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Richard D Ferkel
Arthroscopic ankle arthrodesis is the treatment method of choice to achieve good clinical scores, faster time to union, fewer complications, and shorter hospital stay. However, the union rate, reoperation rate, and operative time are similar to open arthrodesis. The choice of which method to use for arthrodesis is influenced by surgeon preference and experience, clinical presentation, and equipment availability. Overall, we must choose the method of ankle arthrodesis that gives the best result with the least morbidity to the patient...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Christopher Robert Jones, Eric Wong, Gregory R Applegate, Richard D Ferkel
PURPOSE: The purpose of our study was to determine the results of arthroscopic ankle arthrodesis (AAA) and how the procedure affects adjoining joints and functional scores. METHODS: Between 1993 and 2013, 116 patients (120 ankles) underwent AAA. Nineteen ankles were lost to follow-up due to death, insufficient radiographic studies, or inability to contact, resulting in 97 patients (101 ankles). Mean age at surgery was 61.1 years (range, 35.8-79.6 years); mean follow-up was 86 months (range, 24-247 months)...
May 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Keith W Chan, Richard D Ferkel, Brian Kern, Sarah S Chan, Gregory R Applegate
The objective of this study was to characterize magnetic resonance imaging (MRI) findings and correlate with clinical results in patients who underwent autologous chondrocyte implantation (ACI) of osteochondral lesions of the talus (OLT). METHODS: Twenty-four grafts were evaluated at a mean 65.8 months after ACI for OLT. MRI was performed on a 1.5-T GE scanner using multiple sequences. Graft appearance was compared with preoperative MRI and evaluated for 6 criteria: defect fill, surface regularity, signal pattern, bone marrow edema, subchondral plate irregularity, and presence of cystic lesions...
January 2018: Cartilage
Richard D Ferkel
Recalcitrant osteochondral lesions of the talus present a difficult problem to the treating surgeon. Anterior and posterior approaches have been studied to facilitate treatment access. Current research highlights the accessibility of an osteochondral lesion to treatment from an anterior or posterior approach and shows the importance of foot position and noninvasive distraction to facilitate treatment. Moreover, it is important to consider that using both anterior and posterior portals, most osteochondral lesions can be well treated with a patient in the supine position...
December 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
An De Meester, David Stodden, Jacqueline Goodway, Larissa True, Ali Brian, Rick Ferkel, Leen Haerens
OBJECTIVES: This study examined the existence of a threshold level (proficiency barrier) of actual motor competence (MC) below which a child is not likely to attain 60min of moderate-to-vigorous physical activity (MVPA) per day. DESIGN: A cross-sectional study. METHODS: Actual MC was assessed in 326 children (48.5% boys; age=9.50±1.24years) using the Test of Gross Motor Development-2; MVPA was measured with ActiGraph GT3X+accelerometers. Perceived MC, included as a potential mediating variable, was assessed with the Self-Perception Profile for Children...
January 2018: Journal of Science and Medicine in Sport
Michael Isiah Sandlin, Cyrus E Taghavi, Timothy P Charlton, Richard D Ferkel
Surgeons should understand the anatomic, vascular, biomechanical, and predisposing factors related to lateral ankle instability and peroneal tendon injuries, including peroneal tendinitis and tenosynovitis, peroneal tendon tears and ruptures, as well as peroneal tendon subluxation and dislocation. Surgeons should understand the treatment options and recommendations for patients who have lateral ankle instability and peroneal tendon injuries from the perspective of a sports medicine foot and ankle specialist...
February 15, 2017: Instructional Course Lectures
Kurt J Hofmann, Zabrina M Shabin, Eric Ferkel, Jeffrey Jockel, Mark P Slovenkai
BACKGROUND: In recent years, the number of total ankle arthroplasty procedures performed has increased dramatically. We sought to report the clinical results of the largest cohort of patients treated with a modern fixed-bearing total ankle arthroplasty by a single surgeon. METHODS: We retrospectively reviewed the charts of 78 consecutive patients (81 ankles) who underwent total ankle arthroplasty with a minimum clinical follow-up of 2 years. Sixty-three patients completed standardized questionnaires including the Foot and Ankle Disability Index (FADI), the Short Musculoskeletal Function Assessment (SMFA), the Short Form (SF)-36v2, and a visual analog scale (VAS) for pain...
