Foot & ankle international最新文献

{"title":"COFAS Grade and a Fixed-Bearing Total Ankle Arthroplasty: Understanding the Impact of Deformity and Surrounding Joint Arthritis on Outcomes of Ankle Joint Replacement.","authors":"Alastair S E Younger","doi":"10.1177/10711007261472465","DOIUrl":"10.1177/10711007261472465","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1105-1106"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868641","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":"Predictors of Limited Weight-Bearing Dorsiflexion Following Total Ankle Arthroplasty.","authors":"Grant M Thomas, Joseph A S McCahon, Yoni Dulitzki, Zhongxuan Chen, Selene G Parekh, Joseph N Daniel, David I Pedowitz","doi":"10.1177/10711007261457413","DOIUrl":"10.1177/10711007261457413","url":null,"abstract":"<p><strong>Background: </strong>Limited dorsiflexion (DF) after total ankle arthroplasty (TAA) is a challenge that has been associated with worse functional outcomes and lower patient-reported satisfaction. The purpose of this study was to identify predictive variables for limited DF following TAA.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on patients who underwent elective primary TAA between 2013 and 2023 by a single surgeon. Postoperative range of motion (ROM) was assessed using weight-bearing lateral radiographs obtained in maximal DF and plantarflexion (PF). Limited DF was defined as <20° and preoperative DF was based solely on clinical assessment (C-DF). Demographic variables, medical comorbidities, surgical history, and adjunctive procedures, including gastrocnemius recession and tendo-Achilles lengthening (TAL), were collected and compared between patients who achieved full vs limited postoperative DF. Additionally, Foot and Ankle Ability Measure activities of daily living subscale (FAAM-ADL) and visual analog scale (VAS) scores were collected. Multivariable logistic regression was performed to identify independent predictors of final DF.</p><p><strong>Results: </strong>A total of 175 patients were included in this study, with 111 (63.4%) demonstrating limited postoperative DF and 64 (36.6%) achieving full DF at a mean 3.3 years. Age was significantly greater in the full DF group (65.5 vs 61.5 years, <i>P</i> = .013). No significant associations were identified between body mass index / weight, tobacco use, diabetes, sex, medical comorbidities, polyethylene size, or adjuvant procedures and postoperative DF following TAA. Prior open reduction internal fixation was more prevalent in patients with limited DF (<i>P</i> < .05), whereas postoperative FAAM-ADL scores were more favorable in the full DF group (70.0 vs 86.9, <i>P</i> = .010). Multivariable regression analyses identified full C-DF as the only significant independent predictor of improved postoperative DF following TAA.</p><p><strong>Conclusion: </strong>Preoperative clinical dorsiflexion was the only significant independent predictor of postoperative dorsiflexion following TAA. A thorough preoperative discussion regarding anticipated postoperative motion can help establish appropriate expectations and potentially enhance patient satisfaction following TAA.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1178-1186"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148393011","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":"Revision Total Ankle Arthroplasty: A Contemporary Review.","authors":"David I Pedowitz, Selene G Parekh, Tara G Moncman, Joseph A S McCahon","doi":"10.1177/10711007261472454","DOIUrl":"10.1177/10711007261472454","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1107-1116"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868691","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":"Suture Button Syndesmosis Repair Augmented With Nonanatomic vs Anatomic AITFL Reconstruction and the Added Effect of Deltoid Repair: A Cadaveric Biomechanical Study.","authors":"Mitchell R Carlson, Evan P Shoemaker, Caroline Chen, Patrick H Donaghue, Ryan K Moen, J Chris Coetzee, Paul M Cammack, William M Engasser, Rebecca Stone McGaver, Jeffrey D Seybold, Bryan D Den Hartog","doi":"10.1177/10711007261468351","DOIUrl":"10.1177/10711007261468351","url":null,"abstract":"<p><strong>Background: </strong>Optimal fixation methods for syndesmosis injuries remain debated. The anterior-inferior tibiofibular ligament (AITFL) is critical for syndesmosis stability. The purpose of this study was to biomechanically evaluate a suture button (SB) repair of syndesmosis injuries augmented with the tails of the SB construct vs an AITFL suture augmentation, and to measure the effect of deltoid ligament repair in limiting ankle external rotation (ER).