Foot & ankle international最新文献

{"title":"Does the Side Matter? Medial vs Lateral Ankle Dorsiflexion Measurements During the Silfverskiöld Test in Children.","authors":"Suki Liyanarachi, Cecilie Jansen Basma, Olav Andreas Foss, Christian Reidar Øye, Ketil Jarl Holen, Håkon Langvatn","doi":"10.1177/10711007251351317","DOIUrl":"10.1177/10711007251351317","url":null,"abstract":"<p><strong>Background: </strong>Isolated gastrocnemius tightness is associated with several foot conditions. The Silfverskiöld test examines for such tightness, and when assessing passive ankle dorsiflexion it is important to perform the examination with the proper technique. Several studies have reported reproducible examination techniques, yet none, to our knowledge, have evaluated whether measurement side-medial or lateral-affects dorsiflexion values. Understanding measurement consistency is crucial for clinical practice and research standardization. We have undertaken a study investigating whether this is of importance and assessed the repeatability of ankle dorsiflexion measurements.</p><p><strong>Methods: </strong>We performed an exploratory cross-sectional examination of 145 pediatric patients (290 feet) with a 2-person 2-hand Silfverskiöld test. Masked, repeated goniometric measurements were undertaken along both the medial and lateral axis of the leg and foot.</p><p><strong>Results: </strong>There was a small systematic difference between medial and lateral measurements where lateral measurements were on average almost 2 degrees more in equinus. The repeatability coefficient for all repeated measurements ranged from 5.1 to 5.5 degrees. The intraclass correlation coefficient between medial and lateral measurements was excellent (ICC = 0.97).</p><p><strong>Conclusion: </strong>We found a small systematic difference of 2 degrees between medial and lateral measurements that was less than the repeatability coefficient. The repeatability coefficient was 5 degrees, meaning that for ankle dorsiflexion measurements it is unlikely that a second measurement will differ more than 5 degrees. We do not believe that the statistically significant small difference between medial and lateral measurements is clinically relevant; however, it makes sense to consistently measure ankle dorsiflexion on either the medial or lateral side.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251351317"},"PeriodicalIF":2.2,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669146","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":"Minimally Invasive Distal Chevron With Supination Corrects First Metatarsal Pronation in Hallux Valgus: A Retrospective Weightbearing Computed Tomography Study.","authors":"Barbara Piclet-Legre, Eva Schenkels, Delphine Amsellem, Matthieu Lalevée, Lolita Micicoi","doi":"10.1177/10711007251351301","DOIUrl":"https://doi.org/10.1177/10711007251351301","url":null,"abstract":"<p><strong>Background: </strong>Hallux valgus (HV) significantly impacts patients' quality of life. The coronal plane deformity is often not captured by traditional 2-dimensional radiographs, yet its correction may be important. This study explores the efficacy of distal chevron osteotomies with supination in correcting first metatarsal (M1) pronation in HV.</p><p><strong>Methods: </strong>A retrospective analysis of 58 weightbearing CT scans from HV patients undergoing distal chevron with supination was conducted (29 patients had pre- and postoperative CT scans).Functional scores (European Foot and Ankle Society [EFAS], EuroQoL-5 levels, 5 dimensions [EQ5L-5D], EuroQoL-visual analog scale [EQ-VAS]) and angular measurements (hallux valgus angle, intermetatarsal angle, metatarsal pronation angle, alpha angle) were assessed pre- and postoperatively. Inter- and intraobserver reproducibility were evaluated using intraclass correlation coefficients.</p><p><strong>Results: </strong>Postoperative outcomes demonstrated significant improvement in functional scores for all patients, including an increase in EFAS score (Δ = 6.7, <i>P</i> < .001). Angular measurements, including metatarsal pronation angle (MPA), intermetatarsal angle, hallux valgus angle, and alpha angles, improved postoperatively. Preoperative MPA and alpha angle were 14.7 ± 4.9 and 16.6 ± 5.2 (<i>P</i> < .05). Postoperative MPA and alpha angles were 7.9 ± 3.4 and 7.4 ± 4.8 (<i>P</i> < .05). Intraclass correlation coefficient showed moderate to excellent correlations for angular measurements.</p><p><strong>Conclusion: </strong>Distal chevron technique with supination allowed pronational realignment of the M1 head relative to the ground in hallux valgus. Postoperative pronation values were close to the normative ones previously defined in the literature. Although statistically significant improvements were observed, the lack of validated minimal clinically important difference values for EFAS, EQ5L-5D, and EQ-VAS limits confident interpretation of their clinical relevance.