Foot & ankle international最新文献

{"title":"The Impact of Social Deprivation on Outcomes in Forefoot Surgery.","authors":"Tyson Compton, Kade Wagers, Emma H Braun, Angela P Presson, Devon Nixon","doi":"10.1177/10711007251322443","DOIUrl":"https://doi.org/10.1177/10711007251322443","url":null,"abstract":"<p><strong>Background: </strong>The impact of social deprivation (SD) on health outcomes is a topic of increasing interest in orthopaedics. There are limited studies and no clear consensus, though, on the impact of SD on outcomes in foot and ankle surgery. Area deprivation index (ADI) is a well-studied and validated surrogate metric for SD. We hypothesized that patients with greater SD would have worse patient-reported pain and physical function at baseline and at 6 weeks and 6 months following elective forefoot surgery.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 477 forefoot surgeries between January 2015 and December 2022 to determine if SD was associated with patient-reported outcomes (PROs) related to pain and physical function. Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) and pain interference (PI) assessments administered preoperatively and at 6 weeks and 6 months postoperatively. SD was quantified using the ADI. Patients were divided into high- and low-deprivation groups using the national median ADI of 50.</p><p><strong>Results: </strong>At baseline before surgery, PROMIS-PF and PROMIS-PI scores were similar between high and low social deprivation groups. At 6 weeks and 6 months after surgery, there were no significant differences between high- and low-deprivation groups for either PROMIS-PF or PROMIS-PI. Both groups (high and low social deprivation) demonstrated similar improvements in pain and function at 6 months after surgery. The only variable associated with outcomes was employment status, with disabled and unemployed patients exhibiting greater pain and less function before surgery. Disabled patients also had greater pain after surgery.</p><p><strong>Conclusion: </strong>Based on our data, social deprivation did not appear to be associated with patient-reported pain or physical function prior to forefoot surgery or at 6 weeks or 6 months following surgery.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251322443"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618106","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":"Postoperative Medial Gutter Impingement Following Primary Total Ankle Arthroplasty: A Retrospective Case-Control Study.","authors":"Joaquin Palma, Grace DiGiovanni, Seif El Masry, Ricardo Villar, Agnes Jones, Allison Boden, Jensen Henry, Constantine A Demetracopoulos, Scott J Ellis","doi":"10.1177/10711007251321493","DOIUrl":"https://doi.org/10.1177/10711007251321493","url":null,"abstract":"<p><strong>Background: </strong>Medial gutter impingement may compromise the results of an otherwise well-fixed total ankle arthroplasty (TAA), but no previous study has assessed predisposing factors. This case-control study sought to investigate potential risk factors and the role of talar component downsizing in decreasing medial impingement.</p><p><strong>Methods: </strong>A retrospective case-control study with 149 patients was performed. Thirty-four patients reoperated for medial impingement were identified and matched to a control group of 115 patients. Radiographic parameters included pre- and post-TAA coronal alignment, talar center of migration ratio (TCMr), joint line height ratio (JLHR), and absolute talar component rotation (aTR). Demographic and radiographic data were compared. A logistic regression model assessed the correlation between medial gutter impingement with radiographic parameters and talar component downsizing.</p><p><strong>Results: </strong>Talar component downsizing was more frequent in the control group (70.4% vs 29.4%, <i>P</i> < .001). Postoperative varus alignment (91.17 vs 90.45 degrees, <i>P</i> = .012), a more elevated joint line (JLHR = 1.64 vs 1.5, <i>P</i> = .037), increased medial talar translation (TCMr = 10.66% vs 6.65%, <i>P</i> = .018), and internal talar rotation (aTR = 3.58 vs 0.24 degrees, <i>P</i> < .001) were observed in the medial impingement cohort. Regression analysis showed a negative correlation between talar downsize and the probability of medial impingement (OR = 0.18, 95% CI 0.07, 0.44, <i>P</i> < .001). A positive correlation was observed between medial impingement and a medially translated talar component (OR = 1.07, 95% CI 1.01, 1.15, <i>P</i> = .03) and a higher joint line level (OR = 1.23, 95% CI 0.99, 1.51, <i>P</i> = .051).