</p><p><strong>Methods: </strong>This controlled laboratory study used 13 cadaveric lower-leg specimens with robotic forces of 10 Nm internal and external torque under 750 N of axial compression. Each specimen underwent 8 testing surgical states: (1) native/uninjured; (2) sectioned syndesmosis with a sectioned interosseous ligament, AITFL, and posterior-inferior tibiofibular ligament; (3) fully sectioned including deep deltoid ligament; (4) syndesmosis repair with SB construct; (5) added AITFL repair using suture tails repair (SB+tails); (6) added deltoid repair with AITFL tails and syndesmosis repairs (SB+tails+deltoid repair); (7) AITFL augmentation with syndesmosis repair (SB+AITFL augmentation); and (8) additional deltoid repair with AITFL augmentation and syndesmosis repair (SB+AITFL augmentation+deltoid).</p><p><strong>Results: </strong>The SB+AITFL tails repair and SB+AITFL augmentation both had significantly decreased ankle ER (2.25° [1.43°, 3.06°], <i>P</i> < .001, and 2.34° [1.47°, 3.21°], <i>P</i> < .001, respectively) and decreased internal rotation (IR) (2.26° [1.38°, 3.15°], <i>P</i> < .001, and 2.12° [1.13°, 3.10°], <i>P</i> < .001, respectively) compared to the fully sectioned state. No significant differences were observed between these constructs for either ER or IR (<i>P</i> > .99). Additional deltoid repair significantly decreased ER (SB+tails: 0.93° [0.04°, 1.81°], <i>P</i> = .038, SB+ AITFL augmentation: 0.69° [0.35°, 1.02°], <i>P</i> < .001), but not IR (SB+tails: <i>P</i> > .99, SB+AITFL augmentation: <i>P</i> > .99).</p><p><strong>Conclusion: </strong>Both the SB+AITFL tails and SB+AITFL augmentation demonstrated improvements in ankle stability over SB alone; with the numbers available, no significant difference between these methods could be detected. However, no repair construct fully restored external ankle rotation to the native state. The deltoid suture repair added medial stability to both SB+AITFL tails and SB+AITFL augmentation. All absolute differences between constructs were small (fractions of a degree or millimeter), and findings should be interpreted accordingly.</p><p><strong>Clinical relevance: </strong>This study found that, in this cadaveric model, augmenting the AITFL using either method in addition to suture button placement and open deltoid repair was associated with ankle stability approaching preinjury values across most biomechanical measures tested.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1217-1227"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820734","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":"Incidence and Associated Factors of 2-Legged Nitinol Staple Breakage in Foot and Ankle Surgery.","authors":"Yasunari Ikuta, Tomoyuki Nakasa, Saori Ishibashi, Satoru Sakurai, Dan Moriwaki, Taro Chujo, Nobuo Adachi","doi":"10.1177/10711007261462533","DOIUrl":"10.1177/10711007261462533","url":null,"abstract":"<p><strong>Background: </strong>Nitinol staples (NSs) are increasingly used in foot and ankle surgery; nonetheless, staple breakage incidence and determinants remain incompletely defined. This study examined NS breakage in a large consecutive series, focusing on anatomical site, implant geometry, and fixation strategy.</p><p><strong>Methods: </strong>We retrospectively reviewed 333 patients (379 feet) who underwent foot and ankle surgery with 2-legged NS between 2021 and 2025. Overall, 702 staples were analyzed. Staple breakage was assessed on plain radiographs at a minimum follow-up of 6 months to evaluate implant integrity during the critical phase of bone union. Anatomical location, implant geometry (symmetric vs asymmetric), and fixation type (isolated vs combined) were analyzed. Multivariable logistic regression was performed to explore factors associated with breakage in the hindfoot.</p><p><strong>Results: </strong>The overall breakage rate was 4.0% (28/702). Breakage rates varied by anatomical site, with higher rates in the calcaneocuboid (22.2%), talonavicular (12.5%), tibiotalar (8.9%), and other joints than in the first ray (0.37%). In the calcaneocuboid joint, isolated staple fixation showed a higher breakage rate (33.3%) than staple fixation with an adjunct screw (6.7%). In second metatarsal shortening osteotomies, asymmetric staples demonstrated a higher breakage rate (35.7%) than symmetric staples (1.0%). Although most breakages were asymptomatic, 2 patients required revision surgery for symptomatic nonunion. In the hindfoot cohort, procedure category (Chopart arthrodesis) showed an association with breakage; however, with the numbers available, no significant association could be detected for body mass index or sex.