Pub Date : 2026-01-16DOI: 10.1016/j.foot.2026.102224
Pawel Chomej , Kajetan Klos
Surgical treatment of hallux valgus can be very difficult when it occurs together with pes adductus. The medially displaced metatarsal bones prevent a sufficient shifting of the first metatarsal during hallux valgus correction. This can lead to inherently high reoccurrence rates. Open surgical corrections lead to a profound soft tissue trauma and prolonged swelling, while requiring relief from weight-bearing in the affected foot. In this paper, we aim to introduce a useful midshaft modification of the lateralising Distal Metatarsal Minimal-invasive Osteotomy (lat. DMMO) to perform an effective correction of a metatarsus adductus during hallux valgus surgery. 35 patients with a hallux valgus and simultaneous pes adductus deformity who were treated with MICA and a lateralising step-DMMO were followed-up. The radiological and clinical outcomes after a follow-up period of 24 months confirmed a sustained and effective correction of the pes adductus with a well-aligned hallux. We observed no relevant complications and a high level of patient satisfaction. An immediate pain-adapted, post-operative weight-bearing was possible.
{"title":"Lateralising step-DMMO (MIS) – a midshaft modification of the lateralising DMMO for a powerful correction of a pes adductus during surgical treatment of a hallux valgus","authors":"Pawel Chomej , Kajetan Klos","doi":"10.1016/j.foot.2026.102224","DOIUrl":"10.1016/j.foot.2026.102224","url":null,"abstract":"<div><div>Surgical treatment of hallux valgus can be very difficult when it occurs together with pes adductus. The medially displaced metatarsal bones prevent a sufficient shifting of the first metatarsal during hallux valgus correction. This can lead to inherently high reoccurrence rates. Open surgical corrections lead to a profound soft tissue trauma and prolonged swelling, while requiring relief from weight-bearing in the affected foot. In this paper, we aim to introduce a useful midshaft modification of the lateralising Distal Metatarsal Minimal-invasive Osteotomy (lat. DMMO) to perform an effective correction of a metatarsus adductus during hallux valgus surgery. 35 patients with a hallux valgus and simultaneous pes adductus deformity who were treated with MICA and a lateralising step-DMMO were followed-up. The radiological and clinical outcomes after a follow-up period of 24 months confirmed a sustained and effective correction of the pes adductus with a well-aligned hallux. We observed no relevant complications and a high level of patient satisfaction. An immediate pain-adapted, post-operative weight-bearing was possible.</div></div><div><h3>Level of Clinical Evidence</h3><div>3</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"66 ","pages":"Article 102224"},"PeriodicalIF":0.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.foot.2025.102223
Anna Lagergaard Larsen , Pia Skouby Larsen , Mie Engberg Nyvad , Sara Matilde Vassard , Ida Laurberg Andersen , Henrik Riel
Background
Plantar fasciopathy is a common condition described as a combination of degeneration and inflammation of the collagenous tissue. The diagnosis is typically based on medical history, local findings, and ultrasound to assess the thickness of the fascia, where a plantar fascia thickness of 4 mm or more confirms the diagnosis. However, other factors besides plantar fasciopathy may be associated with the thickness of the plantar fascia. This study aims to investigate which characteristics, including foot length, physical activity level, and primary physical activity, are associated with the thickness of the plantar fascia in individuals without a history of heel pain.
Methods
We conducted a cross-sectional study and used multiple linear regression to investigate the association between the thickness of the fascia examined with diagnostic ultrasound and the characteristics of the participants. The included characteristics were foot length, physical activity level, primary physical activity, body weight, height, BMI, age, and sex.
Results
201 participants were included in the study. Age and height were associated with plantar fascia thickness. With a one-year increase in age, the plantar fascia increases by 0.008 mm (P < 0.001), and for every cm increase in height, the thickness of the plantar fascia increases 0.011 mm (P = 0.003).
Conclusion
Age and height were significantly associated with plantar fascia thickness, but had small coefficients. Foot length, physical activity level, and primary physical activity were not associated with plantar fascia thickness. Level III of evidence, cross-sectional study.