</p><p><strong>Conclusion: </strong>Talar component downsizing correlated with an 82% reduction in the probability of medial gutter impingement. Postoperative varus alignment, an elevated joint line level, and medially translated and internally rotated talar component were more prevalent in patients reoperated for medial impingement.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251321493"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618102","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":"Results of Lisfranc Injuries Treated With Interosseous Suture Button Fixation With a Minimum 5-Year Follow-Up.","authors":"Guilherme Honda Saito, Danilo Ryuko Cândido Nishikawa, Adilson Sanches de Oliveira, Paula Jardim Fairbanks, Alberto Abussamra Moreira Mendes, Marcelo Pires Prado","doi":"10.1177/10711007251322166","DOIUrl":"https://doi.org/10.1177/10711007251322166","url":null,"abstract":"<p><strong>Background: </strong>Open reduction and internal fixation or primary arthrodesis are considered gold standards for treating Lisfranc injuries. However, several drawbacks are associated with these procedures, such as joint motion loss and potential cartilage damage. More recently, the suture button emerged as an alternative treatment for ligamentous Lisfranc injuries, which can be used either alone or in combination with traditional techniques, with the potential to mitigate some of these potential disadvantages. The primary outcome of the present study was to evaluate the functional outcomes of 20 patients treated with the suture button technique for Lisfranc injuries over a medium- to long-term follow-up period. The secondary outcome was to assess and describe the complications associated with this procedure.</p><p><strong>Methods: </strong>A retrospective review was conducted on 20 patients who underwent operation for acute Lisfranc injuries using the interosseous suture button technique between 2013 and 2019. The mean follow-up was 83 months (range 60-126). Clinical evaluation involved the assessment of complications, reoperations, visual analog scale (VAS) scores, American Orthopaedic Foot & Ankle Society (AOFAS) midfoot scores, patient satisfaction, and ability to return to previous activities. Radiographic analysis was performed aiming to evaluate reduction maintenance and osteoarthritis development.</p><p><strong>Results: </strong>Patients demonstrated excellent outcomes with an average VAS of 0.50 and a mean AOFAS midfoot score of 95.5. Incomplete reduction was the only factor we identified influencing lower VAS and AOFAS scores. Most complications were minor and solved with conservative treatment. More serious complications, such as loss of reduction and posttraumatic arthritis were observed in 2 patients each.</p><p><strong>Conclusion: </strong>In this small series with a relatively long follow-up, we found that the use of an interosseous suture button technique was a reliable method to treat acute Lisfranc injuries, resulting in satisfactory clinical and functional outcomes. However, outcomes including posttraumatic arthritis and loss of reduction raise remain of concern.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251322166"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618104","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":"Foot Malalignment and Proximal Fifth Metatarsal Fractures.","authors":"Wolfram Grün, Emily Luo, Enrico Pozzessere, Erik Jesus Huanuco Casas, Antoine Acker, Pierre-Henri Vermorel, François Lintz, Cesar de Cesar Netto","doi":"10.1177/10711007251322141","DOIUrl":"https://doi.org/10.1177/10711007251322141","url":null,"abstract":"<p><strong>Background: </strong>Proximal fifth metatarsal fractures are common injuries that are classified into 3 zones according to their anatomical localization. While zone 1 and 2 fractures typically are traumatic, zone 3 fractures may be linked to foot alignment abnormalities, such as hindfoot varus and metatarsus adductus. The aim of the study was to explore the association between hindfoot alignment and different fracture zones, as well as the relationship between traumatic and atraumatic fracture origin and foot alignment.