Foot & ankle specialist最新文献

{"title":"Effect of Diabetes on 30-Day Complications, Readmission, and Reoperation in Patients Undergoing Below-Knee Amputation.","authors":"Solangel Rodriguez Materon, Samantha Trynz, Joshua Morningstar, Dev Patel, Daniel J Scott, Christopher E Gross","doi":"10.1177/19386400261484263","DOIUrl":"https://doi.org/10.1177/19386400261484263","url":null,"abstract":"<p><p>IntroductionRisk factors for early complications and reoperation in the overall population undergoing below-knee amputation (BKA) have been reported; however, there is limited literature investigating adverse postoperative outcomes specific to diabetic patients. This study compares 30-day complication, readmission, reoperation, and mortality rates following BKA in patients with and without diabetes.MethodsThe ACS NSQIP database was queried from 2005 to 2019 to identify 28 776 patients undergoing BKA using current procedural terminology (CPT) codes 27880, 27881, and 27882. Of this cohort, 20 310 (70.6%) had diabetes. Postoperative outcomes, including 30-day complications, readmission, reoperation, and mortality, were compared between groups.ResultsPostoperatively, diabetic patients had significantly higher rates of 30-day complications (Diabetic = 39.0%, Nondiabetic = 34.8%; P < .001), including severe complications (Diabetic = 9.12%, Nondiabetic = 8.20%; P = .012). Diabetic patients also had significantly higher rates of bleeding requiring transfusion (Diabetic = 20.4%, Nondiabetic = 15.0%; P < .001) and sepsis (Diabetic = 6.28%, Nondiabetic = 5.23%; P < .001). On multivariate analysis, diabetes independently predicted increased risk of adverse discharge to a facility (defined as discharge to a skilled nursing or rehabilitation facility rather than home; odds ratio [OR] 1.184; P < .001) but decreased odds of reoperation (OR 0.785; P < .001) and mortality (OR 0.809; P = .002). Among diabetic patients, insulin-dependent diabetic patients experienced significantly higher rates of any postoperative complication (Insulin = 39.7%, Noninsulin = 36.4%; P < .001) and readmission (Insulin = 14.1%; Noninsulin = 12.1%; P = .005), as well as increased length of stay (Insulin = 12.4 days; Noninsulin = 11.6 days; P = .007) compared to other diabetics.ConclusionDiabetic patients undergoing BKA had significantly increased rates of 30-day complications, including severe complications, and adverse discharge to a facility. However, diabetes was independently associated with decreased odds of reoperation and mortality within 30 days. Insulin-dependent diabetic patients experienced further elevated complication and readmission rates. Given the significantly increased rates of bleeding requiring transfusion and sepsis among diabetic patients, targeted perioperative optimization strategies should be employed in this population.Level of Evidence:<i>Level III retrospective cohort study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261484263"},"PeriodicalIF":2.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Tarsometatarsal Joint Slippage With Distal Screw Removal After Third-Generation Minimally Invasive Bunion Surgery: A Retrospective Controlled Study.","authors":"Seif El Masry, Grace M DiGiovanni, Brittany M Ammerman, Joaquín Palma, Allison L Boden, Joseph T Nguyen, Anne Holly Johnson","doi":"10.1177/19386400261484229","DOIUrl":"https://doi.org/10.1177/19386400261484229","url":null,"abstract":"<p><p>BackgroundFollowing Minimally Invasive Bunionectomy (MISB), some patients undergo the removal of hardware (ROH) due to medial-sided pain near the distal metatarsal screw site. Medial pain following MISB has been attributed to multiple factors, including hardware prominence, residual medial bony prominence, and construct-specific considerations. One potential radiographic finding observed postoperatively is medial translation of the first metatarsal base at the tarsometatarsal (TMT) joint, referred to here as \"TMT slippage.