Foot & Ankle International
102 episodes - English - Latest episode: about 1 month ago - ★★★★ - 17 ratingsFoot & Ankle International (FAI), in publication since 1980, is the official journal of the American Orthopaedic Foot & Ankle Society (AOFAS). This monthly medical journal emphasizes surgical and medical management as it relates to the foot and ankle with a specific focus on reconstructive, trauma, and sports-related conditions utilizing the latest technological advances.
Homepage Apple Podcasts Google Podcasts Overcast Castro Pocket Casts RSS feed
Episodes
FAI March 2024 Podcast: Primary Ankle Fusion Using an Antegrade Nail Into the Talus for Early Treatment of OTA Type C3 Distal Tibial Plafond Fractures: A Preliminary Report
March 25, 2024 13:18 - 18 minutes - 11 MBType C3 distal tibial plafond fractures consistently show poor outcomes with high complication rates and significant risk of posttraumatic arthritis. We describe a minimally invasive technique of performing a primary ankle fusion using an anterograde tibial nail and compare our early results to traditional methods of fixation. In conclusion, C3 distal tibial plafond fractures are difficult to manage and there has not been a satisfactory method of treating them that allows early retur...
FAI February 2024 Podcast: Immediate Unprotected Weightbearing vs 2 Weeks Nonweightbearing After Open Reduction Internal Fixation of Ankle Fractures
February 16, 2024 16:54 - 11 minutes - 5.75 MBPostoperative care protocols for ankle fracture surgery remain controversial with variability among care providers. This prospective controlled trial compared 12-week postoperative outcomes for immediate unprotected weightbearing (IMWB) vs nonweightbearing (NWB) for 2 weeks in a splint followed by weightbearing as tolerated (WBAT) in a boot after surgical fixation of selected low-energy ankle fractures without superior articular involvement. In conclusion, in this short-term and relat...
FAI January 2024 Podcast: Outcomes After Proximal Medial Gastrocnemius Recession and Stretching vs Stretching as Treatment of Chronic Plantar Fasciitis at 6-Year Follow-up
January 31, 2024 20:27 - 13 minutes - 9.03 MBEvidence from prospective short-term studies suggest that proximal medial gastrocnemius recession is a safe and efficient procedure to treat chronic plantar fasciitis resistant to nonoperative treatment. The aim of this study was to evaluate the long-term clinical outcomes of proximal medial gastrocnemius recession and stretching compared to a stretching exercise protocol for patients with chronic plantar fasciitis and an isolated gastrocnemius contracture (IGC). In conclusion, this ...
FAI December 2023 Podcast: Outcomes After Hallux Interphalangeal Joint Arthrodesis
December 13, 2023 17:07 - 16 minutes - 11.4 MBHallux interphalangeal joint arthrodesis (HIPJA) is indicated for a variety of pathologies. Despite high nonunion rates, techniques remain unchanged. The aim of this study is to examine nonunion and complication rates and describe risk factors for treatment failure. In conclusion, our cohort represents the largest single-center series of HIPJA procedures published to date. We found relatively high nonunion and reoperation rates with standard current techniques. Click here to re...
FAI November 2023 Podcast: Outcomes of Total Ankle Arthroplasty in Postfracture Ankle Arthritis
November 27, 2023 15:38 - 11 minutes - 7.68 MBAnkle arthritis that develops after fracture accounts for a significant portion of ankle arthritis necessitating total ankle arthroplasty (TAA). It remains unknown whether TAA in postfracture patients produces equivalent outcomes to those without fracture history. The purpose of this study was to evaluate the medium-term outcomes of TAA in postfracture ankle arthritis compared to those without fracture history. In conclusion, in this single-center, retrospective comparative study, we...
