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Long-term Functional Results of Total Ankle Arthroplasty in Stiff Ankles
James W. Brodsky, MD1, David Jaffe, MD2, Andrew Pao, MD3, David Vier, MD1, Akira Taniguchi, MD, PhD4, Yahya Daoud, PhD1, Scott Coleman, MS, MBA1, Daniel J. Scott, MD, MBA5
doi : 10.1177/1071100720977847
Volume: 42 issue: 5, page(s): 527-535
Total 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.
Effect of Mini-invasive Floating Metatarsal Osteotomy on Plantar Pressure in Patients With Diabetic Plantar Metatarsal Head Ulcers
Eran Tamir, MD1, 2, 3, Michael Tamar, MD1, Moshe Ayalon, PhD4, Shlomit Koren, MD3, 5, Noam Shohat, MD1, 5, Aharon S. Finestone, MD, MHA1, 2, 3
doi : 10.1177/1071100720976099
Volume: 42 issue: 5, page(s): 536-543
Distal metatarsal osteotomy has been used to alleviate plantar pressure caused by anatomic deformities. This study’s purpose was to examine the effect of minimally invasive floating metatarsal osteotomy on plantar pressure in patients with diabetic metatarsal head ulcers.
Ultrasonography-Guided Minimally Invasive Surgery for Achilles Sleeve Avulsions
Chi-Yuan Liu, MD1, Tsung-Chiao Wu, MD1, Kai-Chiang Yang, PhD2, Yi-Chen Li, MD1, Chen-Chie Wang, MD, PhD1, 3
doi : 10.1177/1071100720975717
Volume: 42 issue: 5, page(s): 544-553
Achilles sleeve avulsion, a relatively rare disorder, is characterized by sleeve-shaped injury extending from the calcaneus, located near the tendon insertion site. Unlike midsubstance tears of the Achilles tendon, end-to-end repair is difficult because less soft tissue is preserved distally. Open repair with transosseous sutures or suture anchors is currently favored. The purpose of this study was to evaluate the technical feasibility and functional outcomes of ultrasonography-guided Achilles sleeve avulsion repair.
Traditional Modified Brostr?m vs Suture Tape Ligament Augmentation
Robert Kulwin, MD1, Troy S. Watson, MD2, Ryan Rigby, DPM, FACFAS3, J. Chris Coetzee, MD4, Anand Vora, MD1
doi : 10.1177/1071100720976071
Volume: 42 issue: 5, page(s): 554-561
The modified Brostr?m (MB) procedure has long been the mainstay for the treatment of chronic lateral ankle instability (CLAI). Recently, suture tape (ST) has emerged as augmentation for this repair. The clinical benefit of such augmentation has yet to be fully established. The purpose of this study was to determine if ST augmentation provides an advantage over the traditional MB.
Surgical Outcomes and Predictive Factors of Medial Toe Excision for Polysyndactyly of the Fifth Toe
Kyung Rae Ko, MD1, Jong Sup Shim, MD, PhD1, Jiwon Kang, MD1, Jaesung Park, MD1
doi : 10.1177/1071100720971289
Volume: 42 issue: 5, page(s): 562-569
We aimed to report surgical outcomes and analyze prognostic factors of medial toe excision for polysyndactyly of the fifth toe.
Local Ketorolac Injection vs Popliteal Sciatic Nerve Blockade as an Adjuvant to a Spinal Block in Hindfoot Arthrodesis
Bavornrit Chuckpaiwong, MD1, 2, Thos Harnroongroj, MD1, Busara Sirivanasandha, MD3, Theerawoot Tharmviboonsri, MD1
doi : 10.1177/1071100720972666
Volume: 42 issue: 5, page(s): 570-574
Popliteal nerve blocks reduce pain and markedly improve postoperative outcomes during foot and ankle surgery; however, several potential complications may arise from nerve block procedures. The purpose of this study was to investigate local infiltration analgesia with ketorolac as a convenient alternative for pain relief.
Comparison of Preoperative Bone Density in Patients With and Without Periprosthetic Osteolysis Following Total Ankle Arthroplasty
Gun-Woo Lee, MD, PhD1, Hyoung-Yeon Seo, MD, PhD1, Dong-Min Jung, MD1, Keun-Bae Lee, MD, PhD1
doi : 10.1177/1071100720976096
Volume: 42 issue: 5, page(s): 575-581
Modern total ankle arthroplasty (TAA) prostheses are uncemented press-fit designs whose stability is dependent on bone ingrowth. Preoperative insufficient bone density reduces initial local stability at the bone-implant interface, and we hypothesized that this may play a role in periprosthetic osteolysis. We aimed to investigate the preoperative bone density of the distal tibia and talus and compare these in patients with and without osteolysis.
