Foot & ankle international最新文献

{"title":"Fibular Length and Syndesmotic Width Variations in Ankle Osteoarthritis: A Weightbearing CT Analysis of Coronal Plane Deformities.","authors":"Agustin Barbero, Ben Efrima, Carla Carfi, Serban Andrei Constantinescu, Cristian Indino, Camila Maccario, Nicholas Crippaorlandi, Amit Benady, Federico Giuseppe Usuelli","doi":"10.1177/10711007251372938","DOIUrl":"https://doi.org/10.1177/10711007251372938","url":null,"abstract":"<p><strong>Background: </strong>The relationship between fibular morphology, syndesmotic anatomy, and coronal plane deformities in ankle osteoarthritis (OA) remains poorly understood. Whether fibular length and syndesmosis width vary with different alignment patterns is unknown. This study aimed to evaluate these structural parameters in OA patients compared to normal controls using weightbearing computed tomography (WBCT).</p><p><strong>Methods: </strong>We retrospectively analyzed 81 patients with end-stage ankle OA and 82 asymptomatic controls using weightbearing CT. OA patients were stratified by coronal alignment (varus n = 34, valgus n = 32, neutral n = 15) based on talar tilt measurements. Manual WBCT measurements included Tip to Subtalar Distance (TTST), Tip to Tibiotalar Distance (TTTT), syndesmosis width, talocrural angle, and TTST/TTTT ratio. Group comparisons were performed using <i>t</i> tests and Mann-Whitney <i>U</i> tests, and intra- and interrater reliability was assessed via intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Between OA subgroups, tip-to-tibiotalar distance (TTTT) was significantly greater in varus (26.38 mm) versus valgus ankles (20.43 mm; <i>P</i> = .010), suggesting relative fibular lengthening in varus deformity. TTST also differed between these subgroups (1.85 mm vs -2.51 mm; <i>P</i> = .020). Syndesmosis width tended to be greater in valgus ankles (6.00 mm) than in varus (4.71 mm) or normal controls (4.64 mm; <i>P</i> = .086). Talocrural angle was increased in valgus ankles (9.83 degrees) compared with normal (7.79 degrees) and varus (7.24 degrees; <i>P</i> = .090). TTTT showed the highest reliability across raters (ICC > 0.90).</p><p><strong>Conclusion: </strong>This exploratory study identified trends suggesting fibular shortening and syndesmotic widening in valgus OA ankles, with opposite patterns in varus ankles. Although most comparisons with controls were not statistically significant, these hypothesis-generating findings suggest WBCT may detect subtle structural variations that warrant investigation in larger prospective studies.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251372938"},"PeriodicalIF":2.2,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310402","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":"Neuropeptide-Mediated Crosstalk between Subchondral Bone and Articular Cartilage in Ankle Osteoarthritis: A Cross-Sectional Histologic Study of 17 Ankles.","authors":"Saori Ishibashi, Tomoyuki Nakasa, Yasunari Ikuta, Satoru Sakurai, Dan Moriwaki, Taro Chujo, Nobuo Adachi","doi":"10.1177/10711007251372141","DOIUrl":"https://doi.org/10.1177/10711007251372141","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the expression patterns of the neuropeptides, calcitonin gene-related peptide (CGRP), and substance P (SP), in the subchondral bone of patients with ankle osteoarthritis (OA) and examine their association with subchondral bone changes and cartilage degeneration. We hypothesized that neuropeptides were expressed in sclerotic subchondral bone and that this expression was associated with the progression of cartilage degeneration. This study investigated neuropeptide expression and its relationship with subchondral bone changes and cartilage degeneration in ankle OA.</p><p><strong>Methods: </strong>Seventeen ankles of 16 patients who underwent total ankle arthroplasty for ankle OA were analyzed. Radiographic, histologic, and CT evaluations were conducted, including the measurement of Hounsfield unit (HU) values, subchondral bone plate thickness, trabecular bone area, and modified Mankin scores. Immunohistochemistry for CGRP; SP; collagen types I, II, and X; and TRAP staining for osteoclasts were performed.</p><p><strong>Results: </strong>Subchondral bone sclerosis and cartilage degeneration progressed concurrently with increased thickness and trabecular area beneath the degenerated cartilage. CGRP and SP expression were significantly upregulated in the sclerotic subchondral bone, showing strong positive correlations with HU values, subchondral bone thickness, and Mankin scores. CGRP expression appeared earlier than SP expression in moderate degeneration stages. The number of TRAP-positive osteoclasts increased with degeneration and followed a distribution pattern similar to that of CGRP and SP.