FAI October 2023 Podcast: Adverse Events After Ankle Fracture Open Reduction Internal Fixation Among Patients With and Without Documented Cannabis and Tobacco Use
October 19, 2023 17:41 - 13 minutes - 7.46 MBAnkle fractures are common orthopaedic injuries that may be indicated for open reduction internal fixation (ORIF). Although the negative impact of tobacco use on perioperative outcomes of ankle fracture ORIF has been described, the potential impact of cannabis use on related outcomes is not as well established. In conclusion, patients with tobacco use (alone or with cannabis) were at greater odds of 90-day adverse events following ankle fracture ORIF, but cannabis only users were not...
FAI September 2023 Podcast: The Fate of Delayed Unions After Isolated Ankle Fusion
September 14, 2023 14:25 - 17 minutes - 6.69 MBNonunion remains the most common major complication of ankle arthrodesis. Although previous studies have reported delayed union or nonunion rates, few have elaborated on the clinical course of patients experiencing delayed union. In this retrospective cohort study, we sought to understand the trajectory of patients with delayed union by determining the rate of clinical success and failure and whether the extent of fusion on computed tomography scan (CT) was associated with outcomes. ...
FAI August 2023 Podcast: Broström Repair With and Without Augmentation: Comparison of Outcomes at Median Follow-up of 5 Years
August 10, 2023 15:16 - 12 minutes - 9.76 MBAn augmented Broström repair with nonabsorbable suture tape has demonstrated strength and stiffness more similar to the native anterior talofibular ligament (ATFL) compared to Broström repair alone at the time of repair in cadaveric models for the treatment of lateral ankle instability. The study purpose was to compare minimum 2-year patient-reported outcomes (PROs) following treatment of ATFL injuries with Broström repair with vs without suture tape augmentation. In conclusion, at m...
FAI July 2023 Podcast: Association of Preexisting Triple Fusion and Arthroscopic Ankle Arthrodesis nonunion
July 13, 2023 19:08 - 19 minutes - 7.93 MBArthroscopic ankle arthrodesis (AAA) is a successful treatment for end-stage ankle arthritis. A significant early complication of AAA is symptomatic nonunion. Published nonunion rates range from 8% to 13%. Longer term, there is concern that it predisposes to subtalar joint (STJ) fusion. To better understand these risks, we undertook a retrospective investigation of primary AAA. In conclusion, as the largest study of AAA in the literature, our findings suggest prior triple fusion is a...
FAI June 2023 Podcast: Does Patient-Reported Outcome Measures Use at New Foot and Ankle Patient Clinic Visits Improve Patient Activation, Experience, and Satisfaction?
June 05, 2023 16:47 - 14 minutes - 8.65 MBPatient-reported outcome measures (PROMs) can help predict clinical outcomes and improve shared clinical decision-making discussions. There remains a paucity of research assessing how the use of PROMs may drive improved patient experience and patient activation. In conclusion, highly rated foot and ankle surgeons who show and discuss PROM results may not improve patient experience or activation and may, in fact, decrease understanding or patient activation in select populations. Future...
FAI May 2023 Podcast: Risks Associated With Posterior Ankle Hindfoot Arthroscopy Complications
May 16, 2023 14:20 - 18 minutes - 11.8 MBThe use of posterior ankle and hindfoot arthroscopy (PAHA) has been expanding over time. Many new indications have been reported in the literature. The primary objective of this study was to report the rate of PAHA complication in a large cohort of patients and describe their potential associations with demographical and surgical variables. In conclusion, the complication rate in this cohort that was treated with posterior ankle and/or hindfoot arthroscopy was 6.8%. Most complications ...
FAI April 2023 Podcast: Outcomes of Salvage Procedures for Failed Total Ankle Arthroplasty
April 11, 2023 13:39 - 14 minutes - 9.6 MBThe number of total ankle arthroplasty (TAA) procedures increased rapidly in the last years and so have its complications. The main pillars in treating failed TAA are revision total ankle arthroplasty (RTAA), revision total ankle arthrodesis (RAA), or revision tibiotalocalcaneal fusion (RTTC). To evaluate these options, we compared clinical, radiologic, and patient-reported outcomes. In conclusion, this retrospective study suggests lower failure rates, increased short-term survival and ...