背景：足底筋膜病是一种常见的情况，描述为变性和炎症的胶原组织的组合。诊断通常基于病史、局部表现和超声评估筋膜厚度，足底筋膜厚度≥4 mm可确诊。然而，除足底筋膜病外，其他因素可能与足底筋膜厚度有关。本研究旨在探讨无足跟疼痛史的个体的哪些特征（包括足长、体力活动水平和主要体力活动）与足底筋膜厚度相关。方法：采用横断面研究，采用多元线性回归分析诊断超声检查的筋膜厚度与受试者特征之间的关系。纳入的特征包括脚长、体力活动水平、主要体力活动、体重、身高、BMI、年龄和性别。结果：共纳入201名受试者。年龄和身高与足底筋膜厚度有关。随着年龄的增加，足底筋膜厚度增加0.008 mm （P ）。结论：年龄和身高与足底筋膜厚度有显著相关，但系数较小。足长、体力活动水平和主要体力活动与足底筋膜厚度无关。III级证据，横断面研究。
{"title":"Association of plantar fascia thickness and different variables in individuals without heel pain","authors":"Anna Lagergaard Larsen , Pia Skouby Larsen , Mie Engberg Nyvad , Sara Matilde Vassard , Ida Laurberg Andersen , Henrik Riel","doi":"10.1016/j.foot.2025.102223","DOIUrl":"10.1016/j.foot.2025.102223","url":null,"abstract":"<div><h3>Background</h3><div>Plantar fasciopathy is a common condition described as a combination of degeneration and inflammation of the collagenous tissue. The diagnosis is typically based on medical history, local findings, and ultrasound to assess the thickness of the fascia, where a plantar fascia thickness of 4 mm or more confirms the diagnosis. However, other factors besides plantar fasciopathy may be associated with the thickness of the plantar fascia. This study aims to investigate which characteristics, including foot length, physical activity level, and primary physical activity, are associated with the thickness of the plantar fascia in individuals without a history of heel pain.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study and used multiple linear regression to investigate the association between the thickness of the fascia examined with diagnostic ultrasound and the characteristics of the participants. The included characteristics were foot length, physical activity level, primary physical activity, body weight, height, BMI, age, and sex.</div></div><div><h3>Results</h3><div>201 participants were included in the study. Age and height were associated with plantar fascia thickness. With a one-year increase in age, the plantar fascia increases by 0.008 mm (P < 0.001), and for every cm increase in height, the thickness of the plantar fascia increases 0.011 mm (P = 0.003).</div></div><div><h3>Conclusion</h3><div>Age and height were significantly associated with plantar fascia thickness, but had small coefficients. Foot length, physical activity level, and primary physical activity were not associated with plantar fascia thickness. Level III of evidence, cross-sectional study.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"66 ","pages":"Article 102223"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Flatfoot alignment alters foot biomechanics and lower limb coordination; however, its impact on dynamic performance during bilateral heel rises under varying knee conditions remains unclear. This study compared heel-rise kinematics and intersegmental coordination in 12 flatfoot and 12 normal-foot participants performing ten bilateral heel rises at 60 BPM under randomized knee extended and knee flexed conditions. The three-dimensional kinematics were recorded using a 12-camera Vicon system. The ascending and descending phases were divided into the early, middle, and late periods. The maximum normalized heel height, vertical and anterior center-of-mass displacement, anterior knee translation, pelvic and foot kinematics, and shank–hindfoot coordination via modified vector coding were analyzed. Under knee extension, the flatfoot group showed greater vertical center-of-mass displacement (p = 0.044). With knee flexion, anterior knee translation was larger in subjects with flatfoot (p = 0.022), who also exhibited greater hallux extension during the middle to late periods (p < 0.05). In the early ascending period with knee flexion, normal-foot participants displayed more proximal-dominant in-phase shank–hindfoot coupling (47.5 % vs. 23.3 %, p = 0.032), whereas flatfoot participants showed increased distal-dominant in-phase coupling (34.1 % vs. 12.4 %, p = 0.013). Individuals with flatfoot adopt compensatory forward knee translation and enhanced hallux/hindfoot motion, especially under knee flexion, reflecting reduced foot stiffness and altered coordination. Incorporating knee-flexed assessments and coordination metrics into clinical heel-rise testing may improve the detection of foot stiffness deficits and guide personalized rehabilitation.