</p><p><strong>Conclusion: </strong>CGRP and SP expression in the subchondral bone was closely linked to structural bone changes and cartilage degradation in ankle OA. Their early expression and association with osteoclast activity support a potential role in OA pathogenesis; however, causation cannot be inferred from this cross-sectional study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251372141"},"PeriodicalIF":2.2,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310435","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":"Oblique Sliding Fibular Osteotomy as an Adjunct to Supramalleolar Osteotomy in Varus Ankle Osteoarthritis: Comparative Radiographic and Clinical Outcomes.","authors":"Jun Young Choi, Jin Soo Suh, Reuben Ngissah, Ju Hwan Park","doi":"10.1177/10711007251372142","DOIUrl":"https://doi.org/10.1177/10711007251372142","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that fibular osteotomy can enhance correction of varus talar tilt (TT) in ankle osteoarthritis (OA) when combined with supramalleolar osteotomy (SMO). This study introduces a simplified and universally applicable oblique sliding fibular osteotomy (OSFO) technique suitable for joint-preserving procedures.</p><p><strong>Methods: </strong>This retrospective study included 22 patients with varus ankle OA and TT >10 degrees who underwent OSFO with SMO between January 2019 and June 2024, with a minimum of 1-year follow-up. For comparison, 42 patients who underwent SMO with either a medial opening wedge or lateral closing wedge fibular osteotomy were analyzed. Radiographic and clinical outcomes were compared across the 3 groups.</p><p><strong>Results: </strong>Postoperatively, with the numbers available, TT showed a significant decrease (<i>P</i> = .012), the relative fibular length to the tibia decreased by approximately 7.5 mm (<i>P</i> = .01), and fibular valgization averaged 6.4 degrees (<i>P</i> = .01) in all 22 patients. All clinical outcome measures improved significantly (<i>P</i> = .001). In the comparative analysis of the 3 types of fibular osteotomy, the decrease in talocrural angle was significantly greater in the OSFO and lateral closing wedge groups than in the medial opening wedge group (<i>P</i> = .013). The degree of shortening of the relative fibular length to the tibia was smaller in the medial opening wedge group than in the OSFO and lateral closing wedge groups (<i>P</i> = .017). We did not detect a significant difference in the degree of fibular valgization among the groups (<i>P</i> = .591). Notably, improved TT, hindfoot alignment angle, and hindfoot alignment ratio outcomes were observed only in patients undergoing additional inframalleolar procedures in conjunction with OSFO.</p><p><strong>Conclusion: </strong>The OSFO technique appears to offer correction comparable to conventional fibular osteotomy techniques when combined with SMO. Although its clinicoradiographic correction is similar to that of conventional lateral closing-wedge fibular osteotomy, the OSFO technique could offer intraoperative adjustability and eliminate the need for plate fixation, providing distinct surgical advantages.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251372142"},"PeriodicalIF":2.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305086","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":"Statistical Shape Modeling Characterization of Cavovarus Deformity Between Demyelinating and Axonal Subtypes of Charcot-Marie-Tooth Disease.","authors":"Melissa R Requist, Andrew C Peterson, Timothy C Beals, Bopha L Chrea, Amy L Lenz","doi":"10.1177/10711007251373076","DOIUrl":"https://doi.org/10.1177/10711007251373076","url":null,"abstract":"<p><strong>Background: </strong>Charcot-Marie-Tooth disease (CMT) is an inherited peripheral neuropathy that is associated with a cavovarus foot deformity that leads to impaired mobility and pain. Structural differences in the hindfoot, midfoot, and forefoot that contribute to this cavovarus deformity have not been fully characterized or described between disease subtypes. This study aimed to identify structural differences in the foot associated with CMT and between demyelinating and axonal subtypes in a retrospective cross-sectional study.