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Foot & Ankle International

Michael J Granado, Everett B Lohman, Noha S Daher, Keith E Gordon
BACKGROUND: Ultrasound is a widely used diagnostic tool for patients with plantar fasciitis. However, the lack of standardization during the measurement for plantar fascia thickness has made it challenging to understand the etiology of plantar fasciitis, as well as identify risk factors, such as gender. The purpose of this study was to investigate gender differences regarding plantar fascia thickness while controlling for metatarsophalangeal (MTP) joint position in the healthy and those with unilateral plantar fasciitis...
November 9, 2018: Foot & Ankle International
Natalia Gutteck, Alexander Zeh, David Wohlrab, Karl-Stefan Delank
BACKGROUND: Calcaneal osteotomies are often required in the correction of hindfoot deformities. The traditional open techniques, which include a lateral or oblique incision, are occasionally associated with wound healing problems and neurovascular injury. METHODS: A total of 122 consecutive patients who underwent a calcaneal osteotomy for hindfoot realignment treatment were included. Fifty-eight patients were operated using an open incision technique and 64 patients (66 feet) using a percutaneous technique...
November 9, 2018: Foot & Ankle International
Evan M Loewy, Thomas H Sanders, Arthur K Walling
BACKGROUND: Limited intermediate and no real long-term follow-up data have been published for total ankle arthroplasty (TAA) in the United States. This is a report of clinical follow-up data of a prospective, consecutive cohort of patients who underwent TAA by a single surgeon from 1999 to 2013 with the Scandinavian Total Ankle Replacement (STAR) prosthesis. METHODS: Patients undergoing TAA at a single US institution were enrolled into a prospective study. These patients were followed at regular intervals with history, physical examination, and radiographs; American Academy of Orthopaedic Foot and Ankle Surgeons (AOFAS) Ankle-Hindfoot Scale scores were obtained and recorded...
November 9, 2018: Foot & Ankle International
Naudereh Noori, Charles Myerson, Timothy Charlton, David Thordarson
BACKGROUND: The need for dental antibiotic prophylaxis after orthopedic surgery remains unclear. Current recommendations are based on patients with total hip and total knee arthroplasties. We investigated available evidence regarding the need for dental antibiotic prophylaxis in patients post foot and ankle surgery, specifically total ankle arthroplasty. Additionally, we examined the microbiology behind the risk of transient bacteremia from dental procedures and whether this leads to an increased risk for postoperative infection in foot and ankle surgery...
November 8, 2018: Foot & Ankle International
Sydney C Karnovsky, Andrew J Rosenbaum, Bridget DeSandis, Christopher Johnson, Conor I Murphy, Russell F Warren, Samuel A Taylor, Mark C Drakos
BACKGROUND: Fractures of the proximal fifth metatarsal are one of the most common foot injuries in athletes. Repetitive stresses endured by the fifth metatarsal can lead to stress fracture, delayed union, and refracture, making optimal treatment challenging. A radiographic analysis of fifth metatarsal morphology and foot type in National Football League (NFL) players was performed to investigate morphologic risk factors for these injuries. METHODS: This was a case-control study that looked at NFL players treated between 1992 and 2012, as well as participants at the NFL Combine...
November 7, 2018: Foot & Ankle International
Florian Gaul, Luís E P Tírico, Julie C McCauley, Pamela A Pulido, William D Bugbee
BACKGROUND: Fresh osteochondral allograft (OCA) transplantation represents a biologic restoration technique as an alternative treatment option for larger osteochondral lesions of the talus (OLT). The purpose of this study was to evaluate midterm outcomes after OCA transplantation for the treatment of OLT. METHODS: Nineteen patients (20 ankles) received partial unipolar OCA transplant for symptomatic OLT between January 1998 and October 2014. The mean age was 34...
November 1, 2018: Foot & Ankle International
Michel A Taylor, Cynthia L Green, Thomas J Risoli, James K DeOrio, Mark E Easley, James A Nunley, Samuel B Adams
BACKGROUND: Total ankle arthroplasty (TAA) is increasingly being recognized as an effective surgical option for end-stage ankle arthritis. Associated hindfoot arthrodesis procedures are at times needed to correct malalignment or to address adjacent joint arthritis. Results following TAA and associated hindfoot arthrodesis have at times been underwhelming and the devascularization of the talar blood supply has been postulated as a potential cause. This study explored the association between hindfoot arthrodesis fixation and talar component subsidence...