{"title":"Flatfoot kinematics and coordination during bilateral heel rises: Effects of knee angle variation","authors":"Yota Abe , Aimi Tayama , Tomoki Iizuka , Yosuke Tomita","doi":"10.1016/j.foot.2025.102222","DOIUrl":"10.1016/j.foot.2025.102222","url":null,"abstract":"<div><div>Flatfoot alignment alters foot biomechanics and lower limb coordination; however, its impact on dynamic performance during bilateral heel rises under varying knee conditions remains unclear. This study compared heel-rise kinematics and intersegmental coordination in 12 flatfoot and 12 normal-foot participants performing ten bilateral heel rises at 60 BPM under randomized knee extended and knee flexed conditions. The three-dimensional kinematics were recorded using a 12-camera Vicon system. The ascending and descending phases were divided into the early, middle, and late periods. The maximum normalized heel height, vertical and anterior center-of-mass displacement, anterior knee translation, pelvic and foot kinematics, and shank–hindfoot coordination via modified vector coding were analyzed. Under knee extension, the flatfoot group showed greater vertical center-of-mass displacement (p = 0.044). With knee flexion, anterior knee translation was larger in subjects with flatfoot (p = 0.022), who also exhibited greater hallux extension during the middle to late periods (p < 0.05). In the early ascending period with knee flexion, normal-foot participants displayed more proximal-dominant in-phase shank–hindfoot coupling (47.5 % vs. 23.3 %, p = 0.032), whereas flatfoot participants showed increased distal-dominant in-phase coupling (34.1 % vs. 12.4 %, p = 0.013). Individuals with flatfoot adopt compensatory forward knee translation and enhanced hallux/hindfoot motion, especially under knee flexion, reflecting reduced foot stiffness and altered coordination. Incorporating knee-flexed assessments and coordination metrics into clinical heel-rise testing may improve the detection of foot stiffness deficits and guide personalized rehabilitation.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"66 ","pages":"Article 102222"},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.foot.2025.102211
James Ritchie
This article reflects on the 50-year journey of the British Orthopaedic Foot and Ankle Society (BOFAS), tracing its evolution from representing an underappreciated niche interest to being the British face of a mature, technically diverse, and internationally respected surgical sub-specialty. Against the political, social, and medical backdrop of 1970s Britain, the foundation of the original British Orthopaedic Foot Surgery Society (BOFSS) marked a quiet but significant challenge to conventional orthopaedic hierarchies. This review considers the society’s origins, growth, professionalisation, and ongoing struggle for recognition, both within orthopaedics and the wider medical community.
{"title":"Cinderella goes to the ball: Fifty years of BOFAS and the evolution of British foot and ankle surgery","authors":"James Ritchie","doi":"10.1016/j.foot.2025.102211","DOIUrl":"10.1016/j.foot.2025.102211","url":null,"abstract":"<div><div>This article reflects on the 50-year journey of the British Orthopaedic Foot and Ankle Society (BOFAS), tracing its evolution from representing an underappreciated niche interest to being the British face of a mature, technically diverse, and internationally respected surgical sub-specialty. Against the political, social, and medical backdrop of 1970s Britain, the foundation of the original British Orthopaedic Foot Surgery Society (BOFSS) marked a quiet but significant challenge to conventional orthopaedic hierarchies. This review considers the society’s origins, growth, professionalisation, and ongoing struggle for recognition, both within orthopaedics and the wider medical community.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"65 ","pages":"Article 102211"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Equity, diversity and inclusiveness have been identified as areas for improvement across sports and biomechanics research. To identify and prioritise areas for improvement, it is important to understand the current ‘state of play’. This protocol outlines an audit process designed to (1) characterise and compare demographic data of both participants and researchers in published performance shoe research and (2) profile considerations of equity, diversity and inclusiveness in performance shoe design. A comprehensive multi-language, search strategy will be conducted across 4 primarily English and 1 Chinese data base. Sport specific journals published in Chinese, Japanese, Korean, French, Spanish and Portuguese will be hand-searched. All studies, published since 2015, investigating the design or testing of a shoe, insert or orthotic required or facilitating for sports performance will be considered for inclusion. For the purposes of this audit, sports will be limited to those recognised by the International Olympic Committee Summer Olympic International Federations. Footwear company websites will be searched for details on specific performance footwear. Studies will be grouped based on the sports the shoe is designed for. Participants’ gender and/or sex, race and ethnicity will be directly extracted from included studies or by contacting the authors. Researchers’ gender and/or sex, position within the authorship group and location where the study was conducted will be extracted from included studies or obtained through university profiles, professional pages or by directly contacting authors. Differences in demographic data will be compared between shoe type and representativeness of participants, researchers and footwear will be calculated using participation to prevalence ratios. The proposed protocol represents a committed step towards improving equity, diversity and inclusiveness throughout footwear science.
