Foot & ankle international最新文献

{"title":"Three-Dimensional Osseous Alignment and Morphology Patterns of Ankle and Hindfoot Osteoarthritis.","authors":"E Renae Lapins, Andrew C Peterson, Megan K Mills, Charles L Saltzman, Amy L Lenz","doi":"10.1177/10711007261472907","DOIUrl":"10.1177/10711007261472907","url":null,"abstract":"<p><strong>Background: </strong>Patients with advanced ankle and hindfoot osteoarthritis (OA) experience substantial functional limitations and reduced quality of life. Conventional 2-dimensional imaging provides limited insight into 3-dimensional (3D) shape and alignment of the foot and ankle, making it unclear whether isolated subtalar OA (STOA), isolated tibiotalar OA (TTOA), and combined disease (TTSTOA) represent distinct morphologic entities related to foot type.</p><p><strong>Methods: </strong>A retrospective cohort of 196 weightbearing computed tomography (WBCT) scans was analyzed, including 130 OA patients (STOA, TTOA, TTSTOA) and 66 non-osteoarthritic controls classified as planus, rectus (neutral), or cavus. A 14-bone statistical shape model (SSM) characterized 3D morphology and alignment. Principal components analysis (PCA), Hotelling's <i>T</i>² tests, computationally derived radiographic measurements, and joint space analysis quantified alignment patterns and joint space narrowing.</p><p><strong>Results: </strong>PCA mode 1 reflected a cavus-to-planus alignment spectrum, whereas mode 3 captured joint space narrowing. TTOA was most similar to cavus alignment with increased varus hindfoot and higher sagittal arch measures. STOA was most similar to rectus foot type. TTSTOA spanned the widest range, encompassing varus and valgus presentations, and was among the lower observed joint space distances across both joints. The planus group differed from all OA groups across all analyses.</p><p><strong>Conclusion: </strong>Hindfoot and ankle OA presentations were characterized by joint-specific degenerative changes occurring within a broader alignment environment, reflecting altered load distribution and compensatory adaptations. This relationship between local joint degeneration and global alignment underscores the importance of evaluating the foot and ankle as an integrated system, particularly when assessing disease extent, severity, and patterns of multijoint involvement.</p><p><strong>Level of evidence: </strong>Level III, retrospective cross-sectional study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1348-1361"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914846","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":"Corrigendum to \"Opioid-Free Forefoot Surgery vs Traditional Perioperative Opiate Regimen: A Randomized Controlled Trial\".","authors":"","doi":"10.1177/10711007241277453","DOIUrl":"10.1177/10711007241277453","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"NP1-NP2"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304654","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":"Obesity Is Associated With Earlier Mechanical Failure Following Total Ankle Arthroplasty Independent of Tibial Stem or Keel Augmentation.","authors":"Corinne Sommi, Grant M Thomas, Joseph A S McCahon, Thomas Dowd, Anny Hsu, Selene G Parekh, David I Pedowitz","doi":"10.1177/10711007261471132","DOIUrl":"10.1177/10711007261471132","url":null,"abstract":"<p><strong>Background: </strong>Obesity and elevated body mass have been associated with increased rates of aseptic loosening and implant failure following total ankle arthroplasty (TAA). The purpose of this study was to investigate the role for primary stemmed or keeled tibial implants as a protective factor against aseptic loosening in this patient population.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of 699 modern primary TAAs with a minimum 2-year follow-up performed at a large academic institution between 2010 and 2023. Patients were stratified by body mass index (BMI <30 vs ≥30) and implant design (stem/keel vs low-profile). The primary outcome was mechanical failure requiring revision of metal components. Secondary outcomes included patient-reported outcomes (FAAM-ADL and VAS). Kaplan-Meier analysis and multivariable cox proportional hazards were used to assess revision risk.