</p><p><strong>Methods: </strong>In this study, we use statistical shape modeling, a mathematical tool to describe morphologic averages and variation to create a 14-bone model of the tibia through metatarsals from retrospectively identified weightbearing computed tomography (WBCT) images from individuals with CMT and controls, classified as having either demyelinating or axonal disease. We used a Hotelling <i>T</i>² test and a principal components analysis followed by statistical tests to identify significant differences in morphology between CMT and control groups and between demyelinating, axonal, and control groups.</p><p><strong>Results: </strong>Results of this analysis showed similarity in the overall foot deformity between subtypes and supported previous research on foot alignment by highlighting several regions of the foot and ankle with an alignment-driven deformity. Differences in overall cavovarus position were identified between CMT and control groups, with additional increase in hindfoot varus rotation seen in the demyelinating group. Along each component of the deformity, the demyelinating group demonstrated more severe deformity than the axonal group.</p><p><strong>Conclusion: </strong>There are differences in foot morphology throughout the hindfoot, midfoot, and forefoot that contribute to the cavovarus deformity seen in CMT. Demyelinating CMT presents with severe global deformity with pronounced hindfoot varus while axonal CMT has a more midfoot-centered deformity.</p><p><strong>Clinical relevance: </strong>These results demonstrate the importance of disease subtype in treatment planning for individuals with CMT-related cavovarus deformity and support the use of 3-dimensional imaging in characterization of cavovarus foot structure.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251373076"},"PeriodicalIF":2.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305105","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":"Accelerated Rehabilitation after Arthroscopic ATFL Repair for CLAI: Propensity-Matched Cohort Study.","authors":"Canjun Zeng, Nian Sun, Yuxuan Wei, Feijuan Jiang, Yijun Liu, Hao Guo","doi":"10.1177/10711007251376297","DOIUrl":"https://doi.org/10.1177/10711007251376297","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the efficacy and safety of an accelerated postoperative rehabilitation protocol (APRP), which emphasizes immediate full weightbearing (FWB), muscle strength and balance training as early as possible, after arthroscopic anterior talofibular ligament (ATFL) repair for chronic lateral ankle instability (CLAI).</p><p><strong>Methods: </strong>Patients with CLAI who underwent modified ATFL lasso-loop repair procedures between December 2019 and November 2022 were retrospectively screened. Based on their postoperative rehabilitation protocols, subjects were divided into the APRP group and the conventional postoperative rehabilitation protocol (CPRP) group using 1:2 propensity score matching. Clinical outcome measures comprised the Karlsson score, visual analog scale (VAS) for pain, Tegner score, anterior drawer test findings, complications, and magnetic resonance imaging-based ATFL Quality Score (ATFLQS). A receiver operating characteristic curve analysis was employed to investigate the association between preoperative ATFLQS and clinical outcomes in the APRP group.</p><p><strong>Results: </strong>The APRP group demonstrated comparable improvements in Karlsson score (31.8 ± 17.6 vs 36.0 ± 13.4, <i>P</i> = .267) and Tegner score (2 [-1 to 6] vs 2 [0 to 5], <i>P</i> = .168) to the CPRP group. Although the APRP group showed statistically superior VAS pain score improvement (3.5 ± 2.3 vs 2.2 ± 0.7, <i>P</i> < .001), the clinical significance of this 1.3-point difference remains uncertain given the lack of validated minimal clinically important difference thresholds for VAS pain in ankle ligament surgery populations. The overall complication rates between the 2 groups showed no statistically significant difference (10/54 vs 7/28, <i>P</i> = .492). Comparable ATFL quality was also found between the 2 groups based on the ATFLQS. The optimal ATFLQS threshold value for predicting functional outcomes was determined to be 2.5, based on the maximal Youden index, demonstrating a sensitivity of 82.4% and specificity of 83.3%.</p><p><strong>Conclusion: </strong>Comparable outcomes between the 2 groups were found following arthroscopic ATFL repair for CLAI, with no recurrence observed. FWB, muscle strength, and balance training as early as possible demonstrates both efficacy and safety after surgery. However, patients with preoperative ATFLQS <2.5 receiving APRP may have a significantly increased risk for suboptimal functional recovery.