FAI March 2023 Podcast: Patient Satisfaction and Pain Relief After Deep Peroneal Nerve Neurectomy for Midfoot Arthritis: A Preliminary Short Report
March 13, 2023 13:09 - 20 minutes - 11 MBThe deep peroneal nerve (DPN) plays a role in afferent nociceptive dorsal midfoot joint pain perception. DPN neurectomy for treatment of symptomatic dorsal midfoot osteoarthritis allows early mobilization and weightbearing. The purpose of our study was to evaluate the patient satisfaction and pain relief after DPN neurectomy for treatment of chronic dorsal midfoot pain due to osteoarthritis. In conclusion, in this cohort, DPN neurectomy appeared to be a reasonable surgical alternative t...
FAI January 2023 Podcast: Early-Term Results of the Cadence Total Ankle Prosthesis: An European Noninventor Study
January 13, 2023 16:26 - 19 minutes - 13 MBAlthough considerable literature can be found on the outcome of total ankle replacement (TAR), only a few studies have reported the results of the fixed-bearing Cadence prosthesis. This noninventor study reports a consecutive series of 60 Cadence TAR systems with a mean of 2.9 years’ follow-up, focusing on clinical and radiographic outcomes and early complications. This study is the first to assess true postoperative radiographic ankle prosthesis range of motion (ROM) and to report an unanti...
FAI December 2022 Podcast: Minimum 5-Year Follow-up Results: CROSSBAT (Combined Randomised and Observational Study of Surgery vs No Surgery for Type B Ankle Fracture Treatment)
December 19, 2022 16:39 - 15 minutes - 8.11 MBIsolated Weber B, AO (Association for the Study of Internal Fixation) type 44B ankle fractures with no fracture to the medial side are the most common type of ankle fracture and may be treated with internal fixation or without surgery. This study aimed to determine if surgery is superior to nonsurgical management for the treatment of these fractures after a minimum 5-year follow-up. In conclusion, the results of this study suggest that in terms of patient-reported outcomes, surgic...
FAI November 2022 Podcast: Compensation of Dynamic Fixation Systems in the Quality of Reduction of Distal Tibiofibular Joint in Acute Syndesmotic Complex Injuries: A CT-Based Analysis
September 28, 2022 18:24 - 17 minutes - 12.4 MBThere is an ongoing discussion on how to best stabilize syndesmotic injuries. Previous studies have indicated a better quality of reduction of the distal tibiofibular joint (DTFJ) for the suture button systems compared to syndesmotic screw fixation. Still, the reason for this superiority remains unclear. The aims of this retrospective study were to (1) analyze the deviation of the tibial and fibular drilling tunnels of the suture button system and (2) to compare these to the quality of reduc...
FAI October 2022 Podcast: Significant Factors of High Performance Outcomes for Tibial Plafond Fractures
September 28, 2022 18:15 - 11 minutes - 7.97 MBLimited research exists about high performance postsurgical tibial plafond fractures. This study aimed to identify aspects of the plafond fracture injury and care associated with “high performance” based on Patient Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) scores. In conclusion, significant independent factors associated with high performance after tibial plafond fracture are lower BMI, closed fracture, and OTA/AO 43-B (partial articular) fracture....
FAI September 2022 Podcast: Augmenting Osteochondral Autograft Transplantation and Bone Marrow Aspirate Concentrate with Particulate Cartilage Extracellular Matrix Is Associated With Improved Outcomes
September 12, 2022 14:18 - 18 minutes - 12.1 MBOsteochondral autograft transplant (OAT) is often used to treat large osteochondral lesions of the talus and is generally associated with good outcomes. The addition of adjuncts such as cartilage extracellular matrix with bone marrow aspirate concentrate (ECM-BMAC) may further improve the OAT procedure but have not been thoroughly studied. We hypothesized that the placement of ECM-BMAC around the OAT graft would improve radiographic and patient-reported outcomes following OAT. In conclusio...
