Foot & ankle international最新文献

{"title":"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":"10.1177/10711007241294070","DOIUrl":"10.1177/10711007241294070","url":null,"abstract":"<p><strong>Background: </strong>Precontoured cancellous allograft wedges have gained popularity in foot and ankle procedures in recent years because of their ease of use and ability to decrease operative time. A high rate of resorption of such wedges was noted anecdotally by the senior authors, particularly in 2022. The purpose of this study was to identify the resorption and complication rates of precontoured allograft wedges over time.</p><p><strong>Methods: </strong>A retrospective review was performed of patients who had a precontoured allograft wedge from a single source implanted during foot and ankle surgery between 2017 and 2022 at a single institution. Patient demographics, indication for graft use, and fixation method were obtained from chart review, and differences between patients with and without nonunion were analyzed. Radiographic review was completed to identify patients with graft resorption and/or nonunion.</p><p><strong>Results: </strong>Of the 334 wedges implanted, 24 grafts (7.2%) resorbed and an additional 10 wedges (2.9%) developed a nonunion without resorption. Resorption was noted as early as 5.7 weeks postoperatively and as late as 36.6 weeks postoperatively. Older patient age, body mass index (BMI) >30, and the Lapidus graft type were significantly associated with greater risk of resorption or nonunion.</p><p><strong>Conclusion: </strong>We observed an overall radiographic complication rate of 10% with the use of precontoured cancellous wedges. Older age, BMI >30, and Lapidus wedge type were associated with increased risk of radiographic complication. Patients should be counseled on the risk of resorption and nonunion, and caution should be exercised when contemplating the use of precontoured allograft cancellous wedges in foot and ankle surgery.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"29-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669884","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":"Establishment of Minimum Clinically Important Difference and Patient Acceptable Symptom State Thresholds for Foot and Ankle Ability Measure and Visual Analog Scale Scores After Hallux Valgus Surgery.","authors":"Ignacio Pasqualini, Jason R Teplensky, Oguz Turan, Sarah E Poirier, William A Cantrell, James Mueller, Sagar Chawla, Sara Lyn Miniaci-Coxhead","doi":"10.1177/10711007241298675","DOIUrl":"10.1177/10711007241298675","url":null,"abstract":"<p><strong>Background: </strong>Although clinically relevant thresholds such as minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) have been widely described across orthopaedics, their application in hallux valgus surgery remains scarce. The purpose of this study was to determine the MCID and PASS thresholds for the visual analog scale (VAS) and Foot and Ankle Ability Measure (FAAM) scores after hallux valgus surgery.</p><p><strong>Methods: </strong>A retrospective review was performed in patients undergoing hallux valgus surgery at a single institution from January 2021 through December 2022. Patient-reported outcome measures (PROMs) were collected preoperatively and 1 year postoperatively. The specific PROMs used were the FAAM-activities of daily living (FAAM-ADL), Single Assessment Numeric Evaluation (SANE), and VAS scale. Two methods were used to calculate MCID and PASS thresholds: a distribution-based approach for MCID and an anchor-based approach using responses to a 1-year postoperative satisfaction question for PASS. The analysis identified optimal cutoff points that maximized sensitivity and specificity based on the Youden index. Overall, 86% (136/158) completed baseline PROMs, and 73% (99/136) completed 1-year PROMs.</p><p><strong>Results: </strong>The distribution-based MCID for FAAM-ADL, SANE, and VAS were calculated to be 10.8, 14.1, and 1.2, respectively. The percentage of patients who achieved MCID thresholds was 54% for FAAM-ADL, 42% for SANE, and 96% for VAS. The PASS threshold for FAAM-ADL, SANE, and VAS were ≥78.5, ≥85, and ≤ 2, respectively. The percentage of patients who achieved PASS thresholds was 78% for FAAM-ADL, 72% for SANE, and 69% for VAS.</p><p><strong>Conclusion: </strong>This study identified useful values for the MCID and PASS thresholds of FAAM-ADL, SANE, and VAS scores at 1-year follow-up for patients undergoing hallux valgus surgery. Overall, despite not meeting the MCID thresholds, patients undergoing hallux valgus surgery were still likely to be satisfied with their surgery.