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251376297"},"PeriodicalIF":2.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305122","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":"Percutaneous Zadek Osteotomy vs Open Haglund Resection for Insertional Achilles Tendinopathy: Early Outcomes and Complication Rates.","authors":"Sarah Hall Kiriluk, Ettore Vulcano, Oliver N Schipper, Jonathan R M Kaplan, A Holly Johnson, Heidi Ventresca, Chase Gauthier, Harley T Davis, Preston Harrison, Thomas Lewis, Peter Lam, J Benjamin Jackson, Tyler A Gonzalez","doi":"10.1177/10711007251359639","DOIUrl":"https://doi.org/10.1177/10711007251359639","url":null,"abstract":"<p><strong>Background: </strong>Insertional Achilles tendinopathy (IAT) is difficult to manage despite multiple surgical options. Two of the surgical options include an open midline Achilles tendon-splitting Haglund resection and a percutaneous Zadek osteotomy (ZO). The current study compared the patient-reported outcomes and complications of open vs percutaneous procedures in patients with IAT ± Haglund deformity.</p><p><strong>Methods: </strong>A retrospective comparative study of consecutive patients who underwent either an open midline Achilles tendon-splitting Haglund resection or percutaneous ZO for IAT ± Haglund deformity at a single institution with minimum 12 months' follow-up was performed. Preoperative and postoperative Patient-Reported Outcome Measurement Information System (PROMIS) scores and complications were recorded for each patient and compared between cohorts.</p><p><strong>Results: </strong>Forty-three patients were treated with an open midline Achilles tendon-splitting Haglund resection and 34 patients were treated with a percutaneous ZO for IAT ± Haglund deformity. PROMIS function (<i>P</i> < .001), pain (<i>P</i> < .001), and mobility (<i>P</i> < .001) scores significantly improved in patients who received either procedure. In the open midline Achilles tendon-splitting Haglund resection cohort, a significant increase in wound complications (11/43, 25.6%) was observed in comparison to the percutaneous ZO group (1/34, 2.9%; <i>P</i> = .007).ConclusionBoth techniques yielded clinically meaningful improvements in PROMIS scores. In this modest retrospective cohort, the percutaneous ZO was associated with fewer minor wound complications; however, this observation should be interpreted cautiously given the limited sample size, short follow-up, and potential selection bias.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251359639"},"PeriodicalIF":2.2,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234762","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":"Computed Tomography Improves Interobserver Agreement and Influences Surgical Planning in Lauge-Hansen Classification of Ankle Fractures.","authors":"Mehmet Sahin, Yilmaz Ergisi, Uygar Dasar, Selcuk Korkmazer, Ulas Can Kolac, Erdi Ozdemir","doi":"10.1177/10711007251372146","DOIUrl":"https://doi.org/10.1177/10711007251372146","url":null,"abstract":"<p><strong>Background: </strong>The Lauge-Hansen classification is commonly used for ankle fractures but demonstrates poor interobserver reliability when based on radiographs alone. This study was conducted to determine whether the addition of computed tomography (CT) improves observer agreement and influences surgical planning.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with operatively treated ankle fractures. Five masked observers (2 orthopaedic surgeons and 3 orthopaedic surgery residents) classified fractures using the Lauge-Hansen system in 2 sessions: first with radiographs alone and then with radiographs in combination with CT. Interobserver agreement was assessed using Cohen kappa and Fleiss kappa, whereas consistency of each observer's classifications between radiograph-only and CT-assisted sessions was also evaluated. Changes in fracture classification and treatment plans following CT evaluation were also recorded.</p><p><strong>Results: </strong>A total of 145 patients were included. Interobserver agreement improved significantly with the addition of CT, increasing from κ = 0.464 (95% CI: 0.41-0.52) with radiographs alone to κ = 0.804 (95% CI: 0.76-0.85) with radiographs plus CT (<i>P</i> < .001). The use of CT led to a change in fracture classification in 73 to 80 cases across observers (50.3% to 55.2%), and treatment plans were revised in 69 to 75 cases (47.6% to 52.0%).Among these changes, decisions to fix the posterior malleolus increased from 41 to 64 cases after CT evaluation (Δ = 15.9%, 95% CI: 10.8%-22.7%, <i>P</i> = .008), and syndesmotic stabilization was newly planned in 36 to 59 cases (Δ = 15.9%, 95% CI: 10.8%-22.7%, <i>P</i> = .014), depending on the observer. These findings indicate that CT provided critical diagnostic details that influenced both classification and surgical decision making.