Journal of Foot & Ankle Surgery最新文献

{"title":"Reconstruction of the interosseus talocalcaneal ligament in progressive collapsing foot deformity: A review of the literature and description of a novel surgical technique.","authors":"Francois Lintz, Enrico Pozzessere, Carla Carfì, Kanyakorn Riewruja, Wolfram Grün, Canon Cornelius, Scott J Ellis, Cesar de Cesar Netto","doi":"10.1053/j.jfas.2025.06.008","DOIUrl":"10.1053/j.jfas.2025.06.008","url":null,"abstract":"<p><strong>Background: </strong>The Interosseous Talo-Calcaneal Ligament (ITCL) is a key stabilizer of the subtalar joint, essential in preventing talo-calcaneal divergence. Its attenuation significantly contributes to the pathogenesis of Progressive Collapsing Foot Deformity (PCFD). Thus, anatomical reconstruction of the ITCL could offer promise in treating flexible (Stage 1) PCFD, aiming to restore subtalar joint stability and prevent deformity progression. The aim of the present work was to report existing ITCL reconstruction techniques and present a novel approach in PCFD.</p><p><strong>Study design: </strong>Current concept and technical note METHODS: A focused current concepts review of existing literature on ITCL reconstruction was performed to identify opportunities and existing gaps. Subsequently, we introduced a novel surgical technique for anatomically reconstructing the ITCL, spring ligament, and superficial deltoid ligament complex using a semitendinosus allograft. Dedicated targeting guides were employed to ensure precise identification and accurate placement of ligament attachment sites.</p><p><strong>Results: </strong>Current literature primarily discusses ITCL reconstruction within the context of subtalar instability associated with Chronic Lateral Ankle Instability (CLAI). However, no prior method has explicitly addressed ITCL reconstruction for managing PCFD, which constitutes a significant gap in the literature. We describe a novel surgical technique to address ITCL reconstruction in flexible (Stage 1) PCFD.</p><p><strong>Conclusion: </strong>ITCL reconstruction the logical next step in conservative treatment of flexible PCFD with peritalar subluxation (class D), to circumvent the need for joint-sacrificing procedures. A novel surgical procedure is presented. Further clinical studies are warranted to evaluate the radiographic and patient-reported outcomes of ITCL reconstruction.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the impact of calcitonin nasal spray on bone density: A literature review.","authors":"Amit B Lall, Anupam Bhardwaj, Rani Raginee Rajhans, Shazia Safi","doi":"10.1053/j.jfas.2025.06.011","DOIUrl":"10.1053/j.jfas.2025.06.011","url":null,"abstract":"<p><p>There is inadequate evidence-based literature for clinicians supporting the role of adjuvant rehabilitation options in cases of bone deficient pathologies, and fractures. A literature search was done from e-resources such as DELNET, J-gate, Scopus, Web of Science, EBSCO & PubMed from 18 May 2000 to 28 August 2024. The search was performed through the student's corner at our university with keywords such as bone density, calcitonin, calcitonin nasal spray, fractures, and pathology. Thirteen studies were included following the inclusion and exclusion criteria. The reviews emphasized that skeletal muscles typically require 18-24 hours to reach peak responsiveness to calcitonin, while patients with high-turnover osteoporotic syndromes often exhibit a quicker bone response even at lower dosages. A weekly dose of 250-2800 IU (International Unit) calcitonin resulted in a substantial increase in bone density. The side effects of calcitonin therapy are mild and short-term: transient nausea and gastric discomfort were reported in 8 to 10 % of the patients, while facial flushing and skin hypersensitivity occurred in 2 to 5 %. The relatively low bioavailability of calcitonin in nasal formulations also limits its utility. Methodological limitations of the reviewed studies include variability in BMD (bone mineral density) assessment methods, potential selection bias, small sample sizes, and lack of blinding in some trials. Calcitonin enhances bone density at weekly dosages of more than 250 IU thereby lowering the risk of fractures. This literature review provides us with an understanding of the potential future applications of calcitonin nasal spray as an adjuvant for enhancing bone mineralization in patients with pathologies and fractures.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI evaluation of graft maturation following arthroscopic anatomical lateral ligament reconstruction: a one-year follow-up study.","authors":"C Philippe, V Zrounba, R Lopes, E Cavaignac, D Ancelin","doi":"10.1053/j.jfas.2025.06.002","DOIUrl":"10.1053/j.jfas.2025.06.002","url":null,"abstract":"<p><strong>Background: </strong>Chronic lateral ankle instability (CLAI) occurs in 20% to 40% of patients after lateral ankle sprains. Anatomical ligament reconstruction is increasingly used, but magnetic resonance imaging (MRI) evaluation of graft maturation-standard in anterior cruciate ligament (ACL) reconstruction-remains poorly defined for the ankle.