Foot & ankle international最新文献

{"title":"Effects of Calcaneal Osteotomies on Gait Kinematics in Simulated Progressive Collapsing Foot Deformity: A Cadaveric Study.","authors":"Jensen K Henry, Jeffrey K Hoffman, Jaeyoung Kim, Kira Lu, Brett Steineman, Constantine Demetracopoulos, Jonathan Deland, Scott Ellis","doi":"10.1177/10711007251351308","DOIUrl":"10.1177/10711007251351308","url":null,"abstract":"<p><strong>Background: </strong>Calcaneal osteotomies are often used to correct hindfoot valgus and forefoot abduction in patients with PCFD. Calcaneal osteotomies are commonly performed to address hindfoot valgus and forefoot abduction present with PCFD. This study compared the dynamic effects of medializing calcaneal osteotomy (MCO) and lateral column lengthening (LCL), after simulated PCFD (sPCFD), on joint kinematics and plantar pressure during simulated gait.</p><p><strong>Methods: </strong>Twelve cadaveric mid-tibia specimens were loaded on a 6-degree-of-freedom robotic gait simulator. Gait was simulated first in the intact and sPCFD conditions. After sPCFD testing, surgical reconstruction and testing was performed in stages with MCO and LCL (6- and 8-mm grafts). Ankle, subtalar, and talonavicular joint kinematics and plantar pressures were collected, and differences compared between the intact, sPCFD, and surgically corrected conditions.</p><p><strong>Results: </strong>The isolated MCO partially corrected foot kinematics, and notably increased talar dorsiflexion throughout the stance. The isolated LCL restored ankle kinematics, but subtalar eversion and talonavicular abduction were still uncorrected during stance. However, LCL and MCO together were able to restore talonavicular kinematics throughout stance to normal levels. Larger LCL graft size further improved foot kinematics, but resulted in overcorrection in the subtalar and ankle joints during portions of stance. All procedure combinations increased lateral plantar pressure relative to the sPCFD condition.</p><p><strong>Conclusion: </strong>Isolated MCO and LCL, and a combination of both, all partially restored ankle and hindfoot joint kinematics. However, overcorrection in certain planes of motion and increased lateral plantar pressure suggest a risk of lateral column overload as LCL graft size increases.</p><p><strong>Clinical relevance: </strong>The synergistic effect of MCO and LCL may be effective at restoring kinematics, but surgeons should be cautious in increasing osteotomy size at the lateral column to avoid overload. Gait simulation may help us learn how to titrate combinations of corrections that best restore kinematics-and ultimately, improve clinical outcomes.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1030-1038"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610696","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":"Three-Dimensional Assessment of Charcot Neuroarthropathy Deformities: Comparison of Standard 2D vs Patient-Specific 3D Measurements.","authors":"Avani A Chopra, Zachary Adam Koroneos, Michaela D Pitcher, Christian Benedict, Peter Tortora, Taylor Lan, Michael Levidy, Allen Kunselman, Michael Aynardi","doi":"10.1177/10711007251351316","DOIUrl":"10.1177/10711007251351316","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to compare foot and ankle deformity measurements obtained from 2-dimensional (2D) radiographs vs 3-dimensional (3D) modalities in Charcot neuroarthropathy (CN) feet by using a patient-specific coordinate system.</p><p><strong>Methods: </strong>This retrospective study reviewed foot and ankle imaging for 25 patients with a diagnosis of CN of the lower extremity, type 2 diabetes mellitus with diabetic neuropathy, or lower limb neuropathy. Radiographs and either computed tomography (CT) or magnetic resonance imaging (MRI) scans were obtained for each patient and used to make angle and distance measurements used clinically to describe deformity. 2D measurements were obtained using standard methods, involving annotating planar radiographs. The 3D measurement procedure began by manually placing fiducials on anatomic landmarks. Then, a custom-built code was used to automatically transform the foot into a patient-specific anatomic coordinate system and calculate all angle and distance measurements. Each scan was measured by 2 observers and intraclass correlation was calculated for each imaging type.</p><p><strong>Results: </strong>The average age of the patients was 61 years, with 92% being White and 88% having diabetic neuroarthropathy. Measurements for anteroposterior talocalcaneal angle and lateral column height were larger when measured on MRI (91.1 ± 16.7 degrees vs 29.1 ± 2.8 degrees, <i>P</i> = .004) and CT (78.6 ± 18.5 degrees vs 24.6 ± 2.7 degrees, <i>P</i> = .020) compared with radiographic measurements. Additionally, MRI demonstrated significantly greater interobserver reliability for the talocalcaneal angle (0.74 vs 0.19, 95% CI 0.11, 0.96), suggesting improved detection of hindfoot valgus compared with radiographs, whereas CT reliability was comparable to plain radiographs.