December 21, 2016: Journal of Bone and Joint Surgery. American Volume
Laura Ramponi, Youichi Yasui, Christopher D Murawski, Richard D Ferkel, Christopher W DiGiovanni, Gino M M J Kerkhoffs, James D F Calder, Masato Takao, Francesca Vannini, Woo Jin Choi, Jin Woo Lee, James Stone, John G Kennedy
BACKGROUND: The critical lesion size treated with bone marrow stimulation (BMS) for osteochondral lesions of the talus (OLTs) has been 150 mm2 in area or 15 mm in diameter. However, recent investigations have failed to detect a significant correlation between the lesion size and clinical outcomes after BMS for OLTs. PURPOSE: To systematically review clinical studies reporting both the lesion size and clinical outcomes after BMS for OLTs. STUDY DESIGN: Systematic review...
June 2017: American Journal of Sports Medicine
Ross Wodicka, Eric Ferkel, Richard Ferkel
No abstract text is available yet for this article.
September 2016: Foot & Ankle International
Richard D Ferkel
Access to all areas of the ankle during arthroscopy is always problematic. The use of the correct portals and distraction increases access in both the supine and prone positions. Noninvasive distraction up to 30 pounds is safe and effective to perform arthroscopy in the supine position, and avoids the potential complications of pin distraction.
July 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Eric Ferkel, William Hodges Davis, John Kent Ellington
Posterior tarsal tunnel syndrome is the result of compression of the posterior tibial nerve. Anterior tarsal tunnel syndrome (entrapment of the deep peroneal nerve) typically presents with pain radiating to the first dorsal web space. Distal tarsal tunnel syndrome results from entrapment of the first branch of the lateral plantar nerve and is often misdiagnosed initially as plantar fasciitis. Medial plantar nerve compression is seen most often in running athletes, typically with pain radiating to the medial arch...
October 2015: Clinics in Sports Medicine
Betsy M Nolan, Stephan J Sweet, Eric Ferkel, Aniebet-Abasi Udofia, John Itamura
Computed tomography (CT) is often used to evaluate intra-articular distal humerus fracture patterns, but it increases radiation exposure and cost. We conducted a study to determine the effect of adding CT evaluation to plain radiographic evaluation on the classification of, and treatment plans for, intra-articular distal humerus fractures. Nine blinded orthopedic surgeons evaluated 30 consecutive fractures for classification and surgical approach. Evaluations were performed first using plain radiographs and then again using the same radiographs plus CT images...
September 2015: American Journal of Orthopedics
Brian D Dierckman, Richard D Ferkel
BACKGROUND: The modified Broström procedure has been successful for most patients with chronic lateral ankle instability (CLAI); however, a subset of patients has had unsatisfactory outcomes. For those at risk of failure, anatomic reconstruction of the lateral ankle ligaments using a semitendinosus allograft to augment the modified Broström procedure is available. PURPOSE: To report the results of anatomic reconstruction of the lateral ankle with a semitendinosus allograft for the treatment of CLAI...
August 2015: American Journal of Sports Medicine
Femke M A P Claessen, Kimberly I M van den Ende, Job N Doornberg, Thierry G Guitton, Denise Eygendaal, Michel P J van den Bekerom
BACKGROUND: The radiographic appearance of osteochondritis dissecans (OCD) of the humeral capitellum varies according to the stage of the lesion. It is important to evaluate the stage of OCD lesion carefully to guide treatment. We compared the interobserver reliability of currently used classification systems for OCD of the humeral capitellum to identify the most reliable classification system. METHODS: Thirty-two musculoskeletal radiologists and orthopaedic surgeons specialized in elbow surgery from several countries evaluated anteroposterior and lateral radiographs and corresponding computed tomography (CT) scans of 22 patients to classify the stage of OCD of the humeral capitellum according to the classification systems developed by (1) Minami, (2) Berndt and Harty, (3) Ferkel and Sgaglione, and (4) Anderson on a Web-based study platform including a Digital Imaging and Communications in Medicine viewer...