</p><p><strong>Conclusion: </strong>CT significantly improves the consistency of the Lauge-Hansen classification and can have a substantial impact on surgical decision making. CT imaging may be considered, especially when posterior malleolar or syndesmotic involvement is suspected; however, its impact on clinical outcomes remains uncertain.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251372146"},"PeriodicalIF":2.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226552","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":"Peroneus Longus Autograft Harvest: Patient-Reported Donor-Ankle Morbidity at 1 Year.","authors":"Chen-Heng Hsu, Yi-Hsuan Lin, Lei Hsia, Louis Yi Lu, Cheng-Pang Yang, Samuel Ka-Kin Ling, Alvin Chao-Yu Chen, Joe Chih-Hao Chiu","doi":"10.1177/10711007251372121","DOIUrl":"https://doi.org/10.1177/10711007251372121","url":null,"abstract":"<p><strong>Background: </strong>The peroneus longus (PL) tendon is increasingly used as an autograft for ligament and tendon reconstructions, particularly in populations where hamstring graft dimensions may be insufficient. However, donor-site ankle function and patient-reported outcomes measures (PROMs) after PL harvest remain underreported. This study aimed to evaluate changes in PROMs and range of motion (ROM) at the donor-site ankle 1 year after PL autograft harvest and the proportion exceeding minimal clinically important difference (MCID) thresholds.</p><p><strong>Methods: </strong>Patients who underwent PL autograft harvest from January 2021 through April 2023 were retrospectively enrolled. PROMs-including the Single Assessment Numeric Evaluation (SANE), American Orthopaedic Foot & Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), and Cumberland Ankle Instability Tool (CAIT) score-were assessed preoperatively and at 1-year follow-up on the operated ankle. Ankle ROM was also measured. Donor-site morbidity was evaluated using MCID thresholds.</p><p><strong>Results: </strong>Thirty-five patients (mean age: 43 ± 28 years) completed follow-up at a mean of 22.5 ± 10 months. Although ankle ROM was preserved with no statistically significant changes (<i>P</i> > .05), PROMs declined significantly compared with preoperative values (<i>P</i> < .05), with postoperative scores of SANE (92.3 ± 27.3), AOFAS (96.7 ± 10.7), FAOS (97.0 ± 23), and CAIT (27.4 ± 19.4). MCID thresholds were exceeded in 51.4% (SANE), 31.4% (AOFAS), 34.2% (FAOS), and 5.7% (CAIT) of patients. Two patients experienced transient sural nerve hypoesthesia, which resolved without long-term deficit.</p><p><strong>Conclusion: </strong>PL tendon harvest was associated with preserved ankle ROM at 1 year but demonstrated statistically significant declines in PROMs compared with preoperative baselines. A subset of patients exceeded MCID thresholds, indicating clinically meaningful donor-site morbidity in some cases. These findings underscore the importance of informed graft selection and highlight the need for further long-term evaluation.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251372121"},"PeriodicalIF":2.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194255","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":"Weightbearing CT 3-D Mapping of First Metatarsophalangeal and Sesamoid Joint Interactions in Hallux Valgus: A Case-Control Study.","authors":"Vineel Mallavarapu, Kepler Alencar Mendes de Carvalho, Andrew Behrens, Matthew Thomas Jones, Ryan Jasper, Hannah Zeller, Kevin Dibbern, Cesar de Cesar Netto","doi":"10.1177/10711007251363257","DOIUrl":"https://doi.org/10.1177/10711007251363257","url":null,"abstract":"<p><strong>Background: </strong>Traditional methods of evaluating Hallux Valgus (HV) have limitations in assessing 3D deformity elements such as first metatarsal pronation and sesamoid subluxation. This study aimed to use coverage mapping (CM) to analyze surface interactions of the first metatarsophalangeal joint (MTPJ) and metatarsosesamoid joints in HV and control patients, correlating findings with visual analog scale (VAS) pain scores. We hypothesized that patients with HV would show decreased joint coverage, reflective of joint subluxation, and that these changes would correlate with higher VAS scores.