</p><p><strong>Conclusion: </strong>Larger measurements and higher interobserver reliability for the talocalcaneal angle on 3D modalities suggest that a patient-specific 3D approach may improve detection of transverse-plane malalignment in Charcot neuroarthropathy.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"46 9","pages":"1059-1067"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071315","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":"Early Tibiotalar Joint Changes Following Subtalar Arthrodesis for Progressive Collapsing Foot Deformity: A 3D Distance Mapping Short Scientific Report.","authors":"Alessio Bernasconi, Matthieu Lalevée, Céline Fernando, Antonio Izzo, Cesar de Cesar Netto, François Lintz","doi":"10.1177/10711007251361123","DOIUrl":"https://doi.org/10.1177/10711007251361123","url":null,"abstract":"<p><strong>Background: </strong>Subtalar joint (SJ) fusion may be required to treat subtalar osteoarthritis in progressive collapsing foot deformity (PCFD). Our goal was to understand how anterolateral arthroscopic subtalar arthrodesis (ALAPSTA) may alter joint congruency at the tibiotalar level.</p><p><strong>Methods: </strong>We retrospectively assessed pre- and postoperative weightbearing computed tomography images of patients diagnosed with PCFD 2A (arthritic SJ) and/or 2D (peritalar subluxation) which underwent isolated ALAPSTA. Foot alignment was evaluated using the Foot and Ankle Offset. Distance mapping at the tibiotalar joint (in 9 quadrants) allowed to assess changes in joint interaction between pre- and postoperative images.</p><p><strong>Results: </strong>Thirty-three PCFDs were selected. Foot alignment significantly improved after ALAPSTA. We found a significant increase in mean distances occurring in the posterior-medial, posterior-middle, and posterior-lateral zones (from 5.5 to 6.3 mm [adjusted <i>P</i> = .036], from 4.6 to 5.7 mm [adjusted <i>P</i> = .009], and from 4.5 to 5.4 mm [adjusted <i>P</i> = .04], respectively) along with a significant decrease in the anterior-medial, anterior-middle, and anterior-lateral zones (from 9.1 to 8.3 mm [adjusted <i>P</i> = .04], from 8.9 to 7.3 mm [adjusted <i>P</i> = .007], and from 8.9 to 7.1 mm [adjusted <i>P</i> < .008], respectively).</p><p><strong>Conclusion: </strong>In patients diagnosed with PCFD 2A and/or 2D who had undergone ALAPSTA, we observed a significant early imaging-based change in the spatial relationship of the tibiotalar joint in quiet standing, demonstrating dorsiflexion of the talus over the calcaneus, consistent with a \"re-saddling\" effect. These findings are exploratory and require further clinical correlation.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251361123"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983824","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":"Arthroscopic Characteristics and Risk Factors for Syndesmosis Widening in Chronic Lateral Ankle Instability: A Cross-sectional Study of 521 Patients.","authors":"Tong Su, Xiangyun Cheng, Zhuofan Liu, Zhenyu Wang, Haoxuan Liu, Wujia Wang, Qinwei Guo, Chen Jiao, Dong Jiang","doi":"10.1177/10711007251344270","DOIUrl":"10.1177/10711007251344270","url":null,"abstract":"<p><strong>Background: </strong>To report the measured characteristics of inferior tibiofibular syndesmosis (iTFS) widening-a condition involving abnormal separation of the distal tibia and fibula in patients with chronic lateral ankle instability (CLAI)-and to investigate its associated risk factors.</p><p><strong>Methods: </strong>Consecutive CLAI patients undergoing arthroscopy and Broström surgery between June 2020 and August 2023 were included. The anterior, middle, and posterior parts of the transverse iTFS space was measured by using the customized probe under arthroscopy to explore the characteristics of iTFS widening. Univariate and multivariate logistic regression analysis were used to analyze the relationship between related factors (gender, age, body mass index [BMI], time after initial injury, sprain recurrence, Beighton score, and intra-articular lesions) and iTFS widening.</p><p><strong>Results: </strong>A total of 521 CLAI patients were included. Among those patients, 272 (52.2%) were found with arthroscopic widening at middle syndesmosis ≥3 mm, with 67.3% demonstrating wider posterior interval and narrower anterior interval, 31.3% equivalent posterior and anterior interval, and 1.5% wider anterior interval and narrower posterior interval. According to univariate analysis, female sex (<i>P <</i> .001), Beighton score (<i>P =</i> .001), BMI (<i>P =</i> .008), and osteochondral lesion at lateral talus (<i>P =</i> .040) were significantly associated with the presence of iTFS widening. Multivariate analysis revealed that female sex (<i>P <</i> .001; odds ratio 3.130, 95% CI 2.076-4.720) was an independent risk factor of syndesmotic widening in CLAI patients.