{"title":"Audit protocol for evaluating diversity in sport performance footwear research: Assessing footwear design, participant representation, and author demographics in published studies","authors":"Kathryn Mills , Karen Julie Mickle , Sharon Dixon , Thorsten Sterzing , Yannick Denis , FengQin Fu , Emre Ilhan , Nachiappan Chockalingam","doi":"10.1016/j.foot.2025.102213","DOIUrl":"10.1016/j.foot.2025.102213","url":null,"abstract":"<div><div>Equity, diversity and inclusiveness have been identified as areas for improvement across sports and biomechanics research. To identify and prioritise areas for improvement, it is important to understand the current ‘state of play’. This protocol outlines an audit process designed to (1) characterise and compare demographic data of both participants and researchers in published performance shoe research and (2) profile considerations of equity, diversity and inclusiveness in performance shoe design. A comprehensive multi-language, search strategy will be conducted across 4 primarily English and 1 Chinese data base. Sport specific journals published in Chinese, Japanese, Korean, French, Spanish and Portuguese will be hand-searched. All studies, published since 2015, investigating the design or testing of a shoe, insert or orthotic required or facilitating for sports performance will be considered for inclusion. For the purposes of this audit, sports will be limited to those recognised by the International Olympic Committee Summer Olympic International Federations. Footwear company websites will be searched for details on specific performance footwear. Studies will be grouped based on the sports the shoe is designed for. Participants’ gender and/or sex, race and ethnicity will be directly extracted from included studies or by contacting the authors. Researchers’ gender and/or sex, position within the authorship group and location where the study was conducted will be extracted from included studies or obtained through university profiles, professional pages or by directly contacting authors. Differences in demographic data will be compared between shoe type and representativeness of participants, researchers and footwear will be calculated using participation to prevalence ratios. The proposed protocol represents a committed step towards improving equity, diversity and inclusiveness throughout footwear science.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"66 ","pages":"Article 102213"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-20DOI: 10.1016/j.foot.2025.102214
Craig Wyatt , Karan Malhotra , Joel Humphrey , Robert Clayton , David Townshend , Nilesh Makwana , Edward Wood , Lyndon Mason
Background
Hallux rigidus is a common and debilitating condition that increasingly impacts UK healthcare resources. First metatarsophalangeal joint (MTPJ) fusion is a widely performed intervention with excellent clinical outcomes; however, its commissioning has faced restrictions in some regions in the UK due to perceived limited value. Robust national cost-effectiveness evidence is needed to guide policy and ensure equitable access to care.
Methods
A cost–utility analysis was conducted using British Orthopaedic Foot & Ankle Society (BOFAS) Registry data for patients undergoing primary 1st MTPJ fusion. EuroQol-5 Dimension (EQ-5D-5L) outcomes at baseline and 1 year were utilised to estimate quality-adjusted life year (QALY) gains. A lifetime Markov model over 20 years simulated costs, utilities, and complication pathways from the UK NHS perspective. Costs were derived from national tariffs and discounted at 3.5 % per annum. Incremental cost-effectiveness ratios (ICERs) were calculated relative to conservative management, and deterministic sensitivity analysis tested uncertainty across cost and utility assumptions.
Results
Out of 1199 patients, 202 had completed full PROM datasets for cost-utility modelling. EQ-5D-5L improved from 0.53 pre-operatively to 0.77 at one year (p < 0.001), exceeding the MCID by six months and sustained thereafter. The base-case model demonstrated a discounted lifetime QALY gain of 3.331 and cost of £ 4698.15, yielding an ICER of £ 1410.58 per QALY gained. Across all sensitivity scenarios, including increased costs, reduced utility gains, and shortened duration of benefit, the ICER remained well below accepted NICE thresholds (£20,000–£30,000/QALY). In the low-cost scenario, 1st MTPJ fusion became cost-saving (negative ICER) by year 18.
Conclusion
1st MTPJ fusion is a highly cost-effective intervention for hallux rigidus, delivering clinically significant and durable improvements in quality of life at very low cost per QALY gained. This procedure provides greater value for money than many widely commissioned major orthopaedic operations, including hip and knee arthroplasty. Current NHS restrictions on access are not supported by health-economic evidence. These findings reinforce the essential role of 1st MTPJ fusion in value-based foot and ankle surgical care.