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007251351301"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602614","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":"PROMIS Outcomes After Operative vs Nonoperative Treatment of Achilles Rupture.","authors":"Philomena Burger, Mina Botros, Zein El-Zein, Amanda Holleran, John Ketz, A Sam Flemister, David Ciufo","doi":"10.1177/10711007251336756","DOIUrl":"10.1177/10711007251336756","url":null,"abstract":"<p><strong>Background: </strong>Achilles tendon rupture is a common injury in the adult population. The role of operative and nonoperative management remains controversial. The purpose of this study is to evaluate and compare patient-reported outcomes using Patient-Reported Outcomes Measurement Information System (PROMIS) after operative and nonoperative treatment of acute Achilles rupture.</p><p><strong>Methods: </strong>Patients with Achilles ruptures were identified as either undergoing surgical repair or nonoperative functional rehabilitation. The primary outcomes were PROMIS physical function (PF), pain interference (PI), and depression scores. These were routinely collected prospectively during the initial office visit and follow-up appointments. A distribution-based method was used to determine the minimal clinically important difference (MCID), which was ½ SD of each PROMIS domain. These values were further used to calculate the percentage of patients who returned to population mean PROMIS scores at final follow-up. Secondary outcomes included deep vein thrombosis (DVT), wound healing, infections, and reruptures.</p><p><strong>Results: </strong>A total of 216 patients were included (115 nonoperative, 101 operative). Patients treated operatively were younger (35.6 vs 45.1 years, <i>P</i> < .001), with slightly lower BMI (<i>P</i> = .011). Sex distribution among the groups were similar (<i>P</i> = .933). Both treatments improved PROMIS PF, PI, and depression scores. Although there was a trend toward achieving population means in PF earlier in the operative group, the groups equalized over time, with no statistically significant difference between treatment groups for the percentage of patients who were below, at, or above population mean PROMIS values at 6 months and final follow-up. There was no difference in rerupture rates or identified DVTs. However, there were increased wound issues in the operative group (<i>P</i> = .035), with 12.8% symptomatic scarring, 6% infections, 3% delayed healing, and 3% with palpable nodules, compared with 1 case of cellulitis in a nonoperative patient.</p><p><strong>Conclusion: </strong>In our patients with an Achilles tendon rupture, on average, operative management was not associated with statistically meaningful differences in patient-reported physical function compared with nonoperative treatment. Surgery also comes at the cost of increased wound/complication rates and was associated with modestly slower improvement in pain and depression scores.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"715-722"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145116","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":"Ankle Fractures and Deltoid Ligament Repair: A Generational Tale.","authors":"John Y Kwon","doi":"10.1177/10711007251340689","DOIUrl":"10.1177/10711007251340689","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"697-698"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340781","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":"Evaluating Large Language Models for Patient Information: What Is Worth Publishing?","authors":"Charles L Saltzman, Robert B Anderson, Brad D Blankenhorn, John T Campbell, Christopher P Chiodo, Timothy R Daniels, George B Holmes, Ellie Pinsker, Stefan Rammelt, Robert A Vander Griend","doi":"10.1177/10711007251356034","DOIUrl":"https://doi.org/10.1177/10711007251356034","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"46 7","pages":"677-678"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585964","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":"Porous Titanium Wedges Associated With High Rates of Osseointegration and Radiologic Correction in Progressive Collapsing Foot Deformity.","authors":"Carolina Montoya-delaTorre, María José Ilabaca, Eva García-Jarabo, Rubén García-Elvira, Jesús VilayRico, Daniel Poggio-Cano","doi":"10.1177/10711007251334061","DOIUrl":"10.1177/10711007251334061","url":null,"abstract":"<p><strong>Background: </strong>The main purpose of this study is to assess the radiologic correction outcomes following surgical treatment of flexible progressive collapsing foot deformity using porous titanium implants.</p><p><strong>Methods: </strong>Multicenter, retrospective, descriptive, radiologic study. All patients with painful flexible progressive collapsing foot deformity (between 18 and 80 years old) who underwent surgical correction using porous titanium wedges for Cotton and Evans osteotomies between January 2019 and December 2021 were included. Patients with active infection or soft tissue anomalies in the surgical area were excluded. Pediatric patients were not included. Radiographs in weightbearing anteroposterior and lateral views were taken before the surgery and by the end of the 2-year follow-up period. The following were measured and compared: Meary angle and calcaneal pitch angle, Kite angle, and talonavicular coverage percentage. Radiologic osseointegration was assessed through Worth's classification.