\" This study investigated the association between postoperative TMT slippage and subsequent ROH following MISB.MethodsA retrospective analysis identified 38 MISB patients with distal screw ROH and a control group of 40 MISB patients without ROH. Pre- and at least 6-month post-operative anteroposterior (AP) radiographs were measured to obtain transverse TMT slippage, distal and midshaft foot width, hallux valgus angle (HVA), and intermetatarsal angle (IMA). Independent samples t-tests and chi-square analyses compared continuous and categorical characteristics, respectively. Multivariable logistic regression modeling identified ROH risk factors.ResultsInterobserver reliability, measured by intraclass correlation coefficients (ICCs), was high for all measurements (ICC > 0.70). The change in TMT slip was significantly higher in the ROH group compared to the control group (+1.39 vs +0.80, P = .004). A greater decrease in distal foot width (narrower distal width postoperatively) was associated with an increased ROH likelihood (odds ratio [OR] = 0.76), while smaller reductions in HVA and IMA were linked to a higher ROH likelihood (OR = 1.12 and 1.42, respectively). Notably, a larger increase in TMT slip correlated with the highest likelihood of ROH (OR = 2.87).ConclusionWhile midfoot widening was not significantly different between groups, increased TMT slippage and incomplete correction of deformity (lower HVA/IMA change) were associated with higher ROH likelihood. These findings raise the possibility that postoperative TMT slippage may be associated with symptomatic distal screw removal, although causation cannot be inferred.Level of Evidence:Level III, comparative series.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261484229"},"PeriodicalIF":2.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Work-up, Diagnostic Imaging, and Radiographic Classification Systems for Osteochondral Lesions of the Talus: Proceedings of the International Consensus Meetings on Cartilage Repair of the Ankle.","authors":"Alexander Tham, Jared Rubin, James J Butler, Paloma Gauthier, John G Kennedy, Samuel B Adams, Carol L Andrews, Chayanin Angthong, Jorge P Batista, Onno L Baur, Steven Bayer, Christoph Becher, Gregory C Berlet, Lorraine A T Boakye, Roberto Buda, James D F Calder, Gian L Canata, Dominic S Carreira, Thomas O Clanton, Jari Dahmen, Pieter D'Hooghe, Christopher W DiGiovanni, Malcolm E Dombrowski, Mallory Ehlers, Richard D Ferkel, Eric I Ferkel, Paulo N F Ferrao, Eric Giza, Arianna L Gianakos, Mark Glazebrook, Mohamed Gomaa, Simon Görtz, Amgad M Haleem, Kamran S Hamid, Laszlo Hangody, Charles P Hannon, Daniel Haverkamp, Jay Hertel, Beat Hintermann, MaCalus V Hogan, Kenneth J Hunt, Eoghan T Hurley, Jon Karlsson, Stephen R Kearns, Gino M M J Kerkhoffs, Hak Jun Kim, Siu Wah Kong, Sebastian Krebsbach, Sameh A Labib, Kaj T A Lambers, Jin Woo Lee, Keun Bae Lee, Jeffrey S Ling, Umile Giuseppe Longo, Alberto Marangon, Graham McCollum, Kirk McCullough, Adam W Mitchell, Peter N Mittwede, Christopher D Murawski, Stefan Nehrer, Raluca Nicolescu, Philipp Niemeyer, James A Nunley, Martin O'Malley, Cristian Ortiz, David O Osei-Hwedieh, Jochen Paul, Christopher J Pearce, Helder Pereira, Rohan Phadke, Adam Popchak, Marcelo P Prado, Steven M Raikin, Mikel L Reilingh, Guilluame Robert, Benjamin B Rothrauff, Lew C Schon, Helene Simpson, Niall A Smyth, Carolyn M Sofka, Pietro Spennacchio, James W Stone, Martin Sullivan, Masato Takao, Yasuhito Tanaka, Hajo Therman, David B Thordarson, Rocky Tuan, Victor Valderrabano, Christian J A van Bergen, Pim A D van Dijk, C Niek van Dijk, Francesca Vannini, Tanawat Vaseenon, Monika Volesky, Raymond C Walls, Markus Walther, Martin Wiewiorski, Xiangyang Xu, Youichi Yasui, Hua Yinghui, Ichiro Yoshimura, Alastair S E Younger, Urszala Zdanowicz, Zijun Zhang","doi":"10.1177/19386400261478702","DOIUrl":"https://doi.org/10.1177/19386400261478702","url":null,"abstract":"<p><p>BackgroundThe evaluation of osteochondral lesions of the talus (OLT) has long been limited by variability in imaging protocols, lesion measurement techniques, and clinical utility of radiographic classification systems. To address these challenges, 3 International Congress Meetings on Cartilage Repair of the Ankle were convened in Pittsburgh, USA (2017), Dublin, Ireland (2019), and New