{"title":"Lifetime cost-effectiveness of first metatarsophalangeal joint fusion using patient reported outcomes from National Foot and Ankle Registry data in the UK","authors":"Craig Wyatt , Karan Malhotra , Joel Humphrey , Robert Clayton , David Townshend , Nilesh Makwana , Edward Wood , Lyndon Mason","doi":"10.1016/j.foot.2025.102214","DOIUrl":"10.1016/j.foot.2025.102214","url":null,"abstract":"<div><h3>Background</h3><div>Hallux rigidus is a common and debilitating condition that increasingly impacts UK healthcare resources. First metatarsophalangeal joint (MTPJ) fusion is a widely performed intervention with excellent clinical outcomes; however, its commissioning has faced restrictions in some regions in the UK due to perceived limited value. Robust national cost-effectiveness evidence is needed to guide policy and ensure equitable access to care.</div></div><div><h3>Methods</h3><div>A cost–utility analysis was conducted using British Orthopaedic Foot & Ankle Society (BOFAS) Registry data for patients undergoing primary 1st MTPJ fusion. EuroQol-5 Dimension (EQ-5D-5L) outcomes at baseline and 1 year were utilised to estimate quality-adjusted life year (QALY) gains. A lifetime Markov model over 20 years simulated costs, utilities, and complication pathways from the UK NHS perspective. Costs were derived from national tariffs and discounted at 3.5 % per annum. Incremental cost-effectiveness ratios (ICERs) were calculated relative to conservative management, and deterministic sensitivity analysis tested uncertainty across cost and utility assumptions.</div></div><div><h3>Results</h3><div>Out of 1199 patients, 202 had completed full PROM datasets for cost-utility modelling. EQ-5D-5L improved from 0.53 pre-operatively to 0.77 at one year (p < 0.001), exceeding the MCID by six months and sustained thereafter. The base-case model demonstrated a discounted lifetime QALY gain of 3.331 and cost of £ 4698.15, yielding an ICER of £ 1410.58 per QALY gained. Across all sensitivity scenarios, including increased costs, reduced utility gains, and shortened duration of benefit, the ICER remained well below accepted NICE thresholds (£20,000–£30,000/QALY). In the low-cost scenario, 1st MTPJ fusion became cost-saving (negative ICER) by year 18.</div></div><div><h3>Conclusion</h3><div>1st MTPJ fusion is a highly cost-effective intervention for hallux rigidus, delivering clinically significant and durable improvements in quality of life at very low cost per QALY gained. This procedure provides greater value for money than many widely commissioned major orthopaedic operations, including hip and knee arthroplasty. Current NHS restrictions on access are not supported by health-economic evidence. These findings reinforce the essential role of 1st MTPJ fusion in value-based foot and ankle surgical care.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"66 ","pages":"Article 102214"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Plantar fasciitis is one of the most common causes of chronic heel pain, accounting for up to 10 % of running-related injuries and significantly impacting the quality of life in both active and sedentary populations. While the majority of patients respond to conservative measures such as stretching, physiotherapy, orthoses, steroid injections, and extracorporeal shockwave therapy, approximately 5–10 % remain symptomatic despite prolonged non-operative treatment. Surgical intervention is considered in these refractory cases, with both open and endoscopic plantar fasciotomy traditionally employed. However, these approaches are associated with potential drawbacks, including wound complications, prolonged recovery, and altered foot biomechanics. In recent years, minimally invasive alternatives have been investigated to minimize morbidity while providing effective pain relief. The study was conducted to evaluate the clinical outcomes of percutaneous plantar fasciotomy using the microdebrider TOPAZ coblation wand in patients with recalcitrant plantar fasciitis.
Methods
A hospital-based, retrospective observational follow-up study in patients with a primary clinical diagnosis of recalcitrant PF, supported radiologically and underwent percutaneous plantar fasciotomy using a microdebrider TOPAZ coblation wand and had a minimum follow-up of 1 year. Outcome was evaluated using the Foot and Ankle Ability Measure (FAAM) Score, Numerical Rating Scale (NRS)
Results
Of the 18 patients included, 16 (88.9 %) were females. Thirteen (72.1 %) were aged 30–50 years. None had anatomical deformity. There was a significant reduction in pain levels from pre-operative NRS scores (mean 7.56) to NRS scores at 1 year (mean 2.83) (p < 0.001).