FAI August 2022 Podcast: Treatment of Infected Nonunions With Bone Defects Using Autologous Bone Graft and Absorbable Antibiotic-Loaded Calcium Sulfate–Hydroxyapatite Paste
August 05, 2022 15:05 - 17 minutes - 12.1 MBRevision surgery in the presence of infection carries high risks. We describe our results using a new technique to treat these challenging problems. We treated infected nonunions with cavitary voids with adjuvant antibiotic loaded calcium sulfate–hydroxyapatite paste composite and autologous bone graft (ABG) layer technique coupled with stable fixation. In conclusion, layered autologous bone grafting with adjuvant antibiotic-loaded calcium sulfate–hydroxyapatite paste has been shown to be ...
FAI July 2022 Podcast: Avoiding Fifth Metatarsal Intramedullary Screw Head Cuboid Impingement: A Weightbearing Computed Tomography Anatomic Study
July 05, 2022 23:03 - 10 minutes - 5.31 MBMultiple case reports of fifth metatarsal (MT) intramedullary fixation highlight symptomatic hardware with screw head impingement on the cuboid. We developed a fifth MT intramedullary screw trajectory model using weightbearing computed tomography data. The goal was to assess for cuboid impingement with simulated intramedullary screw position. In conclusion, the ideal guidewire placement for fifth MT intramedullary fixation is directly against the cuboid. Approximately 95% of patients would...
FAI June 2022 Podcast: Patient-Specific Instrumentation vs Standard Referencing in Total Ankle Arthroplasty: A Comparison of the Radiologic Outcome
June 06, 2022 16:57 - 8 minutes - 4.48 MBExisting literature on the superiority of patient-specific instrumentation (PSI) in total ankle arthroplasty (TAA) over standard referencing (SR) is limited. Advantages presented include better implant alignment, shorter operating times, and increased accuracy of implant size prediction. The aim of this retrospective study was to analyze PSI in the hands of an experienced foot and ankle surgeon new to both PSI and SR for this specific implant, in regard to determining implant alignment, oper...
FAI May 2022 Podcast: Fibula Nail Outcomes in Soft Tissue Compromised Ankle Fractures
May 09, 2022 17:00 - 18 minutes - 12.8 MBThe background of this study was to determine the clinical outcomes following fibula nail fixation and to identify the indication for the use of fibula nails in lower limb fractures. In conclusion, this multicenter study demonstrates that use of a fibula nail appears to be a safe approach to treating patients who have a physiologically higher risk of surgery, poor skin condition, and a complex fracture pattern. To view the article click here.
FAI April 2022 Podcast: Average 4-Year Outcomes of Distal Oblique First Metatarsal Osteotomy for Stage 1 to 3 Hallux Rigidus
April 11, 2022 16:35 - 13 minutes - 9.04 MBHallux rigidus is the second most frequent pathology of the first ray. Surgical options for degenerative metatarsophalangeal joint disease are either joint destructive or conservative procedures. The hypothesis was that oblique distal shortening osteotomy of the first metatarsal is an effective conservative technique for the management of stage 1 to 3 hallux rigidus. In conclusion, oblique distal osteotomy of the first metatarsal for stage 1-3 hallux rigidus, often in combination with othe...
FAI March 2022 Podcast: Association of First Metatarsal Pronation Correction With Patient-Reported Outcomes and Recurrence Rates in Hallux Valgus
March 04, 2022 16:57 - 15 minutes - 11.1 MBThe purpose of this study was to determine if a postoperative decrease in first metatarsal pronation on 3-dimensional imaging was associated with changes in patient-reported outcomes as measured by the Patient-Reported Outcomes Measurement Information System (PROMIS) physical function, pain interference, and pain intensity domains or recurrence rates in patients with hallux valgus (HV) who undergo a first tarsometatarsal fusion (modified Lapidus procedure). In conclusion, detailed review o...