</p><p><strong>Results: </strong>Of 699 primary TAAs, 39 (5.6%) experienced mechanical failure at a mean follow-up of 5.6 years. After adjustment for age, implant type, and subtalar fusion, BMI ≥30 was associated with a greater than 2-fold increased hazard of mechanical failure (HR 2.27, 95% CI 1.07-4.81, <i>P</i> = .033). Kaplan-Meier survivorship was similar for low-profile (93.7%) and stem/keel (96.1%) implants at 5 years. When stratified by both BMI and implant type, with the numbers available, no significant difference could be detected in mechanical failure, time to revision, or patient-reported outcomes were observed (<i>P</i> > .05). Obese patients had worse preoperative FAAM-ADL and VAS scores but achieved comparable postoperative outcomes.</p><p><strong>Conclusion: </strong>After adjusting for age, implant design, and subtalar fusion, BMI ≥30 was independently associated with a significantly higher hazard of mechanical failure and shorter time to revision. Despite the proposed biomechanical advantages of increased tibial fixation, the stemmed or keeled implants used in this cohort were not associated with improved survivorship or patient-reported outcomes at mid-term follow-up.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1320-1327"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858032","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":"Preoperative Anxiety and/or Depression as a Predictor of Patient‑Reported Outcomes After Total Ankle Arthroplasty.","authors":"Mads Sundet, Marianne Lund Eriksen, Inger Storrønning, Anders Jevnaker, Ivar Husby, Ingvild Østerhus, Ulf Sundin, Siri Lillegraven","doi":"10.1177/10711007261473923","DOIUrl":"10.1177/10711007261473923","url":null,"abstract":"<p><strong>Background: </strong>Psychological distress has been associated with inferior outcomes after major joint arthroplasty, but its impact on outcomes after total ankle arthroplasty (TAA) remains unclear. The main aim of this study was to investigate whether patients reporting anxiety or depression before TAA surgery had inferior outcomes 1 year after surgery.</p><p><strong>Methods: </strong>Retrospective analysis of prospectively collected data from a single-centre ankle arthroplasty registry. The exposure was preoperative anxiety/depression, defined from EuroQol-5 Dimensions-3 Level (EQ-5D-3L) item 5, and dichotomized, reflecting self-reported symptoms rather than a clinical diagnosis. The primary outcome was the adjusted difference between the exposure groups in the Manchester-Oxford Foot and Ankle Questionnaire (MOxFQ) score at 12 months postoperatively. Multivariable linear regression with multiple imputation of missing baseline MOxFQ was used to assess the association between preoperative anxiety/depression and 12-month MOxFQ, adjusting for baseline MOxFQ, age, sex, and diagnosis.</p><p><strong>Results: </strong>Three hundred patients were included, of whom 90 (30%) reported preoperative anxiety and/or depression. These patients were younger and reported worse baseline pain and function. Although patients with preoperative anxiety/depression had worse absolute MOxFQ scores at 12 months (mean 30.2 vs 20.1; <i>P</i> < .001), their improvement from baseline was comparable to patients without anxiety/depression (ΔMOxFQ 41.3 vs 43.9; <i>P</i> = .40). In multivariable regression analyses including baseline values, preoperative anxiety/depression was not independently associated with worse 12-month MOxFQ (β = 4.3; 95% CI -0.9 to 9.5). Among patients with baseline anxiety/depression, approximately two-thirds no longer reported anxiety/depression at 12 months.</p><p><strong>Conclusion: </strong>Preoperative self-reported anxiety or depression was common among patients undergoing TAA and was associated with worse symptoms before surgery. However, the reporting of such symptoms did not appear to limit postoperative improvement in patient-reported outcomes at 12 months. Among patients reporting anxiety/depression preoperatively, approximately two-thirds no longer reported anxiety/depression at 12 months.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study using prospectively collected registry data.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1231-1239"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893209","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":"Screening for Low Bone Mineral Density Using Opportunistic Foot Radiographs.","authors":"J Alex Albright, Matthew W Feldman, Tyler Martin, James D Baker, Rutger Gunther, Paul A Anderson, Kevin L Kirk, Jeannie Huh","doi":"10.1177/10711007261471487","DOIUrl":"10.1177/10711007261471487","url":null,"abstract":"<p><strong>Background: </strong>The gold standard for low bone mineral density (BMD) screening is dual-energy X-ray absorptiometry (DXA) scanning, which has declined in use in recent years for a variety of reasons. This decline warrants alternative screening mechanisms. This study aimed to determine if opportunistic foot radiographs can serve as a screening tool for predicting low BMD as measured by DXA scan.