Nonunion Rates in Hind- and Midfoot Arthrodesis in Current, Ex-, and Nonsmokers
Jack Allport, MBChB, BMedSci1, Jayasree Ramaskandhan, MSc, MPTh1, Malik S. Siddique, MD, MBBS, FRCS, MCh1
doi : 10.1177/1071100720971269
Volume: 42 issue: 5, page(s): 582-588
Nonunion rates in hind or midfoot arthrodesis have been reported as high as 41%. The most notable and readily modifiable risk factor that has been identified is smoking. In 2018, 14.4% of the UK population were active smokers. We examined the effect of smoking status on union rates for a large cohort of patients undergoing hind- or midfoot arthrodesis.
Comparison of Clinical Outcomes After Total Ankle Arthroplasty Between End-Stage Osteoarthritis and Rheumatoid Arthritis
Byung-Ki Cho, MD1, 2, Min-Yong An, MD2, Byung-Hyun Ahn, MD2
doi : 10.1177/1071100720979923
Volume: 42 issue: 5, page(s): 589-597
Total ankle arthroplasty (TAA) is known to be a reliable operative option for end-stage rheumatoid arthritis. However, higher risk of postoperative complications related to chronic inflammation and immunosuppressive treatment is still a concern. With the use of a newer prosthesis and modification of anti-rheumatic medications, we compared clinical outcomes after TAA between patients with osteoarthritis and rheumatoid arthritis.
Suture Button vs Conventional Screw Fixation for Isolated Lisfranc Ligament Injuries
Jaeho Cho, MD1, Jahyung Kim, MD2, Tae-Hong Min, MD2, Dong-Il Chun, MD2, Sung Hun Won, MD2, Suyeon Park, MS3, Young Yi, MD, PhD4
doi : 10.1177/1071100720976074
Volume: 42 issue: 5, page(s): 598-608
Suture buttons have been used for isolated Lisfranc ligament (ILL) fixation. However, no study has reported on its clinical and radiologic outcomes.
Functional Outcomes of Talectomy in Pediatric Feet
Omar A. Al-Mohrej, MD (Hons)1, Abdullah Y. Almarshad, MD1, Thamer S. Alhussainan, MD1
doi : 10.1177/1071100720983779
Volume: 42 issue: 5, page(s): 609-615
Historically, talectomy has been predominantly performed to operatively treat severely rigid equinovarus feet. A limited number of investigators have studied functional outcomes in pediatric patients posttalectomy. We aimed to assess the outcomes of pediatric patients undergoing talectomy using the American Orthopaedic Foot & Ankle Society (AOFAS) score and a subjective survey of patients’ and their caregivers’ satisfaction.
Comparison of Mechanical Axis of the Limb Versus Anatomical Axis of the Tibia for Assessment of Tibiotalar Alignment in End-Stage Ankle Arthritis
Alessio Bernasconi, MD, PhD, FEBOT1, 2, Ali-Asgar Najefi, FRCS(Tr&Orth)3, Andrew J. Goldberg, MD, FRCS(Tr&Orth)4, 5, 6
doi : 10.1177/1071100720972664
Volume: 42 issue: 5, page(s): 616-623
Coronal plane ankle joint alignment is typically assessed using the tibiotalar angle (TTA), which relies on the anatomical axis of the tibia (AAT) and the articular surface of the talus as landmarks. Often, the AAT differs from the mechanical axis of the lower limb (MAL). We set out to test our hypothesis that the TTA using the MAL would differ from the TTA measured using the AAT in patients with ankle osteoarthritis.
Effect of Patient Demographics on Minimally Important Difference of Ankle Osteoarthritis Scale Among End-Stage Ankle Arthritis Patients
Jason M. Sutherland, PhD1, Carmela Melina Albanese, BSc1, Kevin Wing, MD2, Yixiang Jenny Zhang, BSc1, Alastair Younger, MD2, Andrea Veljkovic, MD2, Murray Penner, MD2
doi : 10.1177/1071100720977842
Volume: 42 issue: 5, page(s): 624-632
Ankle replacement and ankle arthrodesis are standard treatments for treating end-stage ankle arthritis when conservative treatment fails. Comparing patient-reported outcome scores to the instrument’s minimal important difference (MID) helps physicians and researchers infer whether a meaningful change in health from the patient’s perspective has occurred following treatment. The objective of this study was to estimate the MID of the Ankle Osteoarthritis Scale among a cohort of operatively treated end-stage ankle arthritis patients undergoing ankle replacement or arthrodesis.