</p><p><strong>Methods: </strong>A distance mapping (DM) algorithm was applied to weightbearing computed tomography (WBCT) images from 44 symptomatic HV patients and 43 controls. Color-coded CMs were obtained from these distance measurements and were divided into quadrants for analysis. Regions showing joint space widths <5 mm indicated normal intraarticular coverage. VAS scores were obtained from the electronic medical record at the time of clinical assessment. Angular measurements were semiautomatically obtained, including the hallux valgus angle (HVA) and first metatarsal rotation angle (MRA). Statistical analyses included paired <i>t</i> tests, Wilcoxon tests, and regression models.</p><p><strong>Results: </strong>CM revealed significant reductions in joint coverage in HV patients, particularly in specific quadrants of the first MTPJ and metatarsosesamoid joints. No association was found between CM features and VAS scores. Higher VAS scores were associated with younger age, lower MRA, and higher BMI.</p><p><strong>Conclusion: </strong>3D WBCT CM revealed significant subluxation and deviation in HV patients. VAS scores were influenced by demographic variables and metatarsal rotation, but not CMs, suggesting unique challenges beyond subluxation and pain. WBCT mapping generates hypothesis-generating visualizations of HV deformity; prospective studies are required before it can guide diagnosis or surgical planning.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251363257"},"PeriodicalIF":2.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180815","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":"MRI Evaluation of Cervical, Spring, and Interosseous Talocalcaneal Ligament Orientation in Progressive Collapsing Foot Deformity.","authors":"Alexander Chang, Brady Huang, Ian Foran","doi":"10.1177/10711007251363927","DOIUrl":"https://doi.org/10.1177/10711007251363927","url":null,"abstract":"<p><strong>Background: </strong>Progressive collapsing foot deformity (PCFD) is a complex condition characterized by progressive ligamentous and osseous changes in the hindfoot, midfoot, and forefoot. Although osseous changes at the subtalar and transverse tarsal joints have been well studied, ligamentous anatomy in PCFD is less understood. This study evaluates the cervical, interosseous talocalcaneal, and superomedial fibers of the spring ligament in patients with PCFD vs controls using magnetic resonance imaging (MRI) analysis.</p><p><strong>Methods: </strong>Nonweightbearing MRI and weightbearing radiographs of 39 patients (23 PCFD, 16 controls) were retrospectively reviewed. MRIs measured the coronal plane orientation of the interosseous talocalcaneal, cervical, and superomedial spring ligaments relative to the subtalar joint middle facet. Radiographic data included anteroposterior (AP) talonavicular coverage percentage, AP talocalcaneal angle (Kite), lateral talar-first metatarsal angle (Meary), talar declination angle, and calcaneal pitch. Two observers measured each radiographic and MRI angle. Statistical analysis included an independent <i>t</i> test and intraclass correlation coefficient (ICC) to assess interobserver reliability.</p><p><strong>Results: </strong>PCFD patients demonstrated significantly more horizontal ligament orientations than controls, with reduced cervical (25.5 vs 45 degrees, <i>P</i> < .001), superomedial spring (11.5 vs 23.1 degrees, <i>P</i> < .001), and interosseous talocalcaneal ligament angles (39.5 vs 49.0 degrees, <i>P</i> = .005). Radiographically, PCFD patients had decreased talonavicular coverage (64.5% vs 80.9%, <i>P</i> < .001), increased Meary angle (22.2 vs -2.3 degrees, <i>P</i> < .001), increased talar declination (37.0 vs 20.6 degrees, <i>P</i> < .001), increased Kite angle (20.7 vs 17.2 degrees, <i>P</i> = .079), and decreased calcaneal pitch (15.5 vs 24.6 degrees, <i>P</i> < .001). Interobserver reliability was excellent, with ICC values exceeding 0.94 for all measurements except interosseous talocalcaneal ligament angle (ICC = 0.83).</p><p><strong>Conclusion: </strong>On nonweightbearing MRI, PCFD patients showed more horizontal orientation of key subtalar ligaments than controls; whether these differences persist under physiologic load should be confirmed with weightbearing imaging.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251363927"},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133088","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}