October 2015: Journal of Shoulder and Elbow Surgery
Steve K Kwak, Brian S Kern, Richard D Ferkel, Keith W Chan, Sina Kasraeian, Gregory R Applegate
BACKGROUND: The treatment of osteochondral lesions of the talus after failed surgery is challenging, with no clear solution. Short-term results using autologous chondrocyte implantation have been promising. PURPOSE: To report the long-term outcomes of patients who underwent autologous chondrocyte implantation (ACI) of the talus after failed marrow stimulation techniques for osteochondral lesions of the talus (OLTs). STUDY DESIGN: Case series; Level of evidence, 4...
September 2014: American Journal of Sports Medicine
Corinna C Franklin, Tishya Wren, Eric Ferkel, Alexandre Arkader
Forearm fractures occur commonly in children; however, there is still uncertainty on what leads to conversion from conservative to operative management. Patients who initially underwent closed reduction and casting for diaphyseal forearm fractures were evaluated for predictors of conversion to operative management. We found that the 20 of 124 (16%) patients in whom there was conversion to operative management were significantly older (11.1 vs. 5.7 nonoperative), had less angulation in the anterior-posterior (or coronal) plane (20...
March 2014: Journal of Pediatric Orthopedics. Part B
Bradley J Dunlap, Richard D Ferkel, Gregory R Applegate
PURPOSE: The purpose of this study was to assess a series of lateral inverted osteochondral fractures of the talus. METHODS: Over a 17-year period, 10 patients with an acute lateral inverted osteochondral fracture of the talus after an inversion injury to the ankle were identified. Diagnosis was made by physical examination, radiographs, magnetic resonance imaging, and/or computed tomography scan. Arthroscopy was initially performed on all patients. All patients had an inverted osteochondral fragment...
November 2013: Arthroscopy: the Journal of Arthroscopic & related Surgery
Michael J Carlson, Richard D Ferkel
Arthroscopy has many potential complications, whether it is done in the ankle, shoulder, knee, or other joints. Foot and ankle arthroscopy has progressed significantly since its beginning by Burman in 1931. Over the past 2 decades, arthroscopy equipment and instrumentation has improved and newer techniques have been developed. A heightened interest in foot and ankle arthroscopy has grown as diagnostic and imaging capabilities have improved. As the number of arthroscopic procedures of the foot and ankle has increased, so has the opportunity for significant complications...
June 2013: Sports Medicine and Arthroscopy Review
Santiago A Lozano-Calderón, Yigal Samocha, James McWilliam
BACKGROUND: Ankle arthroscopy has evolved as a diagnostic and therapeutic tool. Traditionally, it is performed with traction because of the tight ankle joint space. Original traction techniques were invasive but have progressed to the commonly used noninvasive modalities. Recent reports have suggested traction may be unnecessary. The purpose of this study was to compare prospectively ankle arthroscopy with and without traction in terms of ease of visualization of anatomic structures according to the Ferkel's ankle arthroscopy criteria...
September 2012: Foot & Ankle International
Russell Woodman, Kevin Berghorn, Traci Underhill, Meredith Wolanin
Ankle sprains are a common injury. According to the National Electronic Injury Surveillance System (NEISS), an estimated 630,891 ankle sprains occurred in 2009 (CPSC, 2011). The anterior talofibular ligament (AFTL) is frequently sprained as a result of a plantarflexion-inversion injury. Sometimes the calcaneofibular ligament or posterior talofibular ligament (PTFL) is also sprained (Komenda and Ferkel, 1999). The patient in this study presented with lateral ankle pain reproducible by passive plantarflexion and eversion, complaining of pain during exercise and playing sports...
February 2013: Manual Therapy
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