</p><p><strong>Methods: </strong>The fifth metatarsal index (5MI), a novel measurement made using the oblique foot radiograph to evaluate cortical thickness, was calculated for patients 50 years and older who underwent a DXA scan and a foot radiograph within 1 year. <i>T</i> scores and BMD were documented for each patient. Receiver operating characteristic curves were generated, and areas under the curves were calculated to determine which 5MI had optimized sensitivity and specificity for identifying osteoporosis.</p><p><strong>Results: </strong>A total of 89 patients were included in the study cohort. The average 5MI in patients with normal BMD, osteopenia, and osteoporosis was 52.6%, 44.6%, and 35.2%, respectively. The optimal 5MI for identifying osteoporosis based on the DXA-derived <i>T</i> scores was 46.8%, which correlated with an area under the curve of 0.977. This optimal cutoff for identifying osteoporosis had a sensitivity of 93.3% (95% CI, 70.2%-99.7%) and a specificity of 95.0% (95% CI, 76.4%-99.7%) (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>This study describes a potential screening method using low-cost foot radiographs to identify patients with low BMD, which may support earlier detection and referral for bone health evaluation.</p><p><strong>Level of evidence: </strong>Level III, retrospective case series.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1314-1319"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868686","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":"Long-term Survivorship of Transfibular Trabecular Metal Total Ankle Arthroplasty: 10-Year Minimum Clinical and Radiographic Follow-up.","authors":"Kevin A Schafer, Jonathan Day, Katherine Convery, Zijun Zhang, Lew C Schon","doi":"10.1177/10711007261471453","DOIUrl":"10.1177/10711007261471453","url":null,"abstract":"<p><strong>Background: </strong>Total ankle arthroplasty (TAA) utilization has rapidly increased over the last decade despite relatively unknown long-term survivorship of fourth-generation implants. The purpose of this study was to determine the long-term survivorship of the trabecular metal (TM) transfibular TAA and report relevant interval changes.</p><p><strong>Methods: </strong>Retrospective review was performed of prospectively followed patients who underwent primary transfibular TAA by a single surgeon from October 2012 to February 2016, including patients with minimum 10-year clinical and radiographic follow-up. Patient-reported outcomes measures (PROMs) included 12-item Short Form Health Survey physical (SF-12 PCS) and mental (SF-12 MCS) component summary scores, Ankle Osteoarthritis Scale (AOS), and visual analog scale (VAS). Radiographic outcomes included alignment, motion, presence of periprosthetic lucencies. Adverse events and reoperations were reported using the Canadian Orthopaedic Foot and Ankle Society (COFAS) Reoperation Coding System (CROCS).</p><p><strong>Results: </strong>Seventy-one ankles (68 patients) were included out of 79 TAAs (89.9%) with mean age of 61 (range, 28-80) years. Mean follow-up was 11.0 years (IQR, 1.5). There was 1 metal component revision (MCR) for periprosthetic joint infection requiring below-knee amputation (CROCS 11). Twenty-nine (40.8%) ankles underwent reoperations, with no ankles requiring more than 3 reoperations. The most common indication for reoperation was gutter debridement (n = 12; CROCS 4). Five cysts were detected in 4 ankles (7%) at final follow-up. Postoperative PROMs, radiographic alignment and motion were stable between 5- and ≥10-year time points.</p><p><strong>Conclusion: </strong>This single surgeon cohort demonstrated 98.6% implant survivorship of the TM transfibular TAA at a mean 11-year follow-up. Radiographic evaluation showed stable alignment and range of motion between midterm and long-term follow-up, and low rates of periprosthetic lucencies with minimal interval osteolysis between 5- and 10-year evaluations. Overall, these results support transfibular TAA as a durable long-term treatment for ankle arthritis.