</p><p><strong>Purpose: </strong>To evaluate graft incorporation and ligamentization one year after arthroscopic anatomical reconstruction of the anterior talo-fibular ligament (ATFL) and calcaneo-fibular ligament (CFL) using autologous gracilis tendon grafts.</p><p><strong>Study design: </strong>Prospective case series.</p><p><strong>Methods: </strong>We included 93 patients with CLAI unresponsive to conservative treatment who underwent ATFL/CFL reconstruction with an autologous gracilis graft. MRI was performed at one year postoperatively. Graft maturation was assessed using the Signal-to-Noise Quotient Ankle (SNQA) and the Howell scale. Graft incorporation was evaluated via signal intensity at the bone-graft interface. Additional analysis included graft continuity, tunnel positioning, and diameter.</p><p><strong>Results: </strong>Howell grade was ≤2 in 42% of ATFL and 80% of CFL grafts. Mean SNQA was 39.25 ± 159.89 for ATFL and 17.44 ± 80.01 for CFL. Graft incorporation (interface signal grade 1 or 2) was seen in 74% of talar tunnels, 90% of calcaneal tunnels, and 87% of fibular tunnels. All grafts were continuous; no intra-articular complications were identified.</p><p><strong>Conclusion: </strong>Anatomical reconstruction of the ATFL/CFL with gracilis autografts leads to good graft incorporation and ligamentization at one year. MRI parameters described here offer a reproducible evaluation framework, although correlation with functional outcomes remains necessary.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of patient reported outcomes using the Manchester-Oxford Foot Questionnaire and surgical complications following total ankle replacement in rheumatoid arthritis versus osteoarthritis.","authors":"S Kay Robert, Neo Chryssa, M Leow Jun, Shalaby Hisham, McKinley John","doi":"10.1053/j.jfas.2025.05.019","DOIUrl":"10.1053/j.jfas.2025.05.019","url":null,"abstract":"<p><p>Total ankle replacement (TAR) is an alternative to ankle fusion for treatment of end stage ankle arthritis. It has been hypothesized that patients with rheumatoid arthritis may experience inferior outcomes due to altered immune response and low bone quality. Previous studies using the American Orthopaedic Foot & Ankle Society (AOFAS) score suggest patient reported outcomes following TAR for osteoarthritis (OA) versus rheumatoid arthritis (RA) are indifferent, however the AOFAS score has limitations and has largely been superseded by the Manchester-Oxford Foot Questionnaire (MOXFQ) score, which demonstrates favourable data characteristics. The aims of the present study were to compare outcomes in RA versus OA following TAR using the MOXFQ and describe associated complication rates. This single-center cohort study included 114 patients (143 TARs) who underwent primary TAR from 2010 to 2023. Data included patient demographics, comorbidities, satisfaction and MOXFQ. Multivariate logistic regression was used to assess differences in outcomes between OA versus RA adjusting for demographic covariates. Change in MOXFQ score following TAR was equal between the RA and OA group after adjusting for demographic co-variates (OR, 1.01 [95 % CI, 0.99-10.3], p = 0.284). RA was associated with increased risk of wound healing complications (OR 11.75 [95 %CI, 1.06-130.32], p = 0.045). RA status did not influence the likelihood of requiring a revision operation, though this finding lacked sufficient statistical power. RA status was not demonstrated to significantly affect change in MOXFQ score following TAR. Wound healing complications were higher in RA patients, while other surgical and medical complications rates were equivalent.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of minor amputation on occurrence of major amputation in patients with diabetic foot ulcers.","authors":"Nivan Wadhawan, Naohiro Shibuya, Daniel C Jupiter","doi":"10.1053/j.jfas.2025.05.013","DOIUrl":"10.1053/j.jfas.2025.05.013","url":null,"abstract":"<p><p>Diabetic foot ulcers (DFU) may lead to lower extremity amputation (LEA). Although minor LEAs (at or distal to the ankle) can carry a higher risk of perioperative complications compared to major LEAs (proximal to the ankle), they can increase patient independence and quality of life. This study aims to elucidate the impact of minor LEA on the time between DFU occurrence and major LEA to help determine the safer and more efficacious LEA choice for a given clinical situation. Data from 4,199 DFU patients from the TriNetX research platform were utilized. Kaplan-Meier curves and Cox regression were conducted to evaluate the impact of minor amputations on the likelihood of subsequent major