November 1, 2018: Foot & Ankle International
Geoffrey I Watson, Sydney C Karnovsky, David S Levine, Mark C Drakos
BACKGROUND: Stenosing peroneal tenosynovitis (SPT) is an uncommon entity that is equally difficult to diagnose. We evaluated our outcomes with a local anesthetic diagnostic injection followed by surgical release of the sheath and calcaneal exostectomy. METHODS: Eleven patients diagnosed with SPT underwent surgery between 2006 and 2014. Upon initial presentation, all patients reported a persistent history of pain along the ankle. Ultrasound-guided injections of anesthetics were administered into the peroneal tendon sheath to confirm the diagnosis...
October 31, 2018: Foot & Ankle International
Tomoyuki Nakasa, Yasunari Ikuta, Yusuke Tsuyuguchi, Yuki Ota, Munekazu Kanemitsu, Nobuo Adachi
BACKGROUND: Large osteochondral lesions of the talus (OLT) with good articular cartilage can be fixed by using bioabsorbable pins. These pins have various advantages but they can have adverse effects such as foreign body inflammation. This negative impact of pins on subchondral bone can be seen as bone marrow edema (BME) on magnetic resonance imaging (MRI). The purpose of this study was to investigate the course of change in BME on MRI, including osteolytic change around pins in OLT treated with pin fixation...
October 31, 2018: Foot & Ankle International
Troy S Watson, Jordan Panicco, Amit Parekh
The "anchovy" interpositional arthroplasty technique can be used as a salvage option for failed hallux rigidus procedures. The operative technique utilized by the senior author is described. Careful soft-tissue handling, meticulous joint space and graft preparation, and interposition graft stabilization using a bone tunnel and suture anchors are unique aspects of this technique, which in the authors' experience have contributed to improved outcomes. Current literature regarding indications and outcomes is limited and controversial...
October 31, 2018: Foot & Ankle International
Harold B Kitaoka, James E Meeker, Phinit Phisitkul, Samuel B Adams, Jonathan R Kaplan, Emilio Wagner
Outcome measures evaluate various aspects of patient health, and when appropriately utilized can provide valuable information in both clinical practice and research settings. The orthopedic community has placed increasing emphasis on patient-reported outcome measures, recognizing their value for understanding patients' perspectives of treatment outcomes. Patient-reported outcomes are information directly reported by patients regarding their perceptions of health, quality of life, or functional status without interpretation by healthcare providers...
October 31, 2018: Foot & Ankle International
Gerhard Kaufmann, Stefanie Sinz, Johannes M Giesinger, Matthias Braito, Rainer Biedermann, Dietmar Dammerer
BACKGROUND: Recurrence is relatively common after surgical correction of hallux valgus. Multiple factors are discussed that could have an influence in the loss of correction. The aim of this study was to determine preoperative radiological factors with an influence on loss of correction after distal chevron osteotomy for hallux valgus. METHODS: Five hundred twenty-four patients who underwent the correction of a hallux valgus by means of distal chevron osteotomy at our institution between 2002 and 2012 were included...
October 31, 2018: Foot & Ankle International
Mostafa M Abousayed, Christopher K Johnson, Muhammad Moral, Sarah Sternbach, Andrew J Rosenbaum
BACKGROUND: The Centers for Medicare and Medicaid services (CMS) have implemented initiatives to improve postdischarge care and reduce unnecessary readmissions. Readmissions within 30 days are frequent and represent an economic burden on both patients and the healthcare system. The aim of this study was to evaluate the frequency and causes for urgent care visits within 30 days of discharge after ankle open reduction and internal fixation (ORIF) and determine factors correlated with such visits...
October 25, 2018: Foot & Ankle International
Jae Hwang Song, Chan Kang, Deuk Soo Hwang, Gi Soo Lee, Sang Bum Lee
BACKGROUND: We compared the radiographic and clinical outcomes of moderate and severe hallux valgus treated by extended distal chevron osteotomy (EDCO) and distal soft tissue release (DSTR). METHODS: We performed a retrospective analysis comparing the utility of EDCO for the treatment of moderate (36 patients, 46 feet) and severe (36 patients, 42 feet) hallux valgus. The radiologic outcomes were evaluated based on the preoperative and 3-year follow-up x-rays. The clinical results were investigated based on the 3-year follow-up Manchester-Oxford Foot Questionnaire (MOXFQ), patient satisfaction, and postoperative complications...