Functional ability improved notably from a pre-operative FAAM score (mean 59.94) to a 1-year FAAM score (mean 91.33) (p < 0.001)
Conclusion
Radiofrequency coblation using TOPAZ microdebrider wand is an effective intervention for chronic recalcitrant PF.
{"title":"Efficacy of TOPAZ coblation-assisted percutaneous fasciotomy in chronic plantar fasciitis","authors":"Kiran Kumar Vedavyasa Acharya, Anurag Kundapur, Sachin Kumar","doi":"10.1016/j.foot.2025.102212","DOIUrl":"10.1016/j.foot.2025.102212","url":null,"abstract":"<div><h3>Background</h3><div>Plantar fasciitis is one of the most common causes of chronic heel pain, accounting for up to 10 % of running-related injuries and significantly impacting the quality of life in both active and sedentary populations. While the majority of patients respond to conservative measures such as stretching, physiotherapy, orthoses, steroid injections, and extracorporeal shockwave therapy, approximately 5–10 % remain symptomatic despite prolonged non-operative treatment. Surgical intervention is considered in these refractory cases, with both open and endoscopic plantar fasciotomy traditionally employed. However, these approaches are associated with potential drawbacks, including wound complications, prolonged recovery, and altered foot biomechanics. In recent years, minimally invasive alternatives have been investigated to minimize morbidity while providing effective pain relief. The study was conducted to evaluate the clinical outcomes of percutaneous plantar fasciotomy using the microdebrider TOPAZ coblation wand in patients with recalcitrant plantar fasciitis.</div></div><div><h3>Methods</h3><div>A hospital-based, retrospective observational follow-up study in patients with a primary clinical diagnosis of recalcitrant PF, supported radiologically and underwent percutaneous plantar fasciotomy using a microdebrider TOPAZ coblation wand and had a minimum follow-up of 1 year. Outcome was evaluated using the Foot and Ankle Ability Measure (FAAM) Score, Numerical Rating Scale (NRS)</div></div><div><h3>Results</h3><div>Of the 18 patients included, 16 (88.9 %) were females. Thirteen (72.1 %) were aged 30–50 years. None had anatomical deformity. There was a significant reduction in pain levels from pre-operative NRS scores (mean 7.56) to NRS scores at 1 year (mean 2.83) (p < 0.001).</div><div>Functional ability improved notably from a pre-operative FAAM score (mean 59.94) to a 1-year FAAM score (mean 91.33) (p < 0.001)</div></div><div><h3>Conclusion</h3><div>Radiofrequency coblation using TOPAZ microdebrider wand is an effective intervention for chronic recalcitrant PF.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"66 ","pages":"Article 102212"},"PeriodicalIF":0.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145527846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-14DOI: 10.1016/j.foot.2025.102210
Michelle Lyons , Kirsty Lindsay , Louise Burnie
Objective
The AlterG treadmill provides bodyweight support and gait data for rehabilitation. Clinicians often use spatiotemporal gait parameters to assess a patient’s progress during rehabilitation; therefore, the validity and reliability of these metrics are very important. This study aimed to assess the agreement and reliability of the spatiotemporal gait metrics measured by the Stride Smart system in the AlterG treadmill compared to the Xsens motion capture system during walking at different bodyweight support conditions.
Methods
17 healthy adults walked on an AlterG treadmill at 3 km/h and 4 km/h at 4 bodyweight conditions (100, 75, 50, 25 %) while wearing Xsens sensors on the lower body, repeating this session 7.0 ± 0.7 days later. Gait metrics were calculated using the Xsens motion cloud software and the Stride Smart system. Agreement and between-session reliability for the Stride Smart Gait metrics were assessed.
Results
Stride Smart gait metrics cadence, step length and stance time were reliable (ICC ≥ 0.621) and showed good agreement (r ≥ 0.602) for 100 and 75 % bodyweight, but not for 50 and 25 % bodyweight compared to the Xsens system.
Conclusions
Therefore, clinicians should only use gait metrics at ≥ 75 % bodyweight to assess progress in rehabilitation when using the Stride Smart system on the AlterG treadmill.