</p><p><strong>Results: </strong>Forty-one patients (43 feet: 26 right feet and 17 left feet) were included. The mean differential preoperative/postoperative angle measurements were as follows: Meary 14.7 degrees (<i>P</i> = .001), calcaneal inclination 4.3 degrees (<i>P</i> = .001), Kite 11 degrees (<i>P</i> = .03), talonavicular coverage 42.5 degrees (<i>P</i> = .01), and percentage of talonavicular coverage 15% (<i>P</i> = .03). Thirty-eight patients (88%) showed complete osseointegration of the wedges by the end of the follow-up period (grade 4). The remaining 5 patients presented partial integration (grade 3).</p><p><strong>Discussion: </strong>Regardless of the initial deformity severity, all patients consistently recovered and maintained a normal to class BI (Consensus Group classification) radiologic aspect by the end of the follow-up period.</p><p><strong>Conclusion: </strong>In this retrospective series, we found that titanium Cotton and Evan wedges offered reliable radiologic correction, and high osseointegration levels.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"732-739"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113055","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":"Response to \"Letter Regarding: Incidence of Complications With Precontoured Allograft Wedges in Foot and Ankle Surgery\".","authors":"Allison L Boden, Seif El Masry, Grace M DiGiovanni, Constantine A Demetracopoulos, Elizabeth A Cody","doi":"10.1177/10711007251341898","DOIUrl":"https://doi.org/10.1177/10711007251341898","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"46 7","pages":"807"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585966","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":"Does Use of Allograft Affect Union Rates in Minimal Invasive Hallux Valgus Surgery?","authors":"Christian G Guevara, Dino Fanfan, Taylor Schnepp, Daniel Murray, Christopher Hodgkins, Thomas San Giovanni, Cary Chapman","doi":"10.1177/10711007251337459","DOIUrl":"10.1177/10711007251337459","url":null,"abstract":"<p><strong>Background: </strong>Hallux valgus (HV) is a common foot deformity that can cause significant discomfort. Surgical correction of hallux with minimally invasive surgery (MIS) has been gaining popularity in recent years among surgeons. The use of allograft in traditional open approaches has been proposed to improve the outcomes of foot and ankle procedures by expediting time to union. We performed a retrospective analysis of patients undergoing MIS HV correction with and without the allograft at the time of surgery. The primary aim of our study was to determine if use of allograft in HV MIS correction led to different time to union as well as rate of unions.</p><p><strong>Methods: </strong>A retrospective cohort study was designed to compare the radiographic outcomes of patients who underwent hallux valgus correction with or without allograft. Patients included in the analysis underwent primary HV correction using fourth-generation minimally invasive techniques and had postoperative weightbearing radiographs. Exclusion criteria included revision HV surgery, open surgery for HV correction, and patients lost to follow-up. All surgeries were performed by 3 fellowship-trained foot and ankle orthopaedic surgeons at a single center in Miami, Florida, from September 2019 to December 2022, with only 1 surgeon using allograft. All patients had similar postoperative protocols. The allograft group received 2 mL of a demineralized bone matrix (DBM) gel (Allosync; Arthrex). Radiographs were evaluated by 2 independent orthopaedic surgeons who were anonymized to the patient's group allocation. The primary outcome of this study was time to radiographic union, defined as formation of 2 neocortices on postoperative radiographs, as well as overall rate of union. The secondary outcomes included a comparison of traditional radiographic measurements and the incidence of complications.</p><p><strong>Results: </strong>Sixty-eight patients (68 feet) met inclusion criteria: allograft group (n = 26) and a control group (n = 42). Demographics between both groups were similar. In our study, all 68 feet obtained complete union and no malunions or nonunions were observed in either group. The average time to complete union for the allograft group was 5.69 ± 3.16 months (95% CI 4.45-6.93) and the control group was 6.0 ± 3.95 months (95% CI 4.80-7.19); union times between groups did not reach statistical significance (<i>P</i> = .731). Maintenance of surgical correction was observed in all patients.</p><p><strong>Conclusion: </strong>In this study, the use of demineralized bone matrix allograft during MIS HV correction did not result in a statistically significant difference in time to union or overall union rates. Although the allograft group showed a slightly shorter average union time, this difference was not clinically or statistically significant. These findings suggest that the routine use of allograft in MIS HV correction may not provide a meaningful benefit.