Pub Date : 2021-01-01DOI: 10.30795/jfootankle.2021.v15.1558
S. Ahrenholz, M. Lalevée, H. Lee, T. Tazegul, Christian VandeLune, N. Mansur, C. C. César Netto
Peroneal tendon instability is a common injury that occurs in physically active individuals, often as a result of trauma and in the context of an anatomically shallow distal fibular groove. Subluxation of these tendons over the lateral malleolus is accompanied by superior peroneal retinaculum injury. Several techniques have been described in the literature, including fibular groove deepening and retinaculum repair, but few reconstruction techniques are available for cases with insufficient residual retinaculum. We report the case of a 53-year-old man, without a history of trauma, who presented with chronic peroneal instability with a completely obliterated, unsalvageable retinaculum which we treated with a combination of fibular groove deepening and fibular periosteal flap to reconstruct the superior peroneal retinaculum. Level of Evidence V; Case Report; Expert Opinion.
{"title":"Distal fibular periosteal flap for superior peroneal retinaculum reconstruction","authors":"S. Ahrenholz, M. Lalevée, H. Lee, T. Tazegul, Christian VandeLune, N. Mansur, C. C. César Netto","doi":"10.30795/jfootankle.2021.v15.1558","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1558","url":null,"abstract":"Peroneal tendon instability is a common injury that occurs in physically active individuals, often as a result of trauma and in the context of an anatomically shallow distal fibular groove. Subluxation of these tendons over the lateral malleolus is accompanied by superior peroneal retinaculum injury. Several techniques have been described in the literature, including fibular groove deepening and retinaculum repair, but few reconstruction techniques are available for cases with insufficient residual retinaculum. We report the case of a 53-year-old man, without a history of trauma, who presented with chronic peroneal instability with a completely obliterated, unsalvageable retinaculum which we treated with a combination of fibular groove deepening and fibular periosteal flap to reconstruct the superior peroneal retinaculum. Level of Evidence V; Case Report; Expert Opinion.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87913014","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 : 2021-01-01DOI: 10.30795/jfootankle.2021.v15.1533
Eli Ávila Souza Júnior
Anterior ankle impingement is a common cause of chronic pain in this site and has synovial chondromatosis, albeit rare, as one of its possible etiologies. Both arthroscopic approach and open arthrotomy are reported as therapeutic option, but the few published data showed that the first is believed to bring more advantages. In a recent study, one of the limitations found by the authors was the rareness of this condition in the ankle, and thus the small number of publications on the topic. We present the rare case of synovial chondromatosis of the ankle in a middle-aged man, which was clinically manifested as anterior impingement syndrome and treated arthroscopically, showing an atypical arboriform vascularization pattern. Level of Evidence V; Diagnostic Studies; Expert Opinion.
{"title":"Synovial chondromatosis as an etiology of ankle impingement: a case report","authors":"Eli Ávila Souza Júnior","doi":"10.30795/jfootankle.2021.v15.1533","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1533","url":null,"abstract":"Anterior ankle impingement is a common cause of chronic pain in this site and has synovial chondromatosis, albeit rare, as one of its possible etiologies. Both arthroscopic approach and open arthrotomy are reported as therapeutic option, but the few published data showed that the first is believed to bring more advantages. In a recent study, one of the limitations found by the authors was the rareness of this condition in the ankle, and thus the small number of publications on the topic. We present the rare case of synovial chondromatosis of the ankle in a middle-aged man, which was clinically manifested as anterior impingement syndrome and treated arthroscopically, showing an atypical arboriform vascularization pattern. Level of Evidence V; Diagnostic Studies; Expert Opinion.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"146 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80564658","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 : 2021-01-01DOI: 10.30795/jfootankle.2021.v15.1539
Diego Yearson, I. Melendez, Federico Anain, S. Siniscalchi, J. Drago
Objective: To disseminate a rehabilitation protocol with early mobilization and ambulation, with no external supports, reducing the time until full weight-bearing and providing greater postoperative comfort. Methods: We prospectively assessed a series of 68 patients, with level of evidence IV, mean age of 33.3 years. We performed open reduction with ankle lateral approach (Kocher) and internal fixation with an interfragmentary compression screw and a one-third locked tubular plate for neutralization. All patients were subjected to a rehabilitation protocol with early mobilization and weight-bearing. Results: No fracture displacements were observed on the postoperative radiographic controls, neither loosening nor ruptures of implants. There was no need to change rehabilitation guidelines either due to pain or to other subjective limitation. Conclusion: We can state that early joint mobilization and controlled progressive support, with appropriate osteosynthesis, resulting in an early return to everyday activities, both work and sports ones. Level of Evidence IV; Therapeutic Studies; Case Series.