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"83-91"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669882","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":"Functional Outcome and Patient Satisfaction After Primary vs Secondary Arthrodesis for Lisfranc Injuries: Toward a Single-Surgery Approach.","authors":"Esmee Wilhelmina Maria Engelmann, Jens Anthony Halm, Tim Schepers","doi":"10.1177/10711007241288853","DOIUrl":"10.1177/10711007241288853","url":null,"abstract":"<p><strong>Background: </strong>The choice between primary arthrodesis (PA) and open reduction and internal fixation (ORIF) for acute Lisfranc injuries remains contentious. Apart from primary treatment, arthrodesis is often used for treating chronic Lisfranc injuries, including patients in whom initial ORIF or nonoperative treatment failed. The aim of this study was to compare PA and secondary arthrodesis (SA) in terms of complications and functional outcome.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on trauma patients with Lisfranc injuries treated at a level 1 trauma center between July 1, 2010, and July 1, 2020. Selected patients were evaluated at the outpatient clinic and received a survey. Demographics, injury characteristics, management, complications, and patient-reported outcomes (American Orthopaedic Foot & Ankle Society midfoot score, Foot Function Index) were analyzed.</p><p><strong>Results: </strong>Twenty-nine of 37 potential patients (78.4%; PA n = 11, SA n = 18) completed the survey with a median follow-up of 7.1 (PA) to 9.3 (SA) years (<i>P</i> = .01). The majority were female (n = 18, 62.1%); the mean age of PA patients was 57.1 years (SD 14.2) compared with 43.5 years (SD 17.1) in SA patients (<i>P</i> = .04). In the PA group, there was no infection, 100% union, and implants were removed in 5 of 11 patients. In the SA group, 11.1% (n = 2) developed infection, malunion rate was 11.1%, implants were removed in 33.3% (n = 6), and 22.2% required revision surgery. AOFAS was \"good\" in PA (77.7, SD 17.3) compared with rated \"fair\" in SA (67.1, SD 21.3, <i>P</i> = .19). FFI was better in PA (26.0, SD 26.2) than SA (37.6, SD 30.8, <i>P</i> = .32), which exceeded the minimally important clinical difference.</p><p><strong>Conclusion: </strong>Although this study was limited by sample size, the overall results suggest equivalent functional outcome, pain and treatment satisfaction in primary arthrodesis compared with secondary arthrodesis patients for treatment of Lisfranc injury.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"46-53"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585319","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":"Influence of Tibial Component Design Features and Interference Fit on Implant-Bone Micromotion in Total Ankle Replacement: A Finite Element Study.","authors":"Gabriel Clarke, Joshua E Johnson, Cesar de Cesar Netto, Donald D Anderson","doi":"10.1177/10711007241281294","DOIUrl":"10.1177/10711007241281294","url":null,"abstract":"<p><strong>Background: </strong>Implant survivorship in uncemented total ankle replacement (TAR) is dependent on achieving initial stability. This is because early micromotion between the implant and bone can disrupt the process of osseointegration, leading to poor long-term outcomes. Tibial implant fixation features are designed to resist micromotion, aided by bony sidewall retention and interference fit. The goal of this study was to investigate design-specific factors influencing implant-bone micromotion in TAR tibial components with interference fit.</p><p><strong>Methods: </strong>Three implant designs with fixation features representative of current TAR tibial components (ARC, SPIKES, KEEL) were virtually inserted into models of the distal tibias of 2 patients with end-stage ankle arthritis. Tibia models were generated from deidentified patient computed tomography scans, with material properties for modeling bone behavior and compaction during press-fit. Finite element analysis (FEA) was used to simulate 2 fixation configurations: (1) no sidewalls or interference fit, and (2) sidewalls with interference fit. Load profiles representing the stance phase of gait were applied to the models, and implant-bone micromotions were computed from FEA output.</p><p><strong>Results: </strong>Sidewalls and interference fit substantially influenced implant-bone micromotions across all designs studied. When sidewalls and interference fit were modeled, average micromotions were less than 11 µm, consistent across the stance phase of gait. Without sidewalls or interference fit, micromotions were largest near either heel strike or toe-off. In the absence of sidewalls and interference fit, the amount of micromotion generally aligned inversely with the size of implant fixation features; the ARC design had the largest micromotion (~540 µm average), whereas the KEEL design had the smallest micromotion (~15 µm).