York, USA (2025) to establish agreement on the work-up, diagnostic imaging, and radiographic classification systems for OLT.MethodsSeventy-five multidisciplinary experts from over 25 countries and 1 territory participated in a structured Delphi-based consensus process. Blinded surveys, structured questionnaires, and in-person discussions were used to develop and refine statements, supported by literature review and graded evidence (A1-E). Consensus strength was defined as consensus (51%-74%), strong consensus (75%-99%), or unanimous (100%).ResultsIn total, 19 consensus statements were achieved across the 3 meetings. Strong agreement was reached for first-line use of weight-bearing radiographs and complementary use of magnetic resonance imaging (MRI) and computed tomography for lesion characterization. Standardized assessment of lesion size in 3 planes and localization using a 9-zone grid were endorsed. Diagnostic arthroscopy was considered to have limited routine value in the setting of advanced imaging. Post-treatment imaging recommendations clarified indications for radiographs and cross-sectional imaging and emphasized the limited correlation between imaging findings and clinical function. Computed tomography-based classification systems were considered more useful for guiding treatment decisions than plain radiographic or MRI-based systems.ConclusionThese international consensus statements establish a standardized imaging-based framework for the evaluation and classification of OLT, improving consistency in diagnosis, treatment planning, and clinical reporting.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261478702"},"PeriodicalIF":2.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Delphi-Based Consensus Statement on Podiatric Foot & Ankle Surgery Fellowships: Proceedings of the 2025 <i>Montana Fellows' Working Group</i>.","authors":"Thomas S Roukis, Christopher F Hyer, James M Cottom","doi":"10.1177/19386400261485353","DOIUrl":"https://doi.org/10.1177/19386400261485353","url":null,"abstract":"<p><p>Despite the popularity of podiatric foot and ankle surgery fellowships, a clearly agreed-upon consensus statement is lacking. We elected to develop a consensus statement on podiatric foot and ankle surgery fellowships and report the results of the 2025 Montana Fellows Working Group proceedings. Forty-six podiatric foot and ankle surgery fellowship-trained surgeons participated in a process based on a modification of the Delphi method of achieving consensus. Initial statements generated that received >70% strongly agree/agree responses proceeded to a final vote of agree/disagree. The strength of consensus was characterized as follows: consensus 51% to 74%, strong consensus 75% to 99%, and unanimous 100% in favor of a proposed statement. All voting was conducted anonymously and with equal weight among participants. Of the final 15 consensus statements voted on, 6 achieved unanimous consensus, 7 strong consensus, and 2 consensus. We achieved consensus for statements pertinent to podiatric foot and ankle surgery fellowships that can be summarized as follows. First, fellowship training can only occur after graduating from a podiatric residency and should be 12 months long. Second, podiatric fellowships should ideally be devoid of industry sponsorship, can occur worldwide, should be sponsored through a combined private practice and academic center of excellence/university setting and should consist of direct \"hands-on\" clinical and operating room experiences. Finally, the primary purpose of podiatric fellowships is to obtain the highest level of subspecialized training, which is ideally coupled with student/resident education and involves scientific research, thereby becoming a \"content expert\" in their subspeciality.Levels of Evidence:<i>V, Expert opinion-Decision Analysis</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261485353"},"PeriodicalIF":2.