{"title":"Mobilization protocol and early postoperative weight-bearing in transyndesmal ankle fractures","authors":"Diego Yearson, I. Melendez, Federico Anain, S. Siniscalchi, J. Drago","doi":"10.30795/jfootankle.2021.v15.1539","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1539","url":null,"abstract":"Objective: To disseminate a rehabilitation protocol with early mobilization and ambulation, with no external supports, reducing the time until full weight-bearing and providing greater postoperative comfort. Methods: We prospectively assessed a series of 68 patients, with level of evidence IV, mean age of 33.3 years. We performed open reduction with ankle lateral approach (Kocher) and internal fixation with an interfragmentary compression screw and a one-third locked tubular plate for neutralization. All patients were subjected to a rehabilitation protocol with early mobilization and weight-bearing. Results: No fracture displacements were observed on the postoperative radiographic controls, neither loosening nor ruptures of implants. There was no need to change rehabilitation guidelines either due to pain or to other subjective limitation. Conclusion: We can state that early joint mobilization and controlled progressive support, with appropriate osteosynthesis, resulting in an early return to everyday activities, both work and sports ones. Level of Evidence IV; Therapeutic Studies; Case Series.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76952338","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 : 2021-01-01DOI: 10.30795/jfootankle.2021.v15.1537
Rodrigo Guimarães Huyer, M. Cillo, Carlos Daniel Cândido de Castro Filho, H. D. Bertelli, Marcelo Morelli Girondo, Armando Bortolatto Neto
Objective: This study used the AOFAS score to assess the clinical functional results of patients who underwent tarsal coalition resection. Methods: This was a retrospective case series of patients who underwent tarsal coalition resection to correct rigid flat foot. Clinical and functional assessment was performed with the AOFAS score before and 6 months after surgical treatment. Descriptive analysis was performed for 7 patients (11 operated feet) using measurements of position and dispersion (mean, standard deviation, minimum, median and maximum value) for continuous variables and frequency tables (absolute and relative) for categorical variables. Results: The mean patient age was 10 years, 7 months, and the majority (71.43%) were male. The most affected joint was the calcaneonavicular. The right side was affected in 54.55% of the cases. The most frequent type of coalition was osseous (81.82% of the cases). The mean pre- and postoperative AOFAS scores were 32.7 and 70.2 points, respectively, which was a significant increase. Conclusion: The increased scores after coalition resection was considered the main change between the two assessments. Thus, it can be concluded that in rigid flat feet without severe hind- or forefoot deformities for which conservative treatment failed, bar resection should be the surgical procedure of choice. Level of Evidence IV; Therapeutic Studies; Case Series.
{"title":"Clinical and functional outcomes of tarsal coalition resection to correct rigid flat foot","authors":"Rodrigo Guimarães Huyer, M. Cillo, Carlos Daniel Cândido de Castro Filho, H. D. Bertelli, Marcelo Morelli Girondo, Armando Bortolatto Neto","doi":"10.30795/jfootankle.2021.v15.1537","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1537","url":null,"abstract":"Objective: This study used the AOFAS score to assess the clinical functional results of patients who underwent tarsal coalition resection. Methods: This was a retrospective case series of patients who underwent tarsal coalition resection to correct rigid flat foot. Clinical and functional assessment was performed with the AOFAS score before and 6 months after surgical treatment. Descriptive analysis was performed for 7 patients (11 operated feet) using measurements of position and dispersion (mean, standard deviation, minimum, median and maximum value) for continuous variables and frequency tables (absolute and relative) for categorical variables. Results: The mean patient age was 10 years, 7 months, and the majority (71.43%) were male. The most affected joint was the calcaneonavicular. The right side was affected in 54.55% of the cases. The most frequent type of coalition was osseous (81.82% of the cases). The mean pre- and postoperative AOFAS scores were 32.7 and 70.2 points, respectively, which was a significant increase. Conclusion: The increased scores after coalition resection was considered the main change between the two assessments. Thus, it can be concluded that in rigid flat feet without severe hind- or forefoot deformities for which conservative treatment failed, bar resection should be the surgical procedure of choice. Level of Evidence IV; Therapeutic Studies; Case Series.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"12 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78336148","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 : 2021-01-01DOI: 10.30795/jfootankle.2021.v15.1540
Lucas Plens de Britto Costa, L. Fonseca, A. Lemos, V. Pereira, C. C. César Netto, F. Raduan, C. Nery, N. Mansur
Objective: We describe a series of patients treated with resection of the affected band. We assessed functional outcome, recurrence rate, and surgical wound complications, comparing these data with the available literature. Methods: This retrospective study (level of evidence IV) included 14 patients (17 feet) diagnosed with plantar fibromatosis in the medial portion of the fascia that was refractory to conservative treatment. All operations were performed between December 2016 and November 2018. All patients were assessed for symptom improvement and major and minor complications, in addition to recurrence during the study period.Results: Our sample included 9 men and 5 women, whose mean age was 40.6 years (15-63). All of the patients underwent partial fasciectomy of the medial fascial band with margins of at least 2 cm. There was recurrence in 5 of the 17 feet (29%), but only two required further intervention. Wound dehiscence occurred in 3 patients (17%), and one of the cases was severe, requiring plastic surgery. Two feet showed signs of injury to the digital branch of the medial plantar nerve. Conclusion: Partial plantar fasciectomy is an alternative treatment for plantar fibromatosis (Ledderhose’s disease). Our results agree with the literature in terms of recurrence and postoperative complications. The moderate rate of complications must be taken into account when indicating this procedure. Level of Evidence IV; Therapeutic Studies; Case Series.