{"title":"Agreement and reliability of gait metrics measured using the stride smart system in the AlterG treadmill compared to Xsens","authors":"Michelle Lyons , Kirsty Lindsay , Louise Burnie","doi":"10.1016/j.foot.2025.102210","DOIUrl":"10.1016/j.foot.2025.102210","url":null,"abstract":"<div><h3>Objective</h3><div>The AlterG treadmill provides bodyweight support and gait data for rehabilitation. Clinicians often use spatiotemporal gait parameters to assess a patient’s progress during rehabilitation; therefore, the validity and reliability of these metrics are very important. This study aimed to assess the agreement and reliability of the spatiotemporal gait metrics measured by the Stride Smart system in the AlterG treadmill compared to the Xsens motion capture system during walking at different bodyweight support conditions.</div></div><div><h3>Methods</h3><div>17 healthy adults walked on an AlterG treadmill at 3 km/h and 4 km/h at 4 bodyweight conditions (100, 75, 50, 25 %) while wearing Xsens sensors on the lower body, repeating this session 7.0 ± 0.7 days later. Gait metrics were calculated using the Xsens motion cloud software and the Stride Smart system. Agreement and between-session reliability for the Stride Smart Gait metrics were assessed.</div></div><div><h3>Results</h3><div>Stride Smart gait metrics cadence, step length and stance time were reliable (ICC ≥ 0.621) and showed good agreement (r ≥ 0.602) for 100 and 75 % bodyweight, but not for 50 and 25 % bodyweight compared to the Xsens system.</div></div><div><h3>Conclusions</h3><div>Therefore, clinicians should only use gait metrics at ≥ 75 % bodyweight to assess progress in rehabilitation when using the Stride Smart system on the AlterG treadmill.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"65 ","pages":"Article 102210"},"PeriodicalIF":0.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-29DOI: 10.1016/j.foot.2025.102208
Alireza Ebrahimi , Sora Sohn , Jaehyung Shin , Daniel Acevedo , Andreea Lucaciu , Soheil Ashkani-Esfahani , David N. Bernstein , Lorena Bejarano-Pineda , Daniel Guss , John Y. Kwon , Gregory Waryasz
Background
Social determinants of health (SDOH) have been shown to impact postoperative outcomes for several orthopaedic injuries. Understanding the role of these factors in patients sustaining Lisfranc injury can help identify disparities and target interventions to optimize recovery.
Methods
We retrospectively evaluated the influence of SDOH in postoperative outcomes of patients with Lisfranc injury aged ≥ 18 years. Social Vulnerability Index (SVI) and Area Deprivation Index (ADI) were gathered using patient ZIP codes. Patient-Reported Outcome Measures (PROMs) were collected.
Results
Significant differences were found in postoperative physical health (p = 0.02) and function (p = 0.03) across different races, with white patients reporting better postoperative outcomes. Furthermore, private insurance was associated with better physical (p = 0.02) and mental health (p = 0.01). Lower socioeconomic status, minority status, poorer housing/transportation, higher social vulnerability, and higher area deprivation correlated with PROMs across physical, mental, and pain domains (all p < 0.05).
Conclusion
This study found SDOH, including race, neighborhood factors, and socioeconomic status were associated with lower PROMs in patients with Lisfranc injury, highlighting the need for stakeholders to prioritize interventions aiming to address health disparities among patients with orthopaedic injuries.
{"title":"Evaluating the association of social determinants of health and patient-reported outcome measures in patients with lisfranc injuries","authors":"Alireza Ebrahimi , Sora Sohn , Jaehyung Shin , Daniel Acevedo , Andreea Lucaciu , Soheil Ashkani-Esfahani , David N. Bernstein , Lorena Bejarano-Pineda , Daniel Guss , John Y. Kwon , Gregory Waryasz","doi":"10.1016/j.foot.2025.102208","DOIUrl":"10.1016/j.foot.2025.102208","url":null,"abstract":"<div><h3>Background</h3><div>Social determinants of health (SDOH) have been shown to impact postoperative outcomes for several orthopaedic injuries. Understanding the role of these factors in patients sustaining Lisfranc injury can help identify disparities and target interventions to optimize recovery.</div></div><div><h3>Methods</h3><div>We retrospectively evaluated the influence of SDOH in postoperative outcomes of patients with Lisfranc injury aged ≥ 18 years. Social Vulnerability Index (SVI) and Area Deprivation Index (ADI) were gathered using patient ZIP codes. Patient-Reported Outcome Measures (PROMs) were collected.</div></div><div><h3>Results</h3><div>Significant differences were found in postoperative physical health (p = 0.02) and function (p = 0.03) across different races, with white patients reporting better postoperative outcomes. Furthermore, private insurance was associated with better physical (p = 0.02) and mental health (p = 0.01). Lower socioeconomic status, minority status, poorer housing/transportation, higher social vulnerability, and higher area deprivation correlated with PROMs across physical, mental, and pain domains (all p < 0.05).</div></div><div><h3>Conclusion</h3><div>This study found SDOH, including race, neighborhood factors, and socioeconomic status were associated with lower PROMs in patients with Lisfranc injury, highlighting the need for stakeholders to prioritize interventions aiming to address health disparities among patients with orthopaedic injuries.</div></div><div><h3>Level of Evidence</h3><div>III</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"65 ","pages":"Article 102208"},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-29DOI: 10.1016/j.foot.2025.102209
Sofyan Al Shdefat , Zaki Arshad , Rahul Khan , Ibrahim Inzarul Haq , Maneesh Bhatia
Purpose
Patient reported outcome measures (PROMs) are crucial in allowing clinicians to effectively evaluate the outcome of interventions. This systematic review aims to provide a comprehensive, up-to-date analysis of the use of PROMs in the foot and ankle literature.