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1240-1248"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993149","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":"Corrigendum to \"Understanding Pain in Osteochondral Lesions of the Talus: A Cross-Sectional, CT‑Based Analysis Showing Limited and Inconsistent Associations With Pain\".","authors":"","doi":"10.1177/10711007261459114","DOIUrl":"10.1177/10711007261459114","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"NP4"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159519","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":"After Nearly 15 Years, Is It Time We Pay Attention to the Outcomes of the Zimmer TM Total Ankle?","authors":"Constantine A Demetracopoulos","doi":"10.1177/10711007261480023","DOIUrl":"10.1177/10711007261480023","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1249-1250"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993033","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":"Motion-Preserving Salvage for Failed Total Ankle Arthroplasty or Talar AVN: Outcomes of Combined Total Ankle Arthroplasty with Custom 3D-Printed Total Talus Replacement.","authors":"Rachit Saggar, Richard M Smith, Eva Heidinger, Omar M Yaldo, Carl T Hasselman, MaCalus V Hogan, Alex J Kline","doi":"10.1177/10711007261471856","DOIUrl":"10.1177/10711007261471856","url":null,"abstract":"<p><strong>Background: </strong>Talar component collapse following total ankle arthroplasty (TAA) and talar avascular necrosis (AVN) with concurrent ankle arthritis represent challenging clinical scenarios. Traditional salvage with tibiotalocalcaneal arthrodesis sacrifices motion and has nonunion rates approaching 30%. This study evaluates outcomes of a motion-preserving salvage strategy: combined TAA with custom 3D-printed total talus replacement (TAA-TTR).</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive patients who underwent TAA-TTR between September 2020 and December 2023. Indications included talar component collapse following prior TAA or talar AVN with ankle and subtalar arthritis. Subtalar arthrodesis was performed using 2 screws with use of bone marrow aspirate concentrate. Primary endpoint was complication rate; secondary endpoints included reoperations, radiographic assessments, and functional recovery milestones.</p><p><strong>Results: </strong>Eighteen patients (10 females, 8 males; mean age 57.8 ± 10.8 years) were analyzed at mean follow-up of 36.8 ± 16.6 months, after excluding 2 with <12 months' follow-up. Nine had talar AVN and 9 had failed TAA. The complication rate was 33.3% (95% CI: 15.2%-57.3%) (AVN group 44%, revision TAA group 22%). Six patients experienced complications: superficial surgical site infection (SSI) (1), deep SSI requiring debridement surgery (2), extensor hallucis longus rupture (1), nerve-related complication (1), and asymptomatic Chopart joint subluxation (1). Two patients required serial operations, including 1 below-knee amputation for persistent pain and infection. Reoperation rate was 11.1% (95% CI: 3.1%-32.8%). Patients achieved rapid functional recovery: controlled ankle motion boot transition at mean 19.9 days, full weight-bearing at mean 46.9 days, and regular footwear at mean 10.7 weeks. All patients achieved radiographic osseointegration of talar component to the calcaneus.</p><p><strong>Conclusion: </strong>TAA-TTR represents a viable motion-preserving procedure in this challenging population. Although patients achieved relatively rapid functional recovery and transition to regular footwear, rigorous selection remains key. This approach demonstrates a manageable complication rate while addressing tibiotalar and subtalar pathology simultaneously.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1262-1271"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922308","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":"Response to \"Letter Regarding: Does Platelet-Rich Plasma Speed Recovery After Acute Lateral Ankle Sprain? A Prospective Comparative Study Among Athletes\".","authors":"Gil Genuth, Peter Stavrou, Chris Brown, Lukas D Iselin","doi":"10.1177/10711007261484155","DOIUrl":"https://doi.org/10.1177/10711007261484155","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"47 10","pages":"1363"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168480","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}