FAI February 2022 Podcast: Minimally Invasive Distal Metatarsal Metaphyseal Osteotomy of the Lesser Toes: Clinical, Radiologic, and Pedobarographic Outcomes
February 14, 2022 16:42 - 12 minutes - 7.72 MBThe minimally invasive distal metatarsal metaphyseal osteotomy (DMMO) is a percutaneous operative technique with the aim to relieve the symptoms of metatarsalgia. To our knowledge, no previous research has analyzed both pre- and postoperative pedobarographic data including the changes in plantar pressure. In conclusion, the results demonstrate a significant improvement in clinical scores and PPP. A statistically significant relation between metatarsal length and the prevalence of metatarsa...
FAI January 2022 Podcast: Outcomes of Tibialis Anterior Tendon Reconstruction with Autograft or Allograft
January 14, 2022 16:25 - 9 minutes - 5.82 MBIn cases of tibialis anterior tendon (TAT) ruptures associated with significant tendon defect, an interposition graft is often needed for reconstruction. Both auto- and allograft reconstructions have been described in the literature. Our hypothesis was that both graft types would have a good integrity and provide comparable outcomes. In conclusion, reconstructions of TAT achieved good PROs, as well as functional and imaging results with a preserved graft integrity in all cases. There were ...
FAI December 2021 Podcast: Outcomes of 2B Adult Acquired Flatfoot Deformity Correction in Patients With and Without Spring Ligament Tear
November 29, 2021 18:13 - 20 minutes - 8.49 MBIt is currently unclear how injury to the spring ligament (SL) affects the preoperative presentation of adult acquired flatfoot deformity (AAFD) or the outcome of operative reconstruction. The purposes of this study were to assess the preoperative features and pre- or postoperative function of patients who underwent direct operative repair of an SL tear compared to those without a tear. In conclusion, increasing patient age, increasing talonavicular uncoverage percentage, and decreasing ta...
FAI November 2021 Podcast: Outcomes and Complications of Open vs Posterior Arthroscopic Subtalar Arthrodesis: A Prospective Randomized Controlled Multicenter Study
November 15, 2021 16:27 - 16 minutes - 10.8 MBOpen subtalar arthrodesis is the standard treatment for subtalar arthritis. Posterior arthroscopic subtalar arthrodesis (PASTA) has recently gained increasing popularity due to a shorter recovery time and better cosmesis. However, studies comparing outcomes and complications between these 2 techniques are limited. In conclusion, both open and PASTA techniques led to significant improvements in pain and function in patients with isolated subtalar joint arthritis. Although short-term functio...
FAI October 2021 Podcast: The Assessment of First Metatarsal Rotation in the Normal Adult Population Using Weightbearing Computed Tomography
September 21, 2021 23:23 - 20 minutes - 13.3 MBThe importance of the rotational profile of the first metatarsal is increasingly recognized in the surgical planning of hallux valgus. However, rotation in the normal population has only been measured in small series. We aimed to identify the normal range of first metatarsal rotation in a large series using weightbearing computed tomography (WBCT). In conclusion, metatarsal rotation is variable in normal feet. Normal MPA can be defined as less than 16 degrees, and normal α angle can be def...
FAI September 2021 Podcast: Weightbearing Radiographs Reliably Predict Normal Ankle Congruence in Weber B/SER2 and 4a Fractures: A Prospective Case-Control Study
August 26, 2021 18:30 - 28 minutes - 14.8 MBIn Weber B/SER2-4 ankle fractures, assessment with weightbearing radiographs to ascertain stability of the ankle mortise has been advised. However, no previous studies report whether this method leads to preservation of normal ankle congruence. The purpose is to evaluate equivalence of ankle congruence of injured ankles after fracture union, vs the uninjured side, for stable SER2 and partially unstable SER4a fracture types. In conclusion, assessment of stability of Weber B SER2/4a ankle fr...
FAI August 2021: Allograft Interposition Bone Graft for First Metatarsal Phalangeal Arthrodesis: Salvage After Bone Loss and Shortening of the First Ray
July 21, 2021 18:24 - 22 minutes - 10.5 MBPrevious studies have demonstrated success in using autogenous bone graft for arthrodesis in patients with failed surgeries of the hallux. These patients have several causes for pain and dysfunction preoperatively, including a shortened first ray, nonunion, and poor hallux alignment. In conclusion, the use of an interposition patellar wedge allograft can restore length to the first ray and provide successful salvage of arthrodesis nonunions and bone loss from failed hemiarthroplasty and to...