{"title":"Partial plantar fasciectomy for the treatment of plantar fibromatosis","authors":"Lucas Plens de Britto Costa, L. Fonseca, A. Lemos, V. Pereira, C. C. César Netto, F. Raduan, C. Nery, N. Mansur","doi":"10.30795/jfootankle.2021.v15.1540","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1540","url":null,"abstract":"Objective: We describe a series of patients treated with resection of the affected band. We assessed functional outcome, recurrence rate, and surgical wound complications, comparing these data with the available literature. Methods: This retrospective study (level of evidence IV) included 14 patients (17 feet) diagnosed with plantar fibromatosis in the medial portion of the fascia that was refractory to conservative treatment. All operations were performed between December 2016 and November 2018. All patients were assessed for symptom improvement and major and minor complications, in addition to recurrence during the study period.Results: Our sample included 9 men and 5 women, whose mean age was 40.6 years (15-63). All of the patients underwent partial fasciectomy of the medial fascial band with margins of at least 2 cm. There was recurrence in 5 of the 17 feet (29%), but only two required further intervention. Wound dehiscence occurred in 3 patients (17%), and one of the cases was severe, requiring plastic surgery. Two feet showed signs of injury to the digital branch of the medial plantar nerve. Conclusion: Partial plantar fasciectomy is an alternative treatment for plantar fibromatosis (Ledderhose’s disease). Our results agree with the literature in terms of recurrence and postoperative complications. The moderate rate of complications must be taken into account when indicating this procedure. Level of Evidence IV; Therapeutic Studies; Case Series.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74491426","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 : 2021-01-01DOI: 10.30795/jfootankle.2021.v15.1562
Christian VandeLune, T. Tazegul, Samuel J Ahrenholz, C. Iehl, Victoria Y. Vivtcharenko, Eli L Schmidt, Kevin N Dibbern, H. Lee, M. Lalevée, N. S. Barbachan Mansur, C. de César Netto
Objective: To assess the degree of implant-related artifacts (IRA) around metallic and bio-integrative (BI) cannulated screws using Hounsfield units (HU) on computed tomography (CT). Our hypothesis was that BI implants would demonstrate significantly decreased IRA around the inserted screws. Methods: In this cadaveric CT imaging study, we used 2 below-knee specimens. Medial displacement calcaneal osteotomy was performed, and the specimens were fixed with either metallic or BI screws. HU values were measured over 4 different lines that crossed the osteotomy position. Results: The mean HU value was decreased in the BI implants compared to the metallic ones in 3 different positions: near the screw, directly over the screw, and inside the screw cannula. At the line placed 1 cm dorsal to the screw, the HU value for the metallic screw was lower than that for the BI screw. Conclusions: We found metallic implants to demonstrate significantly increased HU values in regions close to the implant and significantly decreased values 1 cm away from the implant, when compared to the BI screw. The decreased HU values 1 cm away from the implant could be due to a shielding effect of the surrounding bone, hindering the assessment of union and healing. BI implants represent an alternative to decrease these IRA effects. Level of Evidence III; Case-Control Study.