</p><p><strong>Conclusion: </strong>This study presents new insights into the effect of TAR fixation features on implant-bone micromotion. With sidewalls and interference fit, micromotion is predicted to be minimal for implants, whereas with no sidewalls and no interference fit, micromotion depended primarily on the implant design.</p><p><strong>Clinical relevance: </strong>This study presents new insights into the effect of TAR primary fixation features on implant-bone micromotion. Although design features heavily influenced implant stability in the model, their influence was greatly diminished when interference fit was introduced. The results of this study show the relative importance of design features and interference fit in the predicted initial stability of uncemented TAR, potentially a key factor in implant survivorship.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1414-1421"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378719","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":"Proposed Classification of Syndesmotic Soft Tissue Impingement and Its Association With Lateral Talar Cartilage Lesions.","authors":"Yeo Kwon Yoon, Kwang Hwan Park, Dong Woo Shim, Wonwoo Lee, Chul-Young Jang, Jin Woo Lee, Seung Hwan Han","doi":"10.1177/10711007241281496","DOIUrl":"10.1177/10711007241281496","url":null,"abstract":"<p><strong>Background: </strong>Syndesmotic impingement syndrome has been described to explain persistent lateral or anterolateral ankle pain. This condition is thought to often result from a rotational ankle injury. This study aimed to identify the type of syndesmotic impingement tissue according to arthroscopic and histologic findings and to analyze its association with lateral talar cartilage lesions.</p><p><strong>Methods: </strong>This retrospective study included 107 ankles in 105 patients who underwent arthroscopic surgery for syndesmotic impingement syndrome from January 2017 to August 2019. Histologic findings of biopsied impingement tissue were obtained in 59 ankles (55.1%) and compared with gross findings on arthroscopy. Cartilage lesions were evaluated using the International Cartilage Repair Society grading system. Risk factors associated with lateral talar cartilage injury were evaluated using multivariate logistic regression analysis.</p><p><strong>Results: </strong>Based on the histologic results, the most common pathology was fibrosis (24 ankles [22.4%]), followed by fatty degeneration (23 ankles [21.5%]), synovial hyperplasia (8 ankles [7.5%]), and inflammatory synovium (4 ankles [3.7%]). Interclass correlation coefficient was 0.841 (<i>P</i> = .001) between histologic results and arthroscopic findings. Patients with fibrotic impingement tissue had on average a significantly longer duration of symptoms (12 vs 48 months, <i>P</i> = .021). A lateral talar dome cartilage lesion was detected in 25 ankles (23.4%). Fibrotic impingement tissue was the only factor significantly associated with lateral talar dome lesion on multivariate logistic regression analysis (odds ratio 10.04; 95% CI 1.84-54.9; <i>P</i> = .008).</p><p><strong>Conclusion: </strong>Syndesmotic impingement with fibrotic tissue was often associated with cartilage lesions at the lateral talar dome. Patients with prolonged anterolateral or lateral ankle pain after a rotational ankle injury warrant careful assessment for possible syndesmotic impingement by fibrotic tissue and associated lateral talar cartilage injury.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1397-1405"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378720","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":"Biomechanical Changes to the Hindfoot After Zadek Osteotomy.","authors":"Nicholas Bellas, Raghunandan Nayak, Mehreen Pasha, Megan Wolf, Thomas McDonald, Elifho Obopilwe, Lauren E Geaney","doi":"10.1177/10711007241281737","DOIUrl":"10.1177/10711007241281737","url":null,"abstract":"<p><strong>Background: </strong>Insertional Achilles tendinopathy (IAT) is a common source of heel pain in active adults and athletes. The Zadek osteotomy (ZO) is a calcaneal dorsal closing wedge osteotomy that has demonstrated clinical success as a treatment for IAT, purported to favorably improve tendon mechanics, decrease impingement, and decrease pressure within the retrocalcaneal bursa. The present study aims to evaluate the biomechanical effects of ZO on Achilles strain, position of the Haglund prominence relative to the Achilles insertion, and retrocalcaneal pressure.