</p><p><strong>Conclusion: </strong>Among CLAI patients undergoing surgery, 52.2% demonstrated concomitant iTFS widening. Arthroscopic measurements revealed an overall trend of a wider posterior iTFS space and a narrower anterior iTFS space. Female sex was identified as an independent risk factor for arthroscopic iTFS widening in CLAI patients. However, the clinical significance of this widening remains uncertain, as no correlation with patient-reported outcomes or postoperative function was assessed.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1016-1024"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487494","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":"Medial and Lateral Column Load Distribution After In Situ Subtalar/Talonavicular Fusion With and Without Calcaneocuboid Fusion: A Cadaveric Study.","authors":"Eslam Alkaramany, Brian P Gallagher, Pooyan Abbasi, Gregory P Guyton","doi":"10.1177/10711007251344916","DOIUrl":"10.1177/10711007251344916","url":null,"abstract":"<p><strong>Background: </strong>Previous investigations have speculated that stiffening the lateral column of the hindfoot in triple arthrodesis can increase lateral plantar pressure with resulting lateral column pain. It is unclear whether sparing of the calcaneocuboid joint in hindfoot arthrodesis yields lower lateral column plantar forefoot pressures vs triple arthrodesis including the calcaneocuboid joint.</p><p><strong>Methods: </strong>Tendon loading and axial pressure were applied to 9 cadaveric legs according to standard cadaveric models. Medial and lateral forefoot pressures were recorded using a pressure-sensitive plate. Specimens were tested in native state, after sequential subtalar and talonavicular fixation, and after added calcaneocuboid fixation. All fixation was performed in situ in a neutral foot position. Testing was performed both on a neutral sensor plate and on a plate with 10 degrees of lateral slope.</p><p><strong>Results: </strong>In neutral position, pressure under the fifth metatarsal increased significantly from 31.0 ± 22.4 kPa in the native state to 63.1 ± 33.0 kPa (<i>P</i> = .018) after CC-sparing fusion and to 54.7 ± 27.9 kPa (<i>P</i> = .023) after triple arthrodesis. In the everted position, there was no significant difference in pressure under the fifth metatarsal from 56.8 ± 31.8 kPa in the native state to 89.7 ± 55.4 kPa (<i>P</i> = .134) after CC-sparing fusion and to 78.9 ± 42.9 kPa (<i>P</i> = .111) after triple fusion. No statistically significant pressure differences under the fifth metatarsal were found between the arthrodesis groups with loading on a neutral (<i>P</i> = .687) or sloped (<i>P</i> = .393) surface.</p><p><strong>Conclusion: </strong>In our in situ fusion cadaveric model, both traditional triple arthrodesis and the calcaneocuboid-sparing procedure resulted in significantly higher lateral forefoot plantar pressure compared with the native state, but there was no significant difference in lateral pressure between the procedures on both a flat and a laterally inclined surface. These findings should be interpreted in light of limitations including small sample size, static loading conditions, intact cartilage, and lack of formal radiographic assessment of hindfoot alignment.</p><p><strong>Clinical relevance: </strong>Although other considerations may warrant sparing the calcaneocuboid joint during hindfoot fusion, its preservation did not reduce lateral column overload in this model.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"46 9","pages":"1025-1029"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071350","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":"Surgeon Preferences, Surgical Location, and Timing of Repair Drive Achilles Tendon Rupture Repair Cost.","authors":"Emily B Parker, Suhas Rao Velichala, Varun Nukala, Soheil Ashkani-Esfahani, Gregory R Waryasz, Jeremy T Smith, Daniel Guss, Christopher P Chiodo, Christopher W DiGiovanni, David N Bernstein","doi":"10.1177/10711007251347278","DOIUrl":"10.1177/10711007251347278","url":null,"abstract":"<p><strong>Background: </strong>Midsubstance Achilles tendon repair is a common procedure, yet the factors influencing its cost have been underexamined and often imprecisely understood. Using time-driven activity-based costing (TDABC), we examined variation in total cost, compared patient-, surgeon-, and surgery-specific characteristics between high- and non-high-cost repairs, and assessed factors associated with total cost to identify specific cost drivers that might reduce expenses without compromising clinical outcomes.</p><p><strong>Methods: </strong>Patients undergoing midsubstance Achilles tendon rupture repair between January 3, 2022 and December 28, 2023 at 2 academic medical centers and their affiliated community hospitals and ambulatory surgical centers were identified. Exclusion criteria included revision procedures and those with concurrent procedures besides fasciotomy. TDABC methodology was used to determine total cost across 3 clinical phases: preoperative, intraoperative, and postoperative. Cost was normalized per institution requirements. Bivariate analysis was performed across all characteristics between high-cost (top decile) procedures and all others. Spearman correlation between operative time and total cost was assessed. Multivariable linear regression was used to identify key cost drivers.