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cartilaginous Non-Structural Allografts in the Management of Foot and Ankle Pathologies.","authors":"Jared Rubin, Alexander Tham, Michael Allen, James J Butler, Samuel R Montgomery, Nathaniel P Mercer, Bradley Lezak, Osama Alzobi, John G Kennedy","doi":"10.1177/19386400261484237","DOIUrl":"https://doi.org/10.1177/19386400261484237","url":null,"abstract":"<p><p>BackgroundCartilaginous non-structural allografts have emerged as biologic adjuncts for the treatment of osteochondral lesions and focal cartilage pathology in the foot and ankle, particularly for lesions that fail bone marrow stimulation (BMS) yet may not warrant osteochondral transplantation. These allografts may serve as an intermediary treatment strategy between BMS and more invasive restorative procedures.MethodsA scoping review of the currently available literature regarding cartilaginous non-structural allografts used in foot and ankle pathology was performed, with a focus on BioCartilage, DeNovo NT, and CartiMax.ResultsBioCartilage may improve radiographic defect fill when used as an adjunct to marrow stimulation procedures, although superior functional outcomes have not been consistently demonstrated. In contrast, DeNovo NT has demonstrated mixed clinical and radiographic outcomes, including persistent postoperative marrow edema, inconsistent graft incorporation, and relatively high complication and failure rates in current studies. Available evidence for BioCartilage and DeNovo NT consists primarily of small clinical studies with heterogeneous methodologies, whereas evidence for CartiMax remains limited to preclinical and industry-supported investigations without published peer-reviewed human clinical outcome studies.ConclusionAlthough these allografts demonstrate potential as biologic adjuncts for cartilage repair, currently available evidence remains limited by heterogeneous study designs, inconsistent outcome reporting, limited comparative data, small cohort sizes, and short-term follow-up. Cost-effectiveness remains an important consideration, given the limited evidence demonstrating long-term functional superiority over traditional marrow stimulation techniques. Further high-quality comparative studies are necessary to determine the long-term efficacy, safety, durability, and cost-effectiveness of cartilaginous non-structural allografts in foot and ankle pathology.Level of Evidence:<i>V: Scoping Review</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261484237"},"PeriodicalIF":2.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Expectations of Foot and Ankle Fellowships: A Comparison Among Foot and Ankle Societies.","authors":"Christopher Hyer, Cameron Meyer, Jae Yoon Kim, Orlando Martinez","doi":"10.1177/19386400261480214","DOIUrl":"https://doi.org/10.1177/19386400261480214","url":null,"abstract":"<p><p>BackgroundFoot and ankle training has evolved with the development of the fellowship curriculum. Increased specialization has enhanced management of foot and ankle pathology. Despite this, physician marketing schemes have clouded this definition.PurposeThe purpose of this study was to review and compare current foot and ankle fellowship programs (podiatric and orthopaedic) to better define what a surgical foot and ankle fellowship is, thereby more appropriately delineating between that of a preceptorship.Study Design/ MethodsA digital search was performed through online published American Orthopedic Foot and Ankle Society (AOFAS) and American College of Foot and Ankle Surgeons (ACFAS) fellowship programs. Number of programs, case volume, faculty demographics, and duration (years) were all recorded.ResultsWe identified 51 total orthopaedic programs compared with 62 podiatric programs. Both societies defined a fellowship as a year-long experience. Each had a large attending faculty-to-fellow ratio [median of 3-1 orthopaedics and 6-1 podiatric, respectively]. Average case volume digitally published per year was on average 680 (±128) cases for orthopaedics and 481 (±123) for podiatric programs. However, publishable data are scarce and hard to prove.ConclusionThe foot and ankle community should continue to vet and differentiate what constitutes \"fellowship training.