目的:应用霍斯菲尔德单元(Hounsfield unit, HU)对金属和生物一体化空心螺钉(BI)周围植入物相关伪影(IRA)的程度进行评估。我们的假设是，BI植入物会显著降低置入螺钉周围的IRA。方法:在本研究中，我们使用了2例膝关节以下的尸体CT图像。行内侧移位跟骨截骨术，标本用金属或BI螺钉固定。在穿过截骨位置的4条不同线上测量HU值。结果:与金属种植体相比，BI种植体在螺钉附近、螺钉正上方和螺钉套管内3个不同位置的平均HU值均有所降低。在距螺钉背侧1cm处，金属螺钉的HU值低于BI螺钉。结论:与BI螺钉相比，我们发现金属种植体在靠近种植体的区域显着增加HU值，而在距离种植体1cm处显着降低HU值。距离种植体1cm处的HU值降低可能是由于周围骨的屏蔽作用，阻碍了对愈合和愈合的评估。BI植入物是减少这些IRA影响的另一种选择。证据等级III;病例对照研究。
{"title":"Implant-related artifacts around metallic and bio-integrative screws: a CT scan 3D Hounsfield unit assessment","authors":"Christian VandeLune, T. Tazegul, Samuel J Ahrenholz, C. Iehl, Victoria Y. Vivtcharenko, Eli L Schmidt, Kevin N Dibbern, H. Lee, M. Lalevée, N. S. Barbachan Mansur, C. de César Netto","doi":"10.30795/jfootankle.2021.v15.1562","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1562","url":null,"abstract":"Objective: To assess the degree of implant-related artifacts (IRA) around metallic and bio-integrative (BI) cannulated screws using Hounsfield units (HU) on computed tomography (CT). Our hypothesis was that BI implants would demonstrate significantly decreased IRA around the inserted screws. Methods: In this cadaveric CT imaging study, we used 2 below-knee specimens. Medial displacement calcaneal osteotomy was performed, and the specimens were fixed with either metallic or BI screws. HU values were measured over 4 different lines that crossed the osteotomy position. Results: The mean HU value was decreased in the BI implants compared to the metallic ones in 3 different positions: near the screw, directly over the screw, and inside the screw cannula. At the line placed 1 cm dorsal to the screw, the HU value for the metallic screw was lower than that for the BI screw. Conclusions: We found metallic implants to demonstrate significantly increased HU values in regions close to the implant and significantly decreased values 1 cm away from the implant, when compared to the BI screw. The decreased HU values 1 cm away from the implant could be due to a shielding effect of the surrounding bone, hindering the assessment of union and healing. BI implants represent an alternative to decrease these IRA effects. Level of Evidence III; Case-Control Study.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74258500","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 : 2021-01-01DOI: 10.30795/jfootankle.2021.v15.1545
L. Carneiro, Luiz Augusto Sampaio Gonzaga Filho, J. Mizusaki, S. Prata, M. Rizzo
Objective: To characterize the epidemiological profile of patients treated at a hospital service with diagnosis of open fracture of the ankle and foot. Methods: Retrospective, descriptive, epidemiological, observational study of open fractures of the ankle and foot selected by convenience sampling in a hospital service in São Paulo, state of São Paulo, Brazil, from March 1, 2017, to March 1, 2019, totaling 109 patients. Data collection was conducted for the analysis of variables included in patients’ medical records. Results: The medical records of 700 patients with open fractures were assessed. Of these patients, 13.2% (109 patients) had open fractures of the ankle and foot. There was a predominance of male young adults (70.8%) and of left lower limb fractures (51.85%). Most cases were classified as Gustilo and Anderson type II fractures (42.6%). Motorcycle accidents (44.45%) predominated, and students and professional motorcyclists were the most frequent occupations (37.04%). The most adopted stabilization method was osteosynthesis (internal fixation) (44.45%), and primary amputation was required in 3.7% of the cases. Conclusion: Male young adults were the most affected by fractures of the ankle and foot, and traffic accidents were the leading cause. Most patients had an educational attainment of complete elementary education. Most fractures were classified as Gustilo and Anderson type II. Greater severity was observed in patients with associated injuries in other body segments and who developed early complications during hospitalization. Level of Evidence IV; Prognostic Studies; Case Series.