</p><p><strong>Results: </strong>Among 341 primary midsubstance Achilles rupture repairs performed by 8 surgeons, the most expensive procedure was 6 times costlier than the least expensive one. Eighty-five percent of the cost, on average, was incurred intraoperatively. A \"good\" correlation was found between operative time and total cost (<i>P</i> < .05). When accounting for covariates, increasing time between rupture and repair was associated with higher cost (<i>P</i> < .05). Surgical location, surgical approach, and repair suture were also associated with total cost (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>Substantial variability in the cost of primary midsubstance Achilles rupture repair is driven by factors including timing of surgical repair, intraoperative surgeon-specific characteristics (ie, surgical approach and suture choice), and surgical location. Further standardization of treatment approach and decreasing time to the operating room could lower cost variability and improve the value of care for patients with midsubstance Achilles tendon rupture undergoing surgery.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1039-1048"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568176","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":"The Filament Union Sign: Prevalence and Clinical Outcomes of Incomplete Bone Remodeling Following Percutaneous Hallux Valgus Surgery.","authors":"Thomas L Lewis, Clare Watt, Lily Fletcher, Evelyn Murphy, Min Jia Chua, Andreas Toepfer, Gabriel Ferraz Ferreira, Peter W Robinson, Robbie Ray, Peter Lam","doi":"10.1177/10711007251346448","DOIUrl":"10.1177/10711007251346448","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive hallux valgus surgery can rarely result in a distinct radiologic finding termed the \"Filament Union sign,\" characterized by a thin, filamentous bone bridge at the osteotomy site <25% of the metatarsal head width and associated with minimal medial, lateral, or central remodeling. This study aimed to determine its prevalence and identify potential contributing factors.</p><p><strong>Methods: </strong>A retrospective radiographic cohort study analyzed 726 feet that underwent percutaneous fourth-generation transverse osteotomy for hallux valgus correction between November 2017 and January 2023. Primary outcome was presence of the filament union sign. Secondary outcomes included patient-reported outcome measures and radiographic deformity analysis.</p><p><strong>Results: </strong>The filament union sign was identified in 24 feet (3.3%, 95% CI: 2.0%-4.6%) with 15 cases (62.5%) occurring in patients who underwent bilateral procedures and 2 patients exhibiting bilateral filament union. Although both groups showed similar baseline characteristics, the filament union group demonstrated statistically but not clinically significant increased Manchester-Oxford Foot Questionnaire (MOXFQ) Index scores (20.6 ± 16.9 vs 13.0 ± 15.7, <i>P</i> = .040) at final follow-up. There was no significant difference in individual MOXFQ domains, <i>P</i> > .05. Preoperative hallux valgus angle was significantly associated with filament union (odds ratio 1.08, 95% CI 1.02-1.15, <i>P</i> = .006). All cases in the filament union group achieved bony union, with 1 case of nonunion observed in the nonfilament group. No instances of fracture or metalwork failure were observed in the filament union group.</p><p><strong>Conclusion: </strong>The filament union sign is an uncommon radiographic finding following percutaneous hallux valgus surgery, occurring in 3% of cases. Although its presence was associated with statistically significant decreased functional outcomes, this difference did not meet the threshold for clinical significance and was also not associated with an increased rate of mechanical failure/fracture or revision surgery rate. Further research is needed to fully understand the mechanical and biological factors contributing to this pattern of bone healing.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1003-1015"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531952","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":"Radiographic Changes in Central Tarsometatarsal Arthritis Following Flatfoot Reconstruction.","authors":"Hansol Moon, InHwa Baek, ChanIn Seo, Woo-Chun Lee","doi":"10.1177/10711007251346471","DOIUrl":"10.1177/10711007251346471","url":null,"abstract":"<p><strong>Background: </strong>Progressive collapsing flatfoot deformity (PCFD) has been reported as a common cause of the nontraumatic degenerative arthritis of the midfoot, and arthrodesis has been used for symptomatic arthritis unresponsive to nonoperative measures. The hypothesis of this study was that nontraumatic central tarsometatarsal (TMT) arthritis associated with PCFD would be improved without arthrodesis by restoration of medial longitudinal arch. The aim of this study was to investigate the clinical and radiologic results of central TMT arthritis with medial longitudinal arch restoration in PCFD.