FAI July 2021: Femoral Head Allografts for Talar Body Defects
June 23, 2021 17:31 - 15 minutes - 6.8 MBLarge structural bone deficits after a failed ankle arthroplasty or avascular necrosis (AVN) of the talus present a complex reconstruction challenge. The aim of this study was to report the results of patients undergoing an ankle arthrodesis or tibiotalocalcaneal fusion using a femoral head allograft (FHA). In conclusion, the use of FHA to treat talar defects was a viable option. In this complex patient population, the arthrodesis rate was high at 89% with very positive patient-reported ou...
FAI June 2021: Outcomes and Surgical Strategies of Minimally Invasive Chevron/Akin Procedures
May 18, 2021 20:20 - 24 minutes - 10.7 MBMinimally invasive surgery (MIS) is increasingly being used for bunion correction, but limited patient outcome data have been reported for third-generation minimally invasive chevron/Akin (MICA) techniques. The aim of this study was to report on radiographic outcomes, pain control, satisfaction, learning curve, and complication rates in a consecutive series of 94 patients undergoing MICA procedures for hallux valgus. It also describes strategies for avoiding perioperative complications that ...
FAI May 2021: Long-term Functional Results of Total Ankle Arthroplasty in Stiff Ankles
April 23, 2021 17:12 - 19 minutes - 8.9 MBTotal ankle arthroplasty (TAA) is advocated over ankle arthrodesis to preserve ankle motion (ROM). Clinical and gait analysis studies have shown significant improvement after TAA. The role and outcomes of TAA in stiff ankles, which have little motion to be preserved, has been the subject of limited investigation. This investigation evaluated the mid- to long-term functional outcomes of TAA in stiff ankles. In conclusion, preoperative ROM was predictive of overall postoperative gait functio...
FAI April 2021: Traditional Approach vs Posterior Approach for Ankle Fractures Involving the Posterior Malleolus
March 19, 2021 00:03 - 13 minutes - 7.96 MBIn the past, posterior malleolus fragments (PMFs) commonly have been indirectly reduced and fixed when fragments involve 25% or more of the tibial articular surface, while smaller fragments were left unfixed. The posterior approach has become increasingly popular and allows fixation of even smaller fragments. This study compares clinical outcome for the 2 treatment strategies. In conclusion, comparison of treatment strategies for ankle fractures involving the posterior malleolus showed sim...
FAI March 2021: Correlating Arthroscopic and Radiographic Findings of Deep Deltoid Ligament Injuries in Rotational Ankle Fractures
February 22, 2021 17:03 - 17 minutes - 8.72 MBThe deep deltoid ligament (DDL) is a key stabilizer to the medial ankle and ankle mortise and can be disrupted in ligamentous supination external rotation type IV (LSER4) ankle fractures. The purpose of this study was to define the medial clear space (MCS) measurement on injury mortise radiographs that corresponds with complete DDL injury. In conclusion, complete DDL injury was found on injury ankle mortise radiographs as MCS widening of ≥5.5 mm, which correlated with arthroscopic visualiz...
FAI February 2021: Risk Factors for Complications Associated with Minimally Invasive Medial Displacement Calcaneal Osteotomy
January 19, 2021 21:12 - 17 minutes - 9.09 MBFew studies have reported the outcomes following minimally invasive medial displacement calcaneal osteotomy (MDCO) for correction of pes planovalgus deformities. In conclusion, patients with higher ASA classification, current tobacco use, and higher BMI were at higher risk for osteotomy healing complications after minimally invasive MDCO procedures. Patients were also more likely to develop nerve complications with more extensive surgical procedures. To view the article click here.