</p><p><strong>Methods: </strong>The ZO was performed on 10 fresh-frozen foot and ankle mid tibia-fibula cadaveric specimens. An osteotomy was performed using a 1-cm dorsal closing wedge procedure secured with a 7.0 mm cannulated screw. Point pressure sensor catheters and differential variable reluctance transducers were used to measure the retrocalcaneal pressure and Achilles strain, respectively, pre- and postosteotomy. Paired t-tests were utilized to detect statistical differences (<i>P</i> < .05).</p><p><strong>Results: </strong>After the ZO, the Haglund prominence was translated 9.9 mm anteriorly with respect to the insertion of the Achilles (<i>P</i> < .05) and the Achilles tendon insertion was translated 3.4 mm proximally (<i>P</i> < .05). The ratio of calcaneal length to greater tuberosity length, the X/Y ratio, increased from 2.56 to 3.52 with the osteotomy (<i>P</i> < .05). At maximum dorsiflexion, retrocalcaneal pressure decreased from 117 to 66 mm Hg (44%, <i>P</i> = .018). The Achilles strain changed from 0.00362 to 0.00436 in the anterior fibers (<i>P</i> = .484) and changed from 0.00467 to 0.00283 in the posterior fibers (<i>P</i> = .088).</p><p><strong>Conclusion: </strong>Biomechanical testing in a cadaveric model demonstrates that the ZO decreased retrocalcaneal pressure, shifted the Achilles tendon insertion proximally, increased the X/Y ratio of the calcaneus, and did not significantly change the strain of the Achilles tendon.</p><p><strong>Clinical relevance: </strong>Despite the clinical success demonstrated in recent literature, there are no biomechanical studies describing the effect of the ZO on the biomechanics of the hindfoot, and the mechanism of symptom relief of the ZO for IAT is not well understood. The present study measures two potential ZO effects relative to Haglund prominence by measuring retrocalcaneal pressure and displacement of the Achilles tendon with respect to the Haglund prominence, and measures one ZO effect relative to calcification of the tendon by measuring the Achilles tendon strain.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1406-1413"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foot Posture and Ankle Dorsiflexion as Risk Factors for Developing Achilles Tendinopathy and Plantar Fasciitis: A Case-Control Study.","authors":"Finn E Johannsen, Julie P Rydahl, Anna S Jacobsen, Cecilie C H Brahe, Peter S Magnusson","doi":"10.1177/10711007241281289","DOIUrl":"10.1177/10711007241281289","url":null,"abstract":"<p><strong>Background: </strong>Plantar fasciitis (PF) and Achilles tendinopathy (AT) are common injuries that primarily affect people engaged in sport or occupational weightbearing activities. Identifying modifiable risk factors is important for the treatment and prevention of these injuries. The purpose of this study was to evaluate whether foot posture or ankle dorsiflexion are risk factors for developing AT or PF, and if there were any differences between PF and AT patients.</p><p><strong>Methods: </strong>This was a case-control study of 108 patients with PF and 114 patients with AT, compared to the same number of referred patients in 2 control groups never having had these injuries, matched for sex, age, body mass index (BMI), sport, and occupational weightbearing activities. Included patients were 20-65 years with ultrasonographic-verified PF or midsubstance AT. Foot posture was assessed using Foot Posture Index (FPI) classifying the feet into 3 categories: FPI 0-5 normal foot, 6-12 hyperpronated, <0 hypopronated. Ankle dorsiflexion was measured with a goniometer in weightbearing with straight and bent knee.</p><p><strong>Results: </strong>Abnormal foot posture was associated with an increased risk for sustaining both AT (odds ratio [OR] 3.4-4.1) and PF (OR 3.2-3.8). Hyperpronation being the major reason for this association with ORs 5.4-5.5 compared with hypopronation with ORs 2.6-2.9. However, decreased dorsiflexion was not a risk factor: instead, there was an increased ankle dorsiflexion in patients with AT or PF compared with their control groups. Comparison between PF and AT patients demonstrated that PF affected mostly women, and AT mostly men, PF patients were 2.4 years (CI 0.2-4.5) younger, and had 25% more occupational weightbearing than AT patients. However, no differences in BMI or weightbearing physical activity was demonstrated.</p><p><strong>Conclusion: </strong>Hypopronation and hyperpronation but not limited ankle dorsiflexion was associated with increased risk for AT or PF.