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with proximal fifth metatarsal fractures who had received a weightbearing computed tomography (WBCT) scan. Feet with zone 1 and 2 fractures were compared to zone 3 fractures and a healthy control group. Additionally, we compared feet with a traumatic fracture origin with those without. Foot alignment parameters, including the foot and ankle offset (FAO) and the forefoot arch angle (FAA), were analyzed alongside data from semiautomated segmentation reports. <i>P</i> <.05 was considered significant.</p><p><strong>Results: </strong>The study included 45 fractures (23 zone 1 and 2, 22 zone 3) and 19 controls. Zone 3 fractures showed a significant association with higher body mass index (<i>P</i> < .01), hindfoot varus (<i>P</i> < .01), and metatarsus adductus (<i>P</i> < .01) compared with zone 1 and 2 fractures, and they more frequently had a nontraumatic origin (<i>P</i> < .01). Zone 3 fractures also showed a significantly higher transverse arch (<i>P</i> < .01). No differences have been observed between zone 1 and 2 fractures and the controls. Fractures with atraumatic origin were significantly associated with hindfoot varus (<i>P</i> < .01), metatarsus adductus (<i>P</i> < .01), hindfoot varus (<i>P</i> < .01), and metatarsus adductus (<i>P</i> < .01).</p><p><strong>Conclusion: </strong>Hindfoot varus, metatarsus adductus, and a high transverse arch were significantly associated with zone 3 fractures as well as fractures with atraumatic origin.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251322141"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618099","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":"Complication and Revision Rate in Complex Intraarticular Calcaneal Fractures: Extended Lateral vs Sinus Tarsi Approach.","authors":"Jan S El Barbari, Matthias Meyer, Paul A Grützner, Benedict J Swartman, Sven Y Vetter, Jochen Franke","doi":"10.1177/10711007251322466","DOIUrl":"https://doi.org/10.1177/10711007251322466","url":null,"abstract":"<p><strong>Background: </strong>Adequate surgical treatment of intra-articular calcaneal fractures is challenging. Current clinical evidence on the superiority of either the extended lateral approach (ELA) or the sinus tarsi approach (STA) and their impact on radiologic and functional outcome remains inconclusive, and studies are characterized by low case numbers and short follow-up periods. We hypothesized that using STA would lead to fewer complications and revisions, without impairing fracture reduction or short- to midterm outcome.</p><p><strong>Methods: </strong>This retrospective cohort study included 241 patients with intra-articular calcaneal fractures receiving surgical therapy by ELA or STA from 2014 to 2020. A propensity score matching was performed to adjust for covariates distribution after which 140 complete data sets were available for analysis. The primary endpoint was the time to surgical revision. Secondary endpoints were time to complication, complication, as well as revision rate, operating room time, length of stay, and the radiologic and functional outcome (12-Item Short Form Health Survey [SF-12], Visual Analogue Scale for Foot and Ankle [VAS-FA]).</p><p><strong>Results: </strong>The hazard ratio for surgical revision was 1.74 (95% CI 0.82-3.68) and for complications 1.66 (95% CI 0.82-3.33), both indicating no difference. Radiologic outcome, assessed by remaining step (<i>P</i> = .437) and gap (<i>P</i> = .911) and the reduction grading (<i>P</i> = .564), as well as the functional outcome assessed by the SF-12 (<i>P</i> <i>=</i> .827) and the VAS-FA (<i>P</i> <i>=</i> .930) was comparable in both groups.</p><p><strong>Conclusion: </strong>Compared with conventional ELA, the less invasive surgical technique via STA has similar short- to midterm complications and is associated with comparable anatomical reductions and functional outcomes. The propensity matching of the fracture severity gives us confidence to consider STA a suitable surgical approach in moderate and severe Sanders 3 and 4 type fractures.