October 21, 2018: Foot & Ankle International
Elizabeth A Cody, Lorena Bejarano-Pineda, James R Lachman, Michel A Taylor, Elizabeth B Gausden, James K DeOrio, Mark E Easley, James A Nunley
BACKGROUND: As the popularity of total ankle arthroplasty (TAA) increases and indications expand, surgeons require a better understanding of which patient factors are associated with implant failure. In this study, we aimed to use a large total ankle database to identify independent risk factors for implant failure at mid- to long-term follow-up. METHODS: A prospectively collected database was used to identify all patients who underwent primary TAA with a minimum 5 years' follow-up...
October 21, 2018: Foot & Ankle International
Jason M Sutherland, Kevin Wing, Alastair Younger, Murray Penner, Andrea Veljkovic, Guiping Liu, Trafford Crump
BACKGROUND: Little is known about the effect of delayed access to bunion correction (hallux valgus) surgery on patient-reported outcomes. The objective of this study was to measure the association between preoperative wait time for bunion correction surgery and postoperative patient-reported outcomes. METHODS: This study prospectively recruited patients to complete preoperative patient-reported outcomes measuring depression, pain, and foot and ankle health, including the Patient Health Questionnaire-9 (PHQ-9); the pain intensity (P), interference with enjoyment (E) of life and general (G) instrument (ie, PEG); and the Foot and Ankle Outcome Score (FAOS), a condition-specific instrument...
October 21, 2018: Foot & Ankle International
Matthias Braito, Dietmar Dammerer, Philipp Hofer-Picout, Gerhard Kaufmann
BACKGROUND: The aim of this study was to assess radiographic and clinical outcomes after double osteotomy with proximal opening wedge first metatarsal osteotomy and first metatarsal distal chevron osteotomy in the treatment of moderate to severe hallux valgus. METHODS: 33 patients (4 male, 29 female; 36 feet; average age 60.7 years) were included in the study. Radiographic and clinical outcome in terms of intermetatarsal angle (IMA), hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), and the American Orthopaedic Foot & Ankle Society metatarsophalangeal-interphalangeal hallux score (AOFAS MTP-IP hallux score) were investigated at 6 weeks, 6 months, and after an average of 28 (range, 7-123) months postoperatively...
October 21, 2018: Foot & Ankle International
Daniel Cunningham, Vasili Karas, James K DeOrio, James A Nunley, Mark E Easley, Samuel B Adams
BACKGROUND: The Comprehensive Care for Joint Replacement (CJR) model provides bundled payments for in-hospital and 90-day postdischarge care of patients undergoing total ankle arthroplasty (TAA). Defining patient factors associated with increased costs during TAA could help identify modifiable preoperative patient factors that could be addressed prior to the patient entering the bundle, as well as determine targets for cost reduction in postoperative care. METHODS: This study is part of an institutional review board-approved single-center observational study of patients undergoing TAA from January 1, 2012, to December 15, 2016...
October 21, 2018: Foot & Ankle International
David A Porter, Adam F Barnes, Angela Rund, Madison T Walrod
BACKGROUND: We report data on the largest cohort to date of patients who sustained a ligamentous Lisfranc injury during sport. To date, the prevalence of concurrent intercuneiform ligament injuries in the competitive athlete with subtle Lisfranc instability has not been reported. METHODS: Eighty-two patients (64 males, 18 females) sustained an unstable Lisfranc injury (49 left, 33 right) and met inclusion criteria. Injuries were classified as traditional dislocation (TRAD, first to second TMT ligament tear), medial column dislocation (MCD, second TMT, and medial-middle cuneiform ligament tear), or proximal extension dislocation (PE, first, second, and medial-middle cuneiform ligament tear) and the injury pattern confirmed at surgery...
October 21, 2018: Foot & Ankle International
Shane D Rothermel, Umur Aydogan, Evan P Roush, Gregory S Lewis
BACKGROUND: Lesser toe proximal interphalangeal (PIP) joint arthrodesis is one of the most common foot and ankle elective procedures often using K-wires for fixation. K-wire associated complications led to development of intramedullary fixation devices. We hypothesized that X Fuse (Stryker) and Smart Toe (Stryker) would provide stronger and stiffer fixation than K-wire fixation. METHODS: 12 cadaveric second toe pairs were used. In one group, K-wires stabilized 6 PIP joints, and 6 contralateral PIP joints were fixed with X Fuse...
October 20, 2018: Foot & Ankle International
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