Intermediate-term Patient-Reported Outcomes and Radiographic Evaluation Following Intramedullary- vs Extramedullary-Referenced Total Ankle Replacement
Craig C. Akoh, MD1, Rishin Kadakia, MD2, Amanda Fletcher, MD3, Young Uk Park, MD4, Hyongnyun Kim, MD5, James A. Nunley, MD3, Mark E. Easley, MD6
doi : 10.1177/1071100720980024
Volume: 42 issue: 5, page(s): 633-645
The purpose of this study was to report on the radiographic outcomes, clinical outcomes, and implant survivorship following extramedullary-referenced (EMr) vs intramedullary-referenced (IMr) total ankle replacement (TAR).
Correlation of Patient-Reported Outcomes With Physical Function After Total Ankle Arthroplasty
Daniel J. Scott, MD, MBA1, Justin Kane, MD2, 3, Samuel Ford, MD1, Yahya Daoud, PhD1, James W. Brodsky, MD1
doi : 10.1177/1071100720978428
Volume: 42 issue: 5, page(s): 646-653
Total ankle arthroplasty (TAA) is successful by both subjective patient-reported outcome measures (PROMs) and objective functional improvements of gait. Each is reproducible and valid, but they are entirely distinct methods. This study investigated the correlation between subjective and objective outcomes of TAA.
Return to Sport Following Operative Treatment of Displaced Medial Sesamoid Fractures in NCAA Division I Football Players
Eric W. Tan, MD1, Ioanna K. Bolia, MD, MS, PhD1, Alexander B. Peterson, MD1, Shane Korber, MD1, Russ Romano, ATC1, Alexander E. Weber, MD1, Seth C. Gamradt, MD1, David B. Thordarson, MD2
doi : 10.1177/1071100720978751
Volume: 42 issue: 5, page(s): 654-657
Level of Evidence: Level V.
Current Concepts Review: Common Peroneal Nerve Palsy After Knee Dislocations
Christopher J. Dy, MD, MPH1, Paul M. Inclan, MD1, Matthew J. Matava, MD1, Susan E. Mackinnon, MD1, Jeffrey E. Johnson, MD1
doi : 10.1177/1071100721995421
Volume: 42 issue: 5, page(s): 658-668
Dislocation of the native knee represents a challenging injury, further complicated by the high rate of concurrent injury to the common peroneal nerve (CPN). Initial management of this injury requires a thorough neurovascular examination, given the prevalence of popliteal artery injury and limb-threatening ischemia. Further management of a knee dislocation with associated CPN palsy requires coordinated care involving the sports surgeon for ligamentous knee reconstruction and the peripheral nerve surgeon for staged or concurrent peroneal nerve decompression and/or reconstruction. Finally, the foot and ankle surgeon is often required to manage a foot drop with a distal tendon transfer to restore foot dorsiflexion. For instance, the Bridle Procedure—a modification of the anterior transfer of the posterior tibialis muscle, under the extensor retinaculum, with tri-tendon anastomosis to the anterior tibial and peroneus longus tendons at the anterior ankle—can successfully return patients to brace-free ambulation and athletic function following CPN palsy. Cross-discipline coordination and collaboration is essential to ensure appropriate timing of operative interventions and ensure maintenance of passive dorsiflexion prior to tendon transfer.
Letter Regarding: Effectiveness of Extracorporeal Shockwave Therapy in the Treatment of Chronic Insertional Achilles Tendinopathy
Marwa Abdullah Amer, MD
doi : 10.1177/10711007211007760
Volume: 42 issue: 5, page(s): 669-670
Response to “Letter Regarding: Effectiveness of Extracorporeal Shockwave Therapy in the Treatment of Chronic Insertional Achilles Tendinopathy”
Siwadol Pinitkwamdee, MD, Sukij Laohajaroensombat, MD, Jakrapong Orapin, MD, Patarawan Woratanarat, MD, PhD
doi : 10.1177/10711007211007756
Volume: 42 issue: 5, page(s): 671-672