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251322466"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618096","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":"Talar Morphology of Charcot-Marie-Tooth Patients With Cavovarus Feet.","authors":"Andrew C Peterson, Melissa R Requist, Jacob C Benna, Jayson R Nelson, Shireen Elhabian, Cesar de Cesar Netto, Timothy C Beals, Amy L Lenz","doi":"10.1177/10711007241309915","DOIUrl":"10.1177/10711007241309915","url":null,"abstract":"<p><strong>Background: </strong>Charcot-Marie-Tooth disease (CMT), a common inherited neurologic disorder, significantly impacts the morphology of foot bones, particularly the talus. The disease has been classified into types based on specific mutations, with the most common being CMT type 1 (CMT1; demyelinating) and CMT type 2 (CMT2; axonal). However, the specific osseous morphologic variations in CMT patients and their major genetic subgroups remain insufficiently understood, posing challenges in clinical management and surgical intervention.</p><p><strong>Methods: </strong>This study analyzed talar morphology in individuals with CMT compared with a healthy control group, employing a single-bone statistical shape model and talar neck offset angle measurements. Participants included 18 CMT individuals (yielding 29 tali) and 43 healthy controls. For individuals with CMT, the average age at diagnosis was 36.5 ± 19.8 years, with a mean interval of 8.6 years between diagnosis and imaging. Talar morphology was evaluated using weightbearing computed tomography and subsequent morphologic and angular analysis.</p><p><strong>Results: </strong>Differences were observed in talar morphology between CMT and healthy individuals. Notably, CMT1 and CMT2 tali exhibited a flatter talar dome and more medial talar head and neck compared with controls. Additionally, the CMT1 and CMT2 subgroups both had a more medially oriented talar neck based on the talar neck offset angle compared with the controls.</p><p><strong>Conclusion: </strong>The findings illustrate significant morphologic variations in the talus of CMT patients, indicating the need for type-specific clinical approaches in treating CMT-related foot deformities. Understanding these talar variations is crucial for tailoring surgical techniques and orthotic designs, and developing effective rehabilitation protocols for individuals with CMT, potentially improving patient care and outcomes.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"268-274"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400956","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 Comparison of Wound Related Complications Between Intramedullary and Lateral Plate Osteosynthesis After Fibula Osteotomy in the Lateral Approach Total Ankle Replacement.","authors":"Michael Phegan, Andrew Wines","doi":"10.1177/10711007241309901","DOIUrl":"10.1177/10711007241309901","url":null,"abstract":"<p><strong>Background: </strong>Total ankle replacement (TAR) has evolved in the last decade from a procedure rife with complication and failure to a promising alternative to arthrodesis. The ability to maintain ankle joint range of motion is showing great promise in patient-reported outcomes, postsurgical pain, as well as long-term sequalae of joint fusion. Although TAR can be performed via either an anterior or lateral approach both with their own sets of benefits and potential complications, the consensus seems to be that one is no better than the other when performed by high-volume surgeons.</p><p><strong>Methods: </strong>Data were gathered over a 6-year period looking at an age- and gender-matched cohort of lateral approach TARs with either plate osteosynthesis or fibula nail fixation in the management of the fibula osteotomy and compared reoperation and infection rates with the working hypothesis that nail fixation would afford better outcomes. Secondary outcomes including rates of fibula union, tourniquet time as an adjunct to procedure length, and patient-reported outcome measures (PROMs) in the form of FAOS Quality scores were included.</p><p><strong>Results: </strong>A total of 234 TARs were analyzed. Forty-five of these used intramedullary nail fixation (IM), and a control group of 45 plate osteosynthesis (PO) fixation cases was correlated. The <i>Foot & Ankle International</i> guidelines on reporting for complications arising from total ankle arthroplasty that resulted in reoperation were applied to the data set, and it was noted that 13 of 19 reoperations were noted in the PO group, which was statistically significant. Also of note, 12 of 16 patients treated with antibiotics, which included all those cases within the reoperation group, were noted to come from the PO group. This was also of statistical significance. Interestingly, the rate of fibula nonunion in the PO group was lower (8.88%) than that of the IM group (23.25%).