.</div></div><div><h3>Results</h3><div>The mean interaxis angles between the TS were − 0.5 degrees, 6.3 degrees, and − 1.8 degrees for the IT, CC, and TL methods, respectively, with a significantly larger value for the CC method than for the IT and TL methods (<em>P</em> &lt; .001). No significant difference was found in the interaxis angle in the anteverted (−0.1 degrees) and retroverted (−1.0 degrees) incisurae when using the IT method (<em>P</em> = .15). The angles in the retroverted incisurae were larger than those of the anteverted incisurae for the CC and TL methods.</div></div><div><h3>Conclusion</h3><div>The fluoroscopic IT method accurately estimated the TS axis. The interaxis angles were consistent, regardless of the incisura anatomy. The fluoroscopic method can be used to clamp and fix the syndesmosis along the TS axis.</div></div><div><h3>Level of evidence</h3><div>Ⅳ</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 1","pages":"Pages 44-49"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141628083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for 30-day hospital readmission in patients with diabetic foot","authors":"C.A. Sánchez ,&nbsp;A. Galeano ,&nbsp;D. Jaramillo ,&nbsp;G. Pupo ,&nbsp;C. Reyes","doi":"10.1016/j.fas.2024.06.003","DOIUrl":"10.1016/j.fas.2024.06.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetic foot<span> (DF) is part of the natural history of diabetes mellitus, ulceration being a severe complication with a prevalence of approximately 6.3 %, which confers a significant economic burden. Hospital readmission in the first thirty (30) days is considered a measure of quality of healthcare and it's been identified that the most preventable causes are the ones that occur in this period. This study seeks to identify the risk factors associated with readmission of patients with DF.</span></div></div><div><h3>Methods</h3><div><span><span>A case-control study was done by performing a secondary analysis of a database. Descriptive statistics were used for all variables of interest, bivariate analysis to identify statistically significant variables, and a </span>logistic regression model for </span>multivariate analysis.</div></div><div><h3>Results</h3><div>575 cases were analyzed (113 cases, 462 controls). A 20 % incidence rate of 30-day readmission was identified. Statistically significant differences were found in relation to the institution of attention (Hospital Universitario de la Samaritana: OR 1.9, p value &lt; 0.01, 95 % CI 1.2–3.0; Hospital Universitario San Ignacio: OR 0.5, p value &lt; 0.01, 95 % CI 0.3–0.8) and the reasons for readmission before 30 days, especially due to surgical site infection<span> (SSI) (OR 7.1, p value &lt; 0.01, 95 % CI 4.1–12.4), sepsis<span> (OR 8.4, p value 0.02, 95 % CI 1.2–94.0), dehiscence in amputation stump (OR 16.4, p value &lt; 0.01, 95 % CI 4.2–93.1) and decompensation of other pathologies (OR 3.5, p value &lt; 0.01, 95 % CI 2.1–5.7).</span></span></div></div><div><h3>Conclusion</h3><div>The hospital readmission rate before 30 days for our population compares to current literature. Our results were consistent with exacerbation of chronic pathologies, but other relevant variables not mentioned in other studies were the hospital in which patients were taken care of, the presence of SSI, sepsis, and dehiscence of the amputation stump. We consider thoughtful and close screening of patients at risk in an outpatient setting might identify possible readmissions.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 1","pages":"Pages 25-30"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of four patient reported outcome measures in patients with ankle fracture: A study on patient preferences and psychometric properties","authors":"Per Hviid Gundtoft ,&nbsp;Julie Ladeby Erichsen ,&nbsp;Mads Terndrup ,&nbsp;Lauritz Walsøe ,&nbsp;Lasse Pedersen ,&nbsp;Bjarke Viberg ,&nbsp;Alice Ørts ,&nbsp;Charlotte Abrahamsen","doi":"10.1016/j.fas.2024.07.001","DOIUrl":"10.1016/j.fas.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><div>The aim was to assess psychometric properties of Manchester Oxford Foot Questionnaire (MOXFQ), the Self-reported Foot and Ankle Score (SEFAS), the Olerud Molander Ankle Score (OMAS), and the Forgotten Joint Score (FJS) in adults with ankle fractures.</div></div><div><h3>Methods</h3><div>Patients received all four questionnaires 6, 12, 14, 24, 52, and 104 weeks following an ankle fracture. According to COSMIN guidelines, statistical tests were performed to assess floor- and ceiling effects, structural validity, construct validity and reliability. Cognitive interview was performed with 9 patients.