\" Improved publicly available data would allow better transparency of different types of extended training. Further studies are warranted to provide a clearer definition of \"fellowship\" training, thereby maintaining quality control and preventing false advertising.Level of Evidence:Level IV.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261480214"},"PeriodicalIF":2.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Reliability and Agreement of Böhler and Gissane Angle Measurements Using PACS and ImageJ.","authors":"Rico Te Boekhorst, Jens A Halm, Robert Hemke, Tim Schepers","doi":"10.1177/19386400261478747","DOIUrl":"https://doi.org/10.1177/19386400261478747","url":null,"abstract":"<p><p>BackgroundBöhler's and Gissane's angles are used in calcaneal fracture assessment, but measurement consistency varies. ImageJ may offer a low-cost alternative to Picture Archiving and Communication System (PACS). This study aimed to define margin of error (MOE) and evaluate whether ImageJ provides measurement agreement and reliability comparable to PACSMethodsMargin of error was predefined based on previously reported variability and expert consensus. Three observers measured Böhler's and Gissane's angles on 42 radiographs using PACS and ImageJ; a consensus PACS measurement served as the reference measurement. Reliability (intraclass correlation coefficient), deviation from the consensus reference (mean/median absolute error; bias), agreement within MOE, and Bland-Altman analyses were performed.ResultsThe predefined margins of error were ±2.5° (Böhler) and ±5° (Gissane). Interobserver reliability was good to excellent for Böhler and poor to moderate for Gissane. Within-observer inter-method agreement was excellent for Böhler and variable for Gissane. Deviations for Gissane frequently exceeded the MOE, with minimal method bias.ConclusionImageJ performed comparably to PACS for Böhler's angle measurements. However, Gissane's angle demonstrated poor reproducibility with both methods, likely due to anatomical and projectional factors.Level of evidence:<i>Diagnostic, level III</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261478747"},"PeriodicalIF":2.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic Renal Cell Carcinoma to the Calcaneus and Talus Presenting as Plantar Fasciitis: A Case Study and Review of the Literature.","authors":"Hana Q Abdul Rahman, Lara C Atwater","doi":"10.1177/19386400261480217","DOIUrl":"https://doi.org/10.1177/19386400261480217","url":null,"abstract":"<p><p>Renal cell carcinoma (RCC) is known for its propensity for distant metastasis, including skeletal involvement; however, metastatic spread to the foot, particularly the calcaneus and talus, is exceptionally rare, with fewer than 15 cases documented in the literature. We report a 59-year-old woman with a history of RCC treated with partial nephrectomy 7 years earlier who presented with 6 months of progressive left foot pain initially attributed to plantar fasciitis. Over the course of 4 emergency department visits spanning approximately 1 month, her oncologic history was not incorporated into the differential diagnosis. Advanced imaging ultimately revealed a 6.2 cm × 6.0 cm × 5.2 cm enhancing soft tissue mass infiltrating both the calcaneus and talus. Histopathology confirmed metastatic clear cell RCC. Given the extent of osseous destruction precluding viable reconstruction, the patient underwent below-knee amputation. Staging identified a concurrent pulmonary lesion, and postoperative systemic immunotherapy was initiated, though interval imaging demonstrated disease progression. This case highlights the diagnostic pitfalls of atypical RCC metastasis and underscores that a prolonged disease-free interval following nephrectomy should not diminish clinical suspicion. Inclusion of metastatic disease in the differential for refractory foot pain in any patient with an oncologic history is essential to enable timely diagnosis and preserve limb-salvage options.Levels of Evidence:<i>Level V: Case report</i>Study Design:Diagnostic case study (Level V); structured single-case analysis with systematic review of the published literature.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261480217"},"PeriodicalIF":2.