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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 mm(2) 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...
November 16, 2016: 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
Rui-jian Yan, Xiao-wen Zhang, Gou-ping Ma, Qiao-feng Guo, Chun Zhang
OBJECTIVE: To explore the clinical results of arthroscopy-assisted open reduction and internal fixation for the treatment of acute Lauge-Hansen stage IV ankle fractures. METHODS: A prospective cohort of study was done in 42 patients of acute ankle fractures treated with arthroscopy-assisted open reduction and internal fixation from January 2008 to December 2009. According to Lauge-Hansen classification, there were 26 supination-eversion stage IV fractures, including 11 females and 15 males; with an average age of (36...
September 2011: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
S Patwardhan, A K Shyam, P Sancheti, P Arora, T Nagda, P Naik
Adult presentation of neglected congenital muscular torticollis is rare. We report 12 patients with this condition who underwent a modified Ferkel's release comprising a bipolar release of sternocleidomastoid with Z-lengthening. They had a mean age of 24 years (17 to 31) and were followed up for a minimum of two years. Post-operatively a cervical collar was applied for three weeks with intermittent supervised active assisted exercises for six weeks. Outcome was assessed using a modified Lee score and a Cheng and Tang score...
June 2011: Journal of Bone and Joint Surgery. British Volume
Richard D Ferkel, Max Tyorkin, Gregory R Applegate, Gregory T Heinen
BACKGROUND: The usefulness of magnetic resonance imaging (MRI) has been questioned in evaluating patients with chronic ankle sprain pain. The purpose of this study was to determine the effectiveness and reliability of routine MR imaging in the diagnosis of anterolateral soft tissue impingement. MATERIALS AND METHODS: Inclusion criteria required that the MR examinations be performed by the same musculoskeletal radiologist after the most recent scanner upgrade and using a dedicated ankle/hindfoot coil...
August 2010: Foot & Ankle International
Stephen J Snyder, Ronald P Karzel, Wilson Del Pizzo, Richard D Ferkel, Marc J Friedman
A specific pattern of injury to the superior labrum of the shoulder was identified arthroscopically in twenty-seven patients included in a retrospective review of more than 700 shoulder arthroscopies performed at our institution. The injury of the superior labrum begins posteriorly and extends anteriorly, stopping before or at the mid- glenoid notch and including the "anchor" of the biceps tendon to the labrum. We have labeled this injury a "SLAP lesion" (Superior Labrum Anterior and Posterior). There were 23 males and four females with an average age of 37...
August 2010: Arthroscopy: the Journal of Arthroscopic & related Surgery
Richard D Ferkel, Pierce E Scranton, James W Stone, Brian S Kern
When conservative treatment is unsuccessful, there are many surgical options to treat patients with symptomatic chronic osteochondral lesions of the talus. The chosen treatment depends on the patient's symptoms, clinical examination findings, preoperative imaging results, and whether prior surgery was unsuccessful. It is important to be aware of treatment alternatives such as marrow stimulation, osteochondral autograft or allograft plugs, autologous chondrocyte implantation, and newer techniques currently being investigated outside the United States...
2010: Instructional Course Lectures
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