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1380-1389"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484097","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":"Progressive First Metatarsal Shortening Is Observed Following Dermal Allograft Interpositional Arthroplasty in Hallux Rigidus: Short Report.","authors":"Aly Maher Fayed, Matthew Jones, Kepler Alencar Mendes de Carvalho, Emily Luo, Antoine Acker, Nacime Salomão Barbachan Mansur, Cesar de Cesar Netto","doi":"10.1177/10711007241281729","DOIUrl":"10.1177/10711007241281729","url":null,"abstract":"<p><strong>Background: </strong>The main goal of this study was to evaluate postoperative changes in the length of the first metatarsal (M1) and the proximal phalanx of the hallux (P1) after acellular dermal allograft interpositional arthroplasty (ADA-IPA). We hypothesized that there would be a shortening of the first ray at the first metatarsal, the proximal phalanx, or both.</p><p><strong>Methods: </strong>In this retrospective study, we assessed patients who underwent ADA-IPA between 2019 and 2022. On standing anteroposterior (AP) foot radiographs, we measured first metatarsal (M1), second metatarsal (M2), proximal phalanx (P1), and the entire hallux (HX) lengths. M1/M2 and P1/HX ratios were calculated. The first metatarsophalangeal joint space was calculated. All measurements were recorded preoperatively, at 6 weeks postoperatively, and at final follow-up.</p><p><strong>Results: </strong>The pilot study included 11 patients. At final follow-up, we found shortening of M1 and P1 in comparison to the preoperative length, as evidenced by lower M1/M2 (82.6 ± 2.3 vs 75.4 ± 5.1; <i>P</i> = .001) and P1/HX ratios (53.4 ± 2.3 vs 48.9 ± 7.9; <i>P</i> = .001). Follow-up length was negatively correlated with M1/M2 (<i>r</i> = -0.76, <i>P</i> = .003).</p><p><strong>Conclusion: </strong>ADA-IPA might be associated with shortening of both first metatarsal and proximal phalanx, with the former showing progressive shortening.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1359-1363"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484099","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":"Education Calendar.","authors":"","doi":"10.1177/10711007241303573","DOIUrl":"https://doi.org/10.1177/10711007241303573","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"45 12","pages":"1422"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808944","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":"Different Positions of Weightbearing CT Images Can Influence the Hindfoot Alignment Evaluation Using 2-Dimensional Methodology.","authors":"Mingjie Zhu, Wanjun Gu, Chao Wang, Songmin Sun, Sera Sempson, Mingzhu Zhang, Kenneth J Hunt, Mark S Myerson, Shuyuan Li","doi":"10.1177/10711007241286889","DOIUrl":"10.1177/10711007241286889","url":null,"abstract":"<p><strong>Background: </strong>Three-dimensional weightbearing CT (WBCT) has been widely used to assess foot and ankle alignment. However, most current measurement methods are based on 2-dimensional concepts-distance, long axis, angulation, etc-and are sensitive to changes in orientation of the WBCT images. This study demonstrated how changes in positioning of the image can significantly influence the evaluation of hindfoot alignment.</p><p><strong>Methods: </strong>WBCT scans of 10 feet without deformities were used. In the horizontal view, the long axis of the foot image was aligned to a neutral position and then rotated 5, 10, 15, and 20 degrees both internally and externally to simulate malposition. The Calcaneal Moment Arm (CMA) was measured by 2 investigators independently in the above positions. An intraclass correlation coefficient (ICC) model was used to assess the intra- and interobserver reliabilities. The correlation between the CMA and the rotation angle of the foot images was analyzed using linear regression.</p><p><strong>Results: </strong>The CMA measurements demonstrated that internal rotation of the image changed the neutral hindfoot into valgus, whereas external rotation led to varus. A 1-degree internal or external rotation of the image correlated with 0.48 (±0.03) mm increase or decrease in the modified WBCT-CMA value (<i>P</i> < .0001, <i>R</i>² = 0.6406).</p><p><strong>Conclusion: </strong>This study demonstrated that although 3D WBCT provides the ability to observe the foot from different perspectives, current alignment evaluation tools are limited to 2 dimensions. Therefore, positioning the WBCT images in a consistent orientation is important to generate correct data.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1390-1396"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515263","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}