</p><p><strong>Conclusion: </strong>The overall breakage rate for 2-legged NS was 4.0%. Breakage was more frequent in several high-demand hindfoot joints, and in second metatarsal osteotomies using asymmetric staples. Hybrid fixation showed a lower breakage rate in the first ray and calcaneocuboid joint. These exploratory findings suggest that anatomical site, staple geometry, and fixation strategy may contribute to the risk of radiographic staple breakage.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1160-1169"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474849","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":"Nitinol Staples in Foot and Ankle Surgery: Current Concept Review.","authors":"Solangel Rodriguez-Materon, W Casey Fox, Joshua L Morningstar, Daniel J Scott, Christopher E Gross","doi":"10.1177/10711007261472456","DOIUrl":"https://doi.org/10.1177/10711007261472456","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007261472456"},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868711","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 \"Sports-Related Posterior Ankle Pain: Diagnosis and Management of Lateral Calcaneal Branch Neuropathy of the Sural Nerve (A Case Series)\".","authors":"","doi":"10.1177/10711007261486470","DOIUrl":"https://doi.org/10.1177/10711007261486470","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007261486470"},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868572","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":"Sesamoid Subluxation in Hallux Valgus Deformity.","authors":"John E Lama, Rachel Thompson, Stone R Streeter, Agnes Jones, Brett D Steineman, Scott J Ellis, A Holly Johnson, Matthew S Conti","doi":"10.1177/10711007261473609","DOIUrl":"https://doi.org/10.1177/10711007261473609","url":null,"abstract":"<p><strong>Background: </strong>Whether sesamoid subluxation relative to the metatarsal head occurs in hallux valgus (HV) remains unestablished. Deep transverse intermetatarsal ligament (DTML) attenuation, which spans the lateral sesamoid to the second metatarsal head, may increase transverse motion and facilitate medial sesamoid subluxation with the first metatarsal. This study aims to compare the average second metatarsal head to lateral sesamoid (2MTLS) distance between HV and control patients, which is a proxy of DTML length. We hypothesize that HV patients demonstrate an increased 2MTLS distance.</p><p><strong>Methods: </strong>Sixty-eight patients were matched into 2 groups: 34 with HV and 34 without HV. Standardized preoperative weightbearing computed tomography scans were used to measure the 2MTLS distance, hallux valgus angle (HVA), intermetatarsal angle (IMA), first metatarsal pronation, and sesamoid station. The 2MTLS distance was anatomically measured from the lateral sesamoid to the second metatarsal head.</p><p><strong>Results: </strong>The 2MTLS distance was significantly greater in HV patients compared with controls (20.90 mm vs 18.56 mm, <i>P</i> < .001). Similarly, the HVA and IMA were increased in HV patients (<i>P</i> < .001). First metatarsal pronation and sesamoid station were significantly greater in HV patients (<i>P</i> < .001). The 2MTLS distance demonstrated a moderately positive correlation with sesamoid station (<i>r</i> = 0.36, 95% CI 0.06-0.60), HVA (<i>r</i> = 0.40, 95% CI 0.12-0.65), and IMA (<i>r</i> = 0.43, 95% CI 0.06-0.71) but was not correlated with first metatarsal pronation (<i>r</i> = -0.18). Inter- and intrarater reliability for the 2MTLS measurements were ICC = 0.911 (95% CI 0.858-0.944) and 0.958 (95% CI 0.933-0.974), respectively.</p><p><strong>Conclusion: </strong>In HV patients, 2MTLS was significantly increased compared with controls. Additionally, as sesamoid station increased, the 2MTLS distance also increased. This challenges the long-standing view that the sesamoids remain anchored in HV and suggests the sesamoids subluxate. Clinically, this highlights the DTML's role as a restraint to first metatarsal medial deviation and suggests against sectioning the ligament during lateral release.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007261473609"},"PeriodicalIF":2.2,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868702","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":"Low Symptom Burden, Limited Gain: Preoperative MOxFQ Predicts Outcome After Chevron Osteotomy.","authors":"Mikaela Engarås Hamre, Benedikte Wendt Ræder, Marius Molund","doi":"10.1177/10711007261473925","DOIUrl":"https://doi.org/10.1177/10711007261473925","url":null,"abstract":"<p><strong>Background: </strong>Radiographic correction after hallux valgus surgery does not necessarily translate into clinically meaningful improvement. The ability of preoperative patient-reported outcome measures (PROMs) to predict clinically meaningful improvement after hallux valgus surgery remains unclear.