</p><p><strong>Conclusion: </strong>Our results confirmed that the rates of reoperation and infection were statistically significantly improved with the use of nail fixation over plate fixation. This was tempered by a concerningly high nonunion rate. This article shows promising results for the use of a simple technique in improving long-term outcomes in ankle arthroplasty.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"315-323"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043868","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":"Morselized Femoral Head Impaction Bone Grafting of Large Defects in Ankle and Hindfoot Fusions.","authors":"Tim Clough, Bakur Jamjoom, Naeem Jagani, Jared Quarcoopome, Rajesh Kakwani, David Townshend, Nicholas Cullen, Shelain Patel, Karan Malhotra, Matthew Welck","doi":"10.1177/10711007241310411","DOIUrl":"10.1177/10711007241310411","url":null,"abstract":"<p><strong>Background: </strong>Ankle and hindfoot fusion in the presence of large bony defects represents a challenging problem. The purpose of this study was to evaluate outcomes of patients who underwent ankle-hindfoot fusions with impaction bone grafting (IBG) with morselized femoral head allograft to fill large bony void defects.</p><p><strong>Methods: </strong>This was a 3-center, retrospective review of a consecutive series of 49 patients undergoing ankle or hindfoot fusions with femoral head IBG for filling large bony defects. Union was assessed clinically and radiologically with radiography or computed tomography. Graft stability/collapse was identified on radiographs as loss of graft height across the fusion interface. Indications included 35 failed total ankle arthroplasty, talar osteonecrosis and collapse (7 patients), failed ankle fusion (4 patients), trauma with bone loss or fracture nonunion (1 patients), and other (2 patients). Tibiotalocalcaneal (TTC) fusion was performed in 36 (73%) patients and ankle (TT) fusion in 13 (27%).</p><p><strong>Results: </strong>Mean age was 59.3 (19-78) years. Mean follow-up was 22.9 ± 8.3 months. Eighteen percent were smokers. Mean depth of the bone defect was 35.2 ±8.7 mm, and mean volume of the defect was 62.2 ±5.8 cm³. Symptomatic nonunion rate was 14% (7/49). The mean time to radiologic union was 7.6 ±3.2 months. Complete radiologic union rate occurred in 73% (36/49). Eight TTC fusion patients (22.2%) united at the tibiotalar joint but not at the subtalar joint, of which 6 were asymptomatic. There was no graft collapse, even in patients developing nonunion, with all patients maintaining bone incorporation and leg length.</p><p><strong>Conclusion: </strong>Impaction of morselized femoral head allograft can fill large bony voids around the ankle or hindfoot during fusion, with rapid graft incorporation and no graft collapse despite early loading. This technique offers satisfactory and comparable union outcomes without limb shortening or expensive custom 3D-printed metal cages.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"257-267"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Treatment of Chronic Plantar Fasciitis with Plantar Heel Spur Pain: A Combined Suprafascial and Infrafascial Approach.","authors":"Marut Arunakul, Pheemaphol Samornpitakul, Warunee Chaisiri, Yingyos Ratanacharatroj, Nattapong Sasipotiwan, Punnawit Pinitchanon, Akaradech Pitakveerakul","doi":"10.1177/10711007241308915","DOIUrl":"10.1177/10711007241308915","url":null,"abstract":"<p><strong>Background: </strong>To determine whether a combined endoscopic suprafascial and infrafascial approach with medial and lateral portals is a safe and effective technique for the endoscopic treatment of chronic plantar fasciitis with plantar heel spur pain.</p><p><strong>Methods: </strong>An interventional, prospective study was conducted. A total of 61 patients with plantar fasciitis with plantar heel spur pain underwent an endoscopic plantar fasciotomy with plantar heel spur resection, using a combined suprafascial and infrafascial approach between January 2018 and August 2022. Preoperative Foot and Ankle Ability Measure (FAAM), 36-Item Short Form Health Survey (SF-36), and visual analog scale (VAS) scores were measured. The measurements were repeated at 6 weeks, 3, 6, and 12 months postoperatively and at the final follow up. Preoperative and 1-year postoperative film parameters (Meary angle, calcaneal pitch angle, medial cuneiform-fifth metatarsal height) were compared.Complications were recorded at each encounter.