</div></div><div><h3>Results</h3><div>MOXFQ showed best model fit in Confirmatory Factor Analysis. When testing construct validity, all hypotheses were accepted except for OMAS and FJS. All questionnaires had an almost perfect test-retest reliability (Interclass Correlation Coefficient 0.81 to 0.91) and Cronbach's alpha ranged from 0.76 to 0.95. MOXFQ was the best rated questionnaire.</div></div><div><h3>Conclusion</h3><div>All questionnaires performed well and we recommend MOXFQ for future use in ankle fracture studies.</div></div><div><h3>Level of Evidence</h3><div>Level IV</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 1","pages":"Pages 58-64"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141628082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of severe planovalgus foot deformity in children with generalised joint hypermobility","authors":"Mohammed Salman Alhassan ,&nbsp;Byoung Kyu Park ,&nbsp;Mudit Shah ,&nbsp;Kun-Bo Park ,&nbsp;Hoon Park ,&nbsp;Isaac Rhee ,&nbsp;Hyun Woo Kim","doi":"10.1016/j.fas.2024.07.004","DOIUrl":"10.1016/j.fas.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the outcomes of calcaneal lengthening osteotomy<span><span> (CLO) and double arthrodesis of the talonavicular and calcaneocuboid joints (DA) for correcting planovalgus </span>foot deformity<span> exclusively in patients with generalised joint hypermobility.</span></span></div></div><div><h3>Methods</h3><div>We retrospectively reviewed 29 feet in 17 consecutive patients who underwent either CLO or DA. The mean age at surgery was 11.3 ± 2.3 years, and the mean follow-up duration was 7.7 ± 3.2 years. Preoperative and final follow-up radiographs and dynamic foot-pressure measurements were analysed.</div></div><div><h3>Results</h3><div>Both operations significantly improved the radiographic parameters, except for the lateral talocalcaneal angle in the CLO group. Pedobarographic study demonstrated an elevation of the medial longitudinal arch and an improved foot-pressure distribution after both surgeries. The plantar pressure in the lateral forefoot significantly increased only in the DA group, while the pressures exerted on the medial forefoot and hindfoot and the arch index improved only in the CLO group.</div></div><div><h3>Conclusions</h3><div>Both CLO and DA effectively improve the foot alignments of the deformity in patients with generalised joint hypermobility. However, differences were observed in the changes in the lateral talocalcaneal angle and plantar pressure distribution between the two procedures.</div></div><div><h3>Level of evidence</h3><div>Therapeutic Level III.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 1","pages":"Pages 79-84"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141628084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Median age of patients undergoing total ankle replacement has not significantly changed between 1999 and 2023: A systematic review of prospective studies","authors":"Alessio Bernasconi ,&nbsp;Antonio Izzo ,&nbsp;Arianna Sgadari ,&nbsp;Martina D’Agostino ,&nbsp;Massimo Mariconda ,&nbsp;Andrew J. Goldberg","doi":"10.1016/j.fas.2024.07.007","DOIUrl":"10.1016/j.fas.2024.07.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Total ankle replacement (TAR) is an effective treatment for end-stage osteoarthritis. The aim of this systematic review was to assess the age of patients undergoing TAR in prospective comparative studies. Our hypothesis is that the age reported in most recent papers might be lower than those reported in older papers.</div></div><div><h3>Methods</h3><div>This systematic review was performed using Pubmed, Scopus, EMBASE and Cochrane databases. Only Level I and II studies dealing with TAR were included. Data regarding demographics, study design, number of cohorts in each study, year of publication and year/years in which surgery was performed were extracted. A two-fold analysis was conducted building groups of patients based on the year of publication and creating 1) two groups (before and after the median year) and 2) three groups (using tertiles) in order to compare age of patients operated in different period of times. A comparison was also performed considering the median year of surgery for patients undergoing TAR.</div></div><div><h3>Results</h3><div>Overall 59 cohorts (42 studies, published between 1999 and 2023; median year of publication: 2017) were included (6397 ankles, 6317 patients, median age 63 years). The difference between the median age for 27 cohorts published until 2016 (weighted median 63 years; IQR, 62.5–64) and the median age for 32 cohorts published after 2017 (weighted median 63.2 years; IQR, 63–67.8) was not statistically significant (p = 0.09). The division in tertiles did not reveal any significant change in the weighted median age at surgery (T1 (1999–2014; 63.2 years; IQR, 62.8–64.1), T2 (2015–2018; 63 years; IQR,63–63.5) and T3 (2019–2023; 63.2 years; IQR, 62.6–67.8)) over time (p = 0.65). The median age of patients operated between 1999 and 2008 vs 2009 and 2023 (data from 48 cohorts) was not different either (p = 0.12).