FAI January 2021: Application of Computerized Adaptive Testing to the Foot and Ankle Ability Measure
December 29, 2020 20:07 - 10 minutes - 4.71 MBPatient-reported outcome measures are an increasingly important tool for assessing the impact of treatments orthopedic surgeons render. Despite their importance, they can present a burden. We examined the validity and utility of a computerized adaptive testing (CAT) method to reduce the number of questions on the Foot and Ankle Ability Measure (FAAM), a validated anatomy-specific outcome measure. In conclusion, the FAAM CAT was able to reduce the number of responses a patient would need to...
FAI December 2020: Effect of Metformin on Development of Tendinopathy Due to Mechanical Overloading in an Animal Model
November 12, 2020 21:33 - 14 minutes - 6.5 MBTendinopathy is a debilitating tendon disorder that affects millions of Americans and costs billions of health care dollars every year. High mobility group box 1 (HMGB1), a known tissue damage signaling molecule, has been identified as a mediator in the development of tendinopathy due to mechanical overloading of tendons in mice. Metformin (Met), a drug approved by the Food and Drug Administration used for the treatment of type 2 diabetes, specifically inhibits HMGB1. This study tested the h...
FAI November 2020: Rate of Delayed Union With Early Weightbearing Following Intramedullary Screw Fixation of Jones Fractures
October 26, 2020 23:08 - 13 minutes - 6.22 MBJones fractures of the proximal fifth metatarsal are predisposed to delayed union and nonunion due to a tenuous blood supply. Solid intramedullary (IM) screw fixation is recommended to improve healing, traditionally followed by delayed weightbearing (DWB). However, early weightbearing (EWB) postoperatively may facilitate functional recovery. The purpose of this study was to compare union rates and time to union after solid IM screw fixation of Jones fractures in patients treated with an EWB ...
FAI October 2020: Comparison of Patients’ and Surgeons’ Expectations in Foot and Ankle Surgery
September 15, 2020 21:42 - 12 minutes - 5.42 MBAligning patient and surgeon expectations may improve patient satisfaction and outcomes. This study aimed to assess differences in expectations of foot and ankle surgery between patients and their surgeons. In conclusion, more than two-thirds of patients had significantly higher expectations than their surgeons. Higher BMI was associated with higher patient than surgeon expectations. These results emphasize the importance for foot and ankle surgeons to adequately educate patients preoperat...
FAI September 2020: Comparison Between Polyvinyl Alcohol Implant and Cheilectomy With Moberg Osteotomy for Hallux Rigidus
August 19, 2020 20:23 - 14 minutes - 6.57 MBIn 2016, the US Food and Drug Administration (FDA) approved the use of a polyvinyl alcohol (PVA) hydrogel implant for the surgical management of hallux rigidus. Though recent studies have evaluated the safety and efficacy of the implant, no study has compared outcomes following PVA implantation with those following traditional joint-preserving procedures for hallux rigidus, such as cheilectomy with Moberg osteotomy. The purpose of this study was to compare clinical and patient-reported outco...
FAI August 2020: Patient Characteristics of Possible Responders and Nonresponders to Total Ankle Arthroplasty
July 17, 2020 22:14 - 10 minutes - 5.21 MBCharacteristics of responders, or those who achieve a clinical improvement above the level of a minimal clinically important difference, have not been defined for total ankle arthroplasty (TAA). The purpose of this study was to determine patient characteristics that distinguish possible responders from possible nonresponders after TAA using criteria established for other arthroplasty surgeries. In conclusion, our data reveal that a higher baseline SF-36 MCS score was associated with increa...
FAI July 2020: Comparison of 5-Year Patient-Reported Outcomes (PROMs) of Total Ankle Replacement (TAR) to Total Knee Replacement (TKR) and Total Hip Replacement (THR)
June 23, 2020 00:02 - 10 minutes - 4.97 MBTotal ankle replacement (TAR) is becoming a more common alternative to ankle arthrodesis for the improvement of pain and function in end-stage arthritis of the ankle. The effects of end-stage arthritis of the ankle are similar to those of end-stage hip arthritis. There is a paucity of literature on patient-reported outcome measures (PROMs) following TARs in comparison with total hip replacement (THR) or total knee replacement (TKR). We aimed to study the 1-, 3-, and 5-year outcomes of TAR in...