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Tobacco Nicotine Dependence is Associated With Increased Risk of Perioperative Complications and Re-Rupture After Achilles Tendon Repair.","authors":"Samuel A Florentino, Vu Bui, Christopher J Kaszluga, Alexander N Berk, Logan M Good, Sara Lyn Miniaci-Coxhead, Alexander S Rascoe, Joshua K Napora","doi":"10.1177/19386400261478749","DOIUrl":"https://doi.org/10.1177/19386400261478749","url":null,"abstract":"<p><p>IntroductionTobacco use is known to have adverse effects on postoperative outcomes after Achilles tendon repair. Non-tobacco nicotine dependence (NTND) is increasing, but its association with outcomes of Achilles tendon repair remains unclear. The purpose of this study was to evaluate the association of NTND on perioperative and long-term outcomes after primary Achilles tendon repair. Study Design. This is a cohort study.MethodsA retrospective cohort study using the TriNetX database was conducted to identify patients who underwent primary Achilles tendon repair from 2004 to 2023. Patients were stratified into NTND (defined by International Classification of Diseases, 10th Revision diagnosis of nicotine dependence after excluding tobacco-specific codes), traditional tobacco nicotine dependent, and non-nicotine control cohorts. Propensity score matching was performed for demographics and comorbidities. Ninety-day and 2-year complications were compared using odds ratios (ORs) with 95% confidence intervals (CIs).ResultsOf 25 874 eligible patients, 1598 (6.2%) had NTND. After matching, 1592 NTND patients were compared with 1592 controls and 1592 tobacco users. Within 90 days, NTND patients demonstrated higher rates of wound dehiscence (OR, 1.98, 95% CI, 1.34-2.92), surgical-site infection (OR, 2.01, 95% CI, 1.32-3.08), emergency department visits (OR, 2.43, 95% CI, 1.84-3.20), and hospitalizations (OR, 3.35, 95% CI, 1.87-5.99) versus controls. Compared with tobacco users, NTND patients had greater odds of wound dehiscence (OR, 1.45, 95% CI, 1.02-2.06) and infection (OR, 1.89, 95% CI, 1.25-2.87). At 2 years, NTND patients showed higher re-rupture rates than both controls (OR, 1.39, 95% CI, 1.01-1.89) and tobacco users (OR, 1.62, 95% CI, 1.17-2.25)ConclusionNon-tobacco nicotine dependence was associated with increased short- and long-term complications after primary Achilles tendon repair. These findings identify NTND as a potential risk factor in patients undergoing Achilles tendon repair.Level of Evidence:<i>3; retrospective cohort study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261478749"},"PeriodicalIF":2.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Lower-Leg Chronic Exertional Compartment Syndrome Treated With In-Office Needle Endoscopic 4-Compartment Fasciotomy in Collegiate Sprinter: A Case Report.","authors":"Guillaume Robert, James J Butler, Cody Perskin, Alexander Tham, Jared Rubin, Arianna L Gianakos, John G Kennedy","doi":"10.1177/19386400261477461","DOIUrl":"https://doi.org/10.1177/19386400261477461","url":null,"abstract":"<p><p>Chronic exertional compartment syndrome (CECS) is a condition which involves sudden and painful increases in pressure of the musculofascial compartments of the lower leg in association with increased physical activity. A variety of surgical options, including endoscopic fasciotomy, exist to mechanically decompress the fascia. Recent progress in in-office needle endoscopy has shown potential for the diagnosis and treatment of various orthopaedic pathologies. We present the case of a 20-year-old collegiate sprinter with a 3-month history of CECS that was treated with bilateral in-office needle endoscopic 4 compartment fasciotomy. The patient was able to return to his previous level of competition 8 weeks postoperatively, and there were no complications. To the authors' knowledge, this is the first report of an in-office endoscopic 4-compartment fasciotomy for the management of CECS.<b>Levels of Evidence:</b> <i>V, case report</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261477461"},"PeriodicalIF":2.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}