</div></div><div><h3>Conclusion</h3><div>According to this review of prospective studies published between 1999 and 2023, the median age for patients undergoing TAR over the last two decades has been 63 years, remaining steady with no significant changes over time.</div></div><div><h3>Level of evidence</h3><div>Level II - systematic review including Level I and Level II studies</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 1","pages":"Pages 3-9"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is smoking a risk factor for complications following total ankle arthroplasty? A meta-analysis","authors":"Yen Thi Thao Le ,&nbsp;Duy Nguyen Anh Tran ,&nbsp;Bao Tu Thai Nguyen ,&nbsp;Tan Thanh Nguyen ,&nbsp;Yu-Pin Chen ,&nbsp;Yi-Jie Kuo","doi":"10.1016/j.fas.2024.06.009","DOIUrl":"10.1016/j.fas.2024.06.009","url":null,"abstract":"<div><h3>Background</h3><div><span>Smoking has long been recognized as a risk factor for impaired wound and bone healing, particularly in the context of </span>ankle and foot surgery<span>. Despite numerous studies exploring the association between smoking and complications following ankle replacement, there remains significant inconsistency in their findings. Therefore, this meta-analysis study aims to elucidate whether smoking increases the rate of complications after total ankle arthroplasty (TAA), providing valuable insights for clinical management.</span></div></div><div><h3>Methods</h3><div><span><span><span>A comprehensive systematic search was conducted in the PubMed, </span>Embase, and Wiley databases to identify relevant English studies on the influence of smoking on </span>postoperative complications following ankle replacement without any restrictions on publication dates. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. Random-effect models were used to calculate odds ratios (OR) and 95 % confidence intervals (CI). This study adhered to </span>PRISMA guidelines for transparent reporting and was registered with PROSPERO.</div></div><div><h3>Results</h3><div>The analysis incorporated data from 12 retrospective cohort studies, totaling 17331 subjects, 2580 of whom were smokers and 791 complications following TAA. The findings revealed a statistically significant disparity in wound-related complications (OR: 2.26; 95 % CI: 1.13–4.50; P = .02), particularly evident in current smokers with an OR of 3.30 (95 % CI: 2.12–5.14; P &lt; .00001). However, we lacked sufficient evidence to substantiate an association between smoking and complications related to the prosthesis (OR: 1.09; 95 % CI: 0.77–1.53; P = .64) or systemic complications (OR: 1.18; 95 % CI: 0.10–14.13; P = .90) following TAA.</div></div><div><h3>Conclusions</h3><div>Smoking, especially current smoking, is associated with increased wound complication risk post-operation for total ankle arthroplasty. Despite a lack of definitive evidence on the optimal timeframe for smoking cessation before surgery, discontinuing smoking appears to be a prudent measure to mitigate these complications.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 1","pages":"Pages 50-57"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of ultrasonographic evaluation methods for ankle syndesmosis in non-weight bearing and weight bearing conditions","authors":"Takuji Yokoe,&nbsp;Fan Yang,&nbsp;Takuya Tajima,&nbsp;Nami Yamaguchi,&nbsp;Yudai Morita,&nbsp;Etsuo Chosa","doi":"10.1016/j.fas.2024.06.002","DOIUrl":"10.1016/j.fas.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate ankle syndesmosis in healthy subjects under non-weight bearing (NWB) and weight bearing (WB) conditions using two US methods.</div></div><div><h3>Methods</h3><div>The anterior tibiofibular clear space (ATFCS) was measured in healthy subjects in NWB and WB conditions using two US procedures. Method 1 measured 10 mm above the ankle joint and Method 2 measured 30° from the line of 10 mm above the ankle joint.</div></div><div><h3>Results</h3><div>A total of 60 ankles from 30 subjects (male/female, 15/15) were included. There was a significant difference in the ATFCS between the two US methods (p &lt; 0.001), and Method 2 was better at detecting the change in diastasis from NWB to WB conditions. The ATFCS was significantly greater on WB than on NWB, irrespective of the US method.</div></div><div><h3>Conclusions</h3><div>Method 2 was better at detecting diastasis of the syndesmosis from NWB to WB conditions. The influence of WB needs to be considered when evaluating syndesmosis using US.</div></div><div><h3>Level of evidence</h3><div>Cross-sectional cohort study; Level of evidence, Ⅳ</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 1","pages":"Pages 20-24"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}