Materials and methods
A systematic review of all articles published between January 2012 and December 2022 in six major orthopaedic journals was performed. All original research articles reporting at least one PROM in any foot and ankle condition were included. An analysis of the most common PROMs overall and according to year of publication, journal of publication and pathology/procedure reported was performed.
Results
Of the 4402 total foot and ankle articles identified, 1553 articles reporting 125 different PROMs were included. The most common PROM overall was the American Orthopaedic foot and Ankle Society (AOFAS) score, reported in 51.5 % of articles, followed by visual analogue scale (VAS) pain score (43.2 %), 36-item short form survey (SF-36) (13.5 %), Foot and Ankle Outcome score (FAOS) (10.8 %) and Foot and Ankle Ability Measure (FAAM) (7.6 %). Only 23 (1.5 %) studies reported the number of patients achieving the minimally clinically important difference.
Conclusion
Although AOFAS score use has declined over time, it remains widely cited despite its limitations and calls for alternatives. Various validated foot and ankle PROMs exist but are used inconsistently. The continued use of suboptimal PROMs limits the quality of conclusions in foot and ankle research. Therefore, greater consistency in using validated PROMs is essential for improving reliability in the literature.
{"title":"Patient reported outcome measures in the foot and ankle literature: A systematic review","authors":"Sofyan Al Shdefat , Zaki Arshad , Rahul Khan , Ibrahim Inzarul Haq , Maneesh Bhatia","doi":"10.1016/j.foot.2025.102209","DOIUrl":"10.1016/j.foot.2025.102209","url":null,"abstract":"<div><h3>Purpose</h3><div>Patient reported outcome measures (PROMs) are crucial in allowing clinicians to effectively evaluate the outcome of interventions. This systematic review aims to provide a comprehensive, up-to-date analysis of the use of PROMs in the foot and ankle literature.</div></div><div><h3>Materials and methods</h3><div>A systematic review of all articles published between January 2012 and December 2022 in six major orthopaedic journals was performed. All original research articles reporting at least one PROM in any foot and ankle condition were included. An analysis of the most common PROMs overall and according to year of publication, journal of publication and pathology/procedure reported was performed.</div></div><div><h3>Results</h3><div>Of the 4402 total foot and ankle articles identified, 1553 articles reporting 125 different PROMs were included. The most common PROM overall was the American Orthopaedic foot and Ankle Society (AOFAS) score, reported in 51.5 % of articles, followed by visual analogue scale (VAS) pain score (43.2 %), 36-item short form survey (SF-36) (13.5 %), Foot and Ankle Outcome score (FAOS) (10.8 %) and Foot and Ankle Ability Measure (FAAM) (7.6 %). Only 23 (1.5 %<em>)</em> studies reported the number of patients achieving the minimally clinically important difference.</div></div><div><h3>Conclusion</h3><div>Although AOFAS score use has declined over time, it remains widely cited despite its limitations and calls for alternatives. Various validated foot and ankle PROMs exist but are used inconsistently. The continued use of suboptimal PROMs limits the quality of conclusions in foot and ankle research. Therefore, greater consistency in using validated PROMs is essential for improving reliability in the literature.</div></div><div><h3>Level of evidence</h3><div>Level IV, systematic review of level I-IV studies</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"65 ","pages":"Article 102209"},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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