</p><p><strong>Methods: </strong>In this prospective cohort study, 193 patients undergoing Chevron osteotomy were included. Clinically meaningful improvement in the Manchester-Oxford Foot Questionnaire (MOxFQ) score at 1 year was defined as a ≥15-point improvement. A mixed effects model was used as the primary longitudinal analysis to assess change over time, whereas logistic regression and receiver operating characteristic (ROC) analysis evaluated clinically meaningful improvement and predictive performance.</p><p><strong>Results: </strong>A total of 139 patients (72%) achieved clinically meaningful improvement. Patients with higher preoperative MOxFQ Index scores were more likely to benefit, whereas those with lower scores showed limited improvement. Preoperative MOxFQ score independently predicted responder status (odds ratio 1.06 per point; <i>P</i> < .001). ROC analysis demonstrated moderate discrimination (area under the curve 0.70), with a threshold of approximately 42 yielding 71% sensitivity and 65% specificity.</p><p><strong>Conclusion: </strong>Preoperative MOxFQ Index score predicts clinically meaningful improvement following Chevron osteotomy. Patients with a higher symptom burden benefit the most, whereas those with low baseline scores have limited potential for meaningful gain. A threshold of approximately 42 may help identify patients most likely to benefit from surgery.</p><p><strong>Level of evidence: </strong>Level IV, prospective case series.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007261473925"},"PeriodicalIF":2.2,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868664","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":"Prosthetic Joint Infection After Total Ankle Arthroplasty: A Propensity-Matched Analysis of Risk Factors and Outcomes.","authors":"Joseph A S McCahon, Grant M Thomas, Matthew Sherman, Anny Hsu, Joseph O'Neil, Selene G Parekh, David I Pedowitz","doi":"10.1177/10711007261472908","DOIUrl":"https://doi.org/10.1177/10711007261472908","url":null,"abstract":"<p><strong>Background: </strong>Prosthetic joint infection (PJI) following total ankle arthroplasty (TAA) is a rare but devastating complication associated with high rates of reoperation and poor functional outcomes. The purpose of this study was to identify risk factors for PJI following primary TAA and to characterize associated treatment approaches and clinical outcomes.</p><p><strong>Methods: </strong>A single-institution retrospective cohort study was conducted, including 1008 primary TAAs performed between 2010 and 2023. PJI was defined using established microbiologic and clinical criteria consistent with prior literature. Patient demographics, comorbidities, preoperative functional status, and operative characteristics were collected. Infected patients were compared with non-infected controls using 2:1 propensity score matching based on age and sex. Associations with PJI were evaluated using penalized logistic regression (Firth method). Microbiologic profiles, surgical management strategies, and outcomes were analyzed for the infection cohort.</p><p><strong>Results: </strong>Twenty-seven PJIs treated by 4 surgeons were identified, yielding an overall infection rate of 2.7%. After matching, cohorts were balanced across patient demographics. Concomitant calcaneal displacement osteotomy and cancer history were significantly associated with PJI (<i>P</i> < .05). When adjusting for prior ankle surgery, BMI, diabetes, and tourniquet time, concomitant calcaneal displacement osteotomy was associated with 9.75-fold increased odds of PJI (95% CI 2.5-52.4) demonstrating an area under the curve of 83.7%. <i>Staphylococcus aureus</i> was the most frequently identified organism (36.7%). Eight (29.6%) PJIs were considered chronic (>4 weeks). Two-stage revision TAA was the predominant surgical strategy (59.3%), with limb salvage achieved in 96.2% of cases and arthroplasty retention maintained in 69.2% at a mean follow-up of 4.07 years.</p><p><strong>Conclusion: </strong>PJI following primary TAA occurred at a rate of 2.7%, with calcaneal displacement osteotomies identified as a significant associated procedural risk factor. Despite the severity of this complication, high rates of limb salvage and arthroplasty retention were observed with contemporary treatment strategies at midterm follow-up.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007261472908"},"PeriodicalIF":2.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820751","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}