amputations. Of the patients studied, 83 (23.85%) underwent minor LEAs, while 265 (76.15%) received major LEAs. DFU patients who had undergone a minor amputation were 28.1 times more likely (P < 0.001) in time-to-event analysis, 63.3 times more likely (P < 0.001) in time-varying analysis, with minor amputation as a time-varying covariate, and 60.8 times more likely (P < 0.001) in multivariate time-varying analysis to receive a major amputation than DFU patients who had not. DFU patients with minor LEAs were at higher risk for subsequent major LEAs. Clinically, these results imply that minor amputations are likely not the last step in a patient's care and that their utilization should be improved. Shared decision-making with DFU patients should account for the potential for upfront major LEA to avoid complications of stepwise progression from DFU to minor to major LEA.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcome of the ilizarov fixator combined with telescopic rod technique to reverse anterior subluxation of the talus during the correction of equinocavovarus deformity.","authors":"Peng Su, Longbin Bai","doi":"10.1053/j.jfas.2025.05.018","DOIUrl":"10.1053/j.jfas.2025.05.018","url":null,"abstract":"<p><p>The effectiveness of the Ilizarov technique combined with telescopic rod technique in the treatment of equinocavovarus foot deformities in adults was undefined. All 72 adult patients (76 feet) who underwent the Ilizarov technique combined with telescopic rod technique for correction of equinovarus foot deformities between February 2012 and May 2022 were included. Clinical outcomes were assessed preoperatively and at the last follow-up by the Visual Analog Scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind foot score, and the Short Form-36 (SF-36) questionnaire. The radiographic outcomes were measured on weight-bearing ankle and foot radiographs taken preoperatively and at the last follow-up. The postoperative VAS and AOFAS ankle-hind foot scores significantly improved compared to the preoperative (P < 0.0001 for each). The postoperative SF-36 scores significantly increased referring to physical function, role-physical, body pain, general health, vitality, social function, role-emotional, mental health, and health transition (P < 0.0001 for each). Early complications were found in 20 feet (27 %) and late complications were found in 8 feet (10.8 %). In addition, the postoperative tibio-talar angle, tibial-sole angle, talus-first metatarsal angle, talo-calcaneal angle and hindfoot alignment view angle significantly improved compared to the preoperative. Sixty-three (87.5 %) patients were satisfied with the treatment effect. The Ilizarov technique combined with telescopic rod technique is an effective and reliable method in correcting equinocavovarus foot deformity, with high satisfaction and few complications.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interval changes in mental health, pain, and function following Brostrom-Gould for ankle instability: A retrospective cohort study.","authors":"Tyler Kelly, Julian Garcia-Acosta, Marc Bernstein, Garrett Jebeles, Gerald McGwin, Binam Shrestha, Payal Gupta, Jacob Burke, Fabio Pencle, Ashish Shah","doi":"10.1053/j.jfas.2025.06.009","DOIUrl":"10.1053/j.jfas.2025.06.009","url":null,"abstract":"<p><p>This study aims to assess interval changes in patient-reported outcomes following Brostrom-Gould (BG) surgery in patients with Chronic Ankle Instability (CAI). Our primary interest is to identify periods of significant change in patient mental health, physical function, and pain to provide a reference to appropriately counsel patients regarding postoperative expectations. This study was designed as a retrospective cohort study. Seventy-eight patients were identified via CPT codes and an extensive review of the surgical scheduling record at a single institution from July 2022 to February 2024. Inclusion criteria were restricted to patients age ≥16, a diagnosis of CAI undergoing a primary BG procedure with completed preoperative patient-reported outcome (PRO) assessments. PROs were prospectively collected preoperatively and at designated postoperative intervals. PROs included Patient Reported Outcome Information Management System (PROMIS) Physical Function (PF), Pain Interference (PI), and Global-10 Mental Health (MH). Patient sociodemographic data and past medical history were collected via retrospective chart review. Among the 40 patients included, the mean preoperative MH was 50.4 [SD = 9.04], PF was 41.0 [SD = 6.75], and PI was 61.8 [SD = 7.0]. Changes in mean PROMIS scores relative to baseline were seen in PROMIS PF (p < 0.0001), PI (p < 0.0001), and MH (p = 0.4830). The greatest improvement in PF and PI occurred between 6 weeks and 3 months. The present study suggests that patients undergoing BG can expect significant improvement in physical function and a reduction of pain within the first year of surgery, beginning as early as 6 weeks postoperatively. These findings may be used in clinical practice to appropriately counsel patients regarding post-operative expectations following surgery.