</p><p><strong>Results: </strong>The mean follow up time was 2.6 ± 1.1 years. At the 6-week postoperative visit, the mean change in FAAM-ADL, FAAM-Sport, SF-36 physical component summary, SF-36 mental component summary, and VAS were 26.0,19.0, 44.8, 61.2, and -5.8, respectively. These changes were statistically significant (<i>P</i> < .001). These findings were sustained and generally improved at all other follow-up points: 3, 6, and 12 months postoperatively and final follow-up. The average period until the recovery of activities of daily living and sport activities were 2.6 and 8.6 weeks, respectively. There were no significant differences between the pre- and 1-year postoperative radiographic values (<i>P</i> > .05). No cases resulted in medial arch collapse. Five cases (8%) had an injury to the first branch of lateral plantar nerve.</p><p><strong>Conclusion: </strong>Endoscopic plantar fascia release and plantar heel spur resection using a combined suprafascial and infrafascial approach resulted in the improvement of postoperative FAAM, SF-36, and VAS scores and involved a low incidence of postoperative complications.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"303-314"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018876","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":"Patients With Chronic Lateral Ankle Instability and Small Osteochondral Lesions of the Talus Obtain Good Postoperative Results: A Minimum 10-Year Follow-up With Radiographic Evidence.","authors":"Tong Su, Xiangyun Cheng, Yichuan Zhu, Hao Xu, Yanfang Jiang, Chen Jiao, Qinwei Guo, Dong Jiang","doi":"10.1177/10711007241311858","DOIUrl":"10.1177/10711007241311858","url":null,"abstract":"<p><strong>Background: </strong>Few studies reported the long-term clinical outcomes and joint degeneration of patients with chronic lateral ankle instability (CLAI) and small osteochondral lesions of the talus (OLTs) following simultaneous open modified Broström-Gould (MBG) surgery and arthroscopic bone marrow stimulation (BMS). The purpose of this study was to study the long-term results of patients after BMS and BMG surgery, and to further evaluate the potential effect of OLT size on postoperative results.</p><p><strong>Methods: </strong>In this retrospective study, 110 CLAI patients were divided into 57 patients with OLTs (including 24 patients having combined small osteochondral lesions of the tibial plafond) receiving simultaneous BMS and MBG surgeries (BMS+MBG group), and 53 patients without OLTs receiving isolated open MBG surgery (MBG group). The OLT size and pre- and postoperative Kellgren-Lawrence grade were assessed. The subjective scores (visual analog scale pain score, Tegner activity, and Karlsson-Peterson scores), surgical complications, and return to sports were also compared pre- and postoperatively.</p><p><strong>Results: </strong>Patients were followed up at a mean of 144.2 ± 14.9 and 145.6 ± 11.4 months for the BMS+MBG and MBG groups, respectively. Subjective scores were significantly improved (<i>P</i> < .001), and no difference was found in subjective scores or surgical complications between the 2 groups (<i>P</i> > .05). Both groups showed progression of osteoarthritis grade (<i>P</i> < .001), but with no significant difference of changes from the preoperative to the final follow-up (BMS+MBG group: 0.84 ± 0.75 to 1.32 ± 0.80; MBG group: 0.32 ± 0.48 to 0.86 ± 0.56, changes: 0.48 ± 0.59 vs 0.55 ± 0.51, <i>P</i> = .575). For sports function, both groups had similar results in Tegner scores (5.8 ± 1.3 vs 6.2 ± 1.3, <i>P</i> = .081). However, in a subgroup analysis, we found that in the BMS+MBG group, patients exceeding the mean size of OLTs (50 mm²) were associated with an average lower postoperative Karlsson-Peterson score (<i>P</i> = .025) and higher postoperative osteoarthritis grade (<i>P</i> = .037), with more changes (<i>P</i> = .017) than those with OLTs <50 mm².</p><p><strong>Conclusion: </strong>Patients with CLAI and small OLTs following simultaneous open MBG surgery and arthroscopic BMS showed good long-term outcomes and only mild progression of joint degeneration-overall similar to patients treated for CLAI with MBG surgery. Moreover, as OLT size increased, good outcomes were less predictable.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"277-286"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049219","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}