</p><p><strong>Methods: </strong>From April 2017 to December 2022, 18 patients (21 feet) with nontraumatic central TMT arthritis and PCFD who underwent medial longitudinal arch reconstruction with flexor hallucis longus (FHL) transfer were included. Mean follow-up was 30.2 (range, 12-67) months. Clinical findings were evaluated with visual analog scale (VAS) and Foot Function Index (FFI). Radiologic staging of second TMT joint was done based on CT scans because it was the most common and severely involved joint. Changes in radiographic parameters for PCFD were assessed.</p><p><strong>Results: </strong>Clinical results were improved. VAS changed from 7.1 ± 1.3 to 1.6 ± 0.5, FFI changed from 53.3 ± 0.5 to 12.2 ± 7.0 at the preoperative and postoperative periods, respectively (<i>P</i> < .001). Radiologic stage of the second TMT joint was improved (<i>P</i> < .001) from 3.4 (range 2-4) to 1.2 (range 1-2). Lateral talo-first metatarsal angle was improved from 33.3. ± 7.4 to 16.8 ± 5.4 degrees (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>Nontraumatic central tarsometatarsal arthritis associated with progressive collapsing flatfoot deformity showed radiographic improvement without central TMT joint arthrodesis following medial longitudinal arch reconstruction. However, clinical outcome improvement after surgery cannot be specifically attributed to the TMT joint changes.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"968-976"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577419","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":"Repair of Acute Achilles Tendon Ruptures: What Is the Real Debate?","authors":"James Calder","doi":"10.1177/10711007251361909","DOIUrl":"10.1177/10711007251361909","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"958-959"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983863","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":"3D-Printed Customized Endoprosthetic Reconstruction Following Resection of Metatarsal Malignancy: Case Series and Review of Reconstructive Strategies.","authors":"Shangkun Tang, Chuang Li, Xin Hu, Zhuangzhuang Li, Linyun Tan, Hao Wang, Minxun Lu, Yi Luo, Yong Zhou, Chongqi Tu, Yitian Wang, Li Min","doi":"10.1177/10711007251355952","DOIUrl":"https://doi.org/10.1177/10711007251355952","url":null,"abstract":"<p><strong>Background: </strong>Malignant tumors of the metatarsals are relatively rare, presenting unique challenges in limb salvage surgery and functional reconstruction because of their critical role in weightbearing and foot biomechanics. This study aims to provide a basic assessment of the clinical outcomes of 3D-printed customized metatarsal endoprosthesis for the reconstruction of bone defects following the resection of metatarsal malignancy.</p><p><strong>Methods: </strong>This retrospective study analyzed 6 patients with malignant metatarsal tumors who underwent tumor resection and reconstruction using 3D-printed customized endoprostheses. The prostheses were designed based on CT and MRI data for precise anatomical adaptation and were fabricated using titanium alloy (Ti-6Al-4V) with a porous structure (70% porosity) to enhance osseointegration and mechanical stability. Outcomes were assessed using the visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS), and Musculoskeletal Tumor Society 93 (MSTS-93) score systems. Imaging modalities, including radiographs and Tomosynthesis-Shimadzu Metal Artefact Reduction Technology, were used to evaluate prosthesis integration and stability.</p><p><strong>Results: </strong>All patients (range, 8-27 years) underwent wide-margin resections with no local recurrence or distant metastasis observed during a mean follow-up of 35 (range, 22-50) months. All lesions involved the first to third metatarsals, sparing the fourth and fifth. Postoperative improvements were observed in this small series, including a reduction in pain (VAS score 1), enhanced limb function (AOFAS score 88), and improved musculoskeletal functionality (MSTS-93 score 27). Imaging showed satisfactory bone-prosthesis integration without aseptic loosening or bone resorption. No major complications, such as infection, immune rejection, or mechanical failure, were observed, and all surgical wounds healed successfully.</p><p><strong>Conclusion: </strong>This case series provides early experience with 3D-printed metatarsal endoprostheses for reconstruction following tumor resection. The findings of this small series highlight the potential of 3D-printed prostheses to provide satisfactory functional outcomes, initial stability, and relatively few complications.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251355952"},"PeriodicalIF":2.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983908","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}