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"740-746"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113054","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":"Mid- to Long-Term In Vivo Polyethylene Wear Rates in Salto Talaris Total Ankle Arthroplasty.","authors":"Joseph A S McCahon, Tyler Radack, Hope Thalody, Adam Lencer, Tiffany Bridges, Tara G Moncman, David I Pedowitz, Selene G Parekh, Joseph N Daniel","doi":"10.1177/10711007251336752","DOIUrl":"10.1177/10711007251336752","url":null,"abstract":"<p><strong>Background: </strong>Polyethylene wear particles have been shown to be a contributing factor of osteolysis and aseptic loosening. To date, no clinical study has investigated the in vivo wear rates of Salto Talaris total ankle arthroplasty (TAA). Therefore, the purpose of our study was to evaluate mid- and long-term outcomes and in vivo wear rates in primary total ankle arthroplasty and their association with peri-implant osteolysis, complications, and implant survivorship.</p><p><strong>Methods: </strong>A retrospective review was performed to determine the mid- and long-term in vivo polyethylene wear rates in primary TAA. Patients with a minimum of 5-year clinical and radiographic data from a primary TAA with a fixed-bearing, semiconstrained, ultrahigh-molecular-weight polyethylene (UHMWPE) system were identified and included in this study. Polyethylene wear rates at final follow-up were analyzed using anteroposterior ankle radiographs and a validated computer-assisted Roman software. In addition, demographic data, peri-implant osteolysis, complications, reoperations, and revisions were recorded.</p><p><strong>Results: </strong>Fifty-four patients with a mean follow-up of 8.1 years (range, 5.2-13.0) were included in this study. The median polyethylene wear rate for the entire cohort was 0.06 mm/y (95% CI 0.04-0.08). Linear wear rate was found to have no true correlation relationship with patient age, BMI, or polyethylene size. More than half of patients (57%) demonstrated some radiographic signs of peri-implant osteolysis or cysts at final follow-up; however, comparative analysis investigating the relationship between wear rate and peri-implant osteolysis found no significant difference in wear rates for patients with tibial or talar osteolysis compared with those without (<i>P</i> = .451 and <i>P</i> = .434, respectively).</p><p><strong>Conclusion: </strong>UHMWPE in this primary TAA demonstrated low in vivo wear rates. Rates of peri-implant osteolysis remain high with no clear association between wear rates and osteolysis.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"757-764"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129750","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":"Severity of Bone Marrow Edema on MRI Predicts the Diagnostic Potential of Foot Joint Injections.","authors":"Matthäus Cieciera, Reto Sutter, Stephan H Wirth, Tobias Götschi, Nadja A Farshad-Amacker","doi":"10.1177/10711007251334097","DOIUrl":"10.1177/10711007251334097","url":null,"abstract":"<p><strong>Background: </strong>Intraarticular steroid and local anesthetic injections are often performed for foot pain. Localizing the exact joint acting as a pain generator in foot pain is eminent for optimal and cost-effective treatment. Because of the complex anatomy of the foot with multiple small articulations side by side, this can be challenging. This study's purpose was to determine magnetic resonance imaging (MRI) findings as possible predictive factors for the immediate outcome of intraarticular injections of the foot.</p><p><strong>Methods: </strong>All single joint foot injections at our institution from January 2019 to May 2020 with prior MRI scans were included in this retrospective study. Visual analog scale (VAS) pain assessments before and after injection, relative change in pain scores and indication were recorded. All MRIs were retrospectively analyzed by 2 blinded radiologists regarding the presence and severity of subchondral bone marrow edema (BME), subchondral cysts, cartilage defects, osteophytes, joint effusion, and soft tissue edema. Spearman analysis was used to assess correlation between MRI findings and pain relief. Interrater variability was assessed using weighted Cohen κ analysis.</p><p><strong>Results: </strong>A total of 164 injections from 162 patients were included (mean age, 53 years ± 15.5, 99 females). Relative pain reduction correlated significantly with BME severity (<i>P</i> < .05). Interrater reliability assessing BME was excellent (weighted Cohen κ 0.863).</p><p><strong>Conclusion: </strong>The degree of pain reduction after intraarticular foot injections correlates significantly with the severity of subchondral bone marrow edema-like signal on MRI before injection.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"747-756"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058465","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}