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic deprivation and preoperative presentation in elective foot and ankle surgical patients in the southeastern US.","authors":"Tyler Kelly, Garrett Jebeles, LaMiah Hall, Keerthi Jaliparthy, Rohit Chaparala, Emilio Feijoo, Ashish Shah","doi":"10.1053/j.jfas.2025.06.007","DOIUrl":"10.1053/j.jfas.2025.06.007","url":null,"abstract":"<p><p>There are gaps remaining in understanding how social deprivation varies across practice settings, particularly as it relates to orthopaedic foot and ankle surgical populations. The Area Deprivation Index (ADI) is a tool that allows for the comparison of various social determinants of health at the neighborhood level that may ultimately impact a person's overall quality of life. In this investigation, a retrospective observational study was performed to identify patients presenting for elective foot and ankle surgical intervention. Baseline physical function was assessed through the prospective administration of three patient-reported outcome measures. Ultimately, a total of 372 patients met the inclusion criteria for analysis. Patients were grouped into tertiles according to their state ADI deciles, with the first tertile representing less deprivation and the third representing greater deprivation. The median Foot Functional Index score was statistically significantly different (H = 17.318, P < 0.001). Post-hoc comparisons indicated significant differences between the first and second tertiles (P < 0.001) and the first and third tertiles (P < 0.001). There were no significant associations between ADI tertile and duration of reported symptoms (p = 0.463). Median patient-reported pain was significantly greater among the second and third tertiles relative to the median reported scores in the first tertile. Among a population in the southeastern United States, patients presenting for elective foot and ankle surgery from areas of greater social deprivation were observed to report increased pain and relatively lower physical function compared to those from areas of less deprivation.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study of dorsiflexion closing wedge osteotomy of the metatarsal head and osteochondral autologous transplantation for Freiberg disease treatment: A multicenter analysis.","authors":"Andreas Rehm, Luke Granger, Felix Morriss, Rebecca J Worley, Rachael Clegg, Ben Gompels","doi":"10.1053/j.jfas.2025.04.012","DOIUrl":"10.1053/j.jfas.2025.04.012","url":null,"abstract":"","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of microfracture combined with extracorporeal shock wave therapy and hyaluronic acid injections for treating osteochondral lesion of the talus and its impact on early rehabilitation: A retrospective case study.","authors":"Jia Zheng, Changgui Zhang, Liu Yang, Xin Chen, Xiaojun Duan","doi":"10.1053/j.jfas.2025.05.020","DOIUrl":"10.1053/j.jfas.2025.05.020","url":null,"abstract":"<p><p>Arthroscopic microfracture is a conventional technique for treating osteochondral lesions of the talus (OLT) that are less than 1.5 cm² in area. Since the defects are filled with fibrocartilage after repair, some patients experience local pain postoperatively, subsequently affecting early rehabilitation. This study evaluates efficacy of combining microfracture with extracorporeal shock wave therapy (ESWT) and intra-articular hyaluronic acid (HA) injections for treating OLT and its impact on early rehabilitation. Patients were divided into Group A with patients experiencing walking pain at full weight-bearing 4-6 weeks after surgery, Group B with those experiencing pain 6-8 weeks after surgery. ESWT targeted the cartilage injury area and other pressure pain points, delivered weekly for five sessions. After each session, a 2.0-2.5 mL intra-articular injection of HA was administered to the ankle joint. Assessments were made before ESWT began, six weeks after the final treatment, and at the final follow-up. The primary outcome was the Visual Analogue Scale (VAS) pain score, and the secondary outcome was the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. Forty-two patients were included, with a pre-treatment VAS score of 7.16 ± 1.54 decreasing to 2.11 ± 1.09 at the final follow-up, and the AOFAS score increasing from 67.78 ± 13.87 to 93.54 ± 4.10, showing significant differences (p < 0.05). Group A and B showed no significant differences in VAS and AOFAS scores across each time points (p > 0.05). ESWT synergizes with HA injections to significantly reduce post-microfracture weight-bearing pain and promote early joint function recovery.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}