FAI June 2020: Effect of Microfracture on Functional Outcomes and Subchondral Sclerosis Following Distraction Arthroplasty of the Ankle Joint
May 18, 2020 20:36 - 14 minutes - 6.63 MBTreatment for post-traumatic osteoarthritis (PTOA) of the ankle remains challenging. Distraction arthroplasty (DA) is an alternative for patients who are averse to or poor candidates for arthrodesis or joint replacement. The purpose of this study was to examine the role of microfracture (MFX) and concentrated bone marrow aspirate (CBMA) on the outcome of patients undergoing DA for end-stage PTOA of the ankle joint. The current study showed no benefit from MFX when combined with DA in the t...
FAI May 2020: Mobility Limitation After Surgery for Degenerative Pathology of the Ankle, Hindfoot, and Midfoot vs Total Hip Arthroplasty
April 16, 2020 16:22 - 11 minutes - 10.6 MBSurgery for degenerative foot and ankle conditions often results in a lengthy recovery. Current outcome measures do not accurately assess postoperative mobility, especially in older patients. The Life-Space Assessment (LSA), a questionnaire quantifying patients’ mobility after a medical event, was used in this study to assess perioperative mobility in total hip arthroplasty (THA) and foot and ankle surgery patients. We hypothesized that patients undergoing elective foot and ankle surgery wou...
FAI April 2020: Return to Weightbearing and High-Impact Activities Following Jones Fracture Intramedullary Screw Fixation
March 18, 2020 23:40 - 14 minutes - 12.9 MBAlthough the benefit of primary intramedullary (IM) screw fixation of fifth metatarsal Jones fractures in athletes is clear, limited data support its use in conventional patient populations. This study evaluated radiographic and functional outcomes following primary IM screw fixation in a series of Jones fractures to determine if similar excellent outcomes were achievable. Primary IM screw fixation was a safe, reliable option for all appropriate operative candidates with Jones fractures an...
FAI March 2020: Relationship of Preoperative Patient-Reported Outcome Measures (PROMs) to Postoperative Success in End-Stage Ankle Arthritis
February 19, 2020 18:16 - 16 minutes - 15.2 MBAnkle osteoarthritis is a significant cause of pain and disability. Despite the effectiveness of treatments, a subset of patients remains with persistent pain and functional limitations. The purpose of this study was to use preoperative patient-reported outcome measures to predict which ankle osteoarthritis patients would be most likely to experience postoperative improvements in functional outcomes. Preoperative patient-reported outcomes measures could predict postoperative improvement in...
FAI February 2020: Effect of the Modified Lapidus Procedure on Pronation of the First Ray in Hallux Valgus
January 21, 2020 18:42 - 13 minutes - 12.4 MBHallux valgus (HV) is a triplanar deformity of the first ray including pronation of the first metatarsal with subluxation of the sesamoids. The purpose of this study was to investigate if a first tarsometatarsal fusion (modified Lapidus technique), without preoperative knowledge of pronation measured on weightbearing computed tomographic (CT) scans, changed pronation of the first metatarsal and determine if reduction of the sesamoids was correlated with changes in first metatarsal pronation....
FAI January 2020: 3D, Weightbearing Topographical Study of Periprosthetic Cysts and Alignment in Total Ankle Replacement
December 17, 2019 01:35 - 9 minutes - 8.58 MBWe investigated the association between hindfoot residual malalignment assessed on weightbearing computed tomography (WBCT) images and the development of periprosthetic cysts (PPCs) after total ankle replacement (TAR). We hypothesized that PPCs would be found predominantly medially in the varus configuration and laterally in the valgus configuration. In this series, the PPC volume after primary TAR significantly correlated with postoperative hindfoot malalignment and longer follow-up. ...