{"title":"Epidemiological study of open fractures of the ankle and foot","authors":"L. Carneiro, Luiz Augusto Sampaio Gonzaga Filho, J. Mizusaki, S. Prata, M. Rizzo","doi":"10.30795/jfootankle.2021.v15.1545","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1545","url":null,"abstract":"Objective: To characterize the epidemiological profile of patients treated at a hospital service with diagnosis of open fracture of the ankle and foot. Methods: Retrospective, descriptive, epidemiological, observational study of open fractures of the ankle and foot selected by convenience sampling in a hospital service in São Paulo, state of São Paulo, Brazil, from March 1, 2017, to March 1, 2019, totaling 109 patients. Data collection was conducted for the analysis of variables included in patients’ medical records. Results: The medical records of 700 patients with open fractures were assessed. Of these patients, 13.2% (109 patients) had open fractures of the ankle and foot. There was a predominance of male young adults (70.8%) and of left lower limb fractures (51.85%). Most cases were classified as Gustilo and Anderson type II fractures (42.6%). Motorcycle accidents (44.45%) predominated, and students and professional motorcyclists were the most frequent occupations (37.04%). The most adopted stabilization method was osteosynthesis (internal fixation) (44.45%), and primary amputation was required in 3.7% of the cases. Conclusion: Male young adults were the most affected by fractures of the ankle and foot, and traffic accidents were the leading cause. Most patients had an educational attainment of complete elementary education. Most fractures were classified as Gustilo and Anderson type II. Greater severity was observed in patients with associated injuries in other body segments and who developed early complications during hospitalization. Level of Evidence IV; Prognostic Studies; Case Series.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85873461","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 : 2020-12-21DOI: 10.30795/jfootankle.2020.v14.1198
M. Khademi, P. Ferrao, N. Saragas
Objective: The aim of this study was to determine patient satisfaction, survivorship, and revision rate of the HINTEGRA total ankle arthroplasty (TAA). Our secondary objective was to assess hindfoot function. Methods: All patients who underwent a HINTEGRA TAA between 2007 and 2014 were evaluated. We included a total of 69 patients (69 ankles), who were subjected to clinical and radiological examination and completed a visual analogue scale (VAS) for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score, and the self-reported foot and ankle score (SEFAS). Hindfoot function was assessed using the AOFAS hindfoot score. Mean follow-up was 62 (57–101) months. Results: The mean VAS score was 2 (0–3) and the SEFAS was 37 (26–48) at the most recent follow-up, while the AOFAS ankle score improved from 57 (52–62) to 87 (82–93). The AOFAS hindfoot score improved from 82 to 92 postoperatively. Eight patients had periprosthetic osteolysis and 5 underwent bone grafting of cysts. We detected polyethylene and hydroxyapatite particles in specimens obtained from the cysts. Eight patients had their procedures converted to an ankle arthrodesis. Conclusion: In select patients, TAA improved quality of life. Our medium-term follow-up of the HINTEGRA TAA observed a survivorship of 89% at 5 years with an improvement in the AOFAS score and a mean SEFAS score of 37. We recommend that large periprosthetic cysts, which may be caused by the hydroxyapatite coating and polyethylene particles, be bone grafted prophylactically. We found hindfoot function to be preserved. Level of Evidence IV; Therapeutic Studies; Case Series.
{"title":"Medium-term results of the HINTEGRA total ankle arthroplasty","authors":"M. Khademi, P. Ferrao, N. Saragas","doi":"10.30795/jfootankle.2020.v14.1198","DOIUrl":"https://doi.org/10.30795/jfootankle.2020.v14.1198","url":null,"abstract":"Objective: The aim of this study was to determine patient satisfaction, survivorship, and revision rate of the HINTEGRA total ankle arthroplasty (TAA). Our secondary objective was to assess hindfoot function. Methods: All patients who underwent a HINTEGRA TAA between 2007 and 2014 were evaluated. We included a total of 69 patients (69 ankles), who were subjected to clinical and radiological examination and completed a visual analogue scale (VAS) for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score, and the self-reported foot and ankle score (SEFAS). Hindfoot function was assessed using the AOFAS hindfoot score. Mean follow-up was 62 (57–101) months. Results: The mean VAS score was 2 (0–3) and the SEFAS was 37 (26–48) at the most recent follow-up, while the AOFAS ankle score improved from 57 (52–62) to 87 (82–93). The AOFAS hindfoot score improved from 82 to 92 postoperatively. Eight patients had periprosthetic osteolysis and 5 underwent bone grafting of cysts. We detected polyethylene and hydroxyapatite particles in specimens obtained from the cysts. Eight patients had their procedures converted to an ankle arthrodesis. Conclusion: In select patients, TAA improved quality of life. Our medium-term follow-up of the HINTEGRA TAA observed a survivorship of 89% at 5 years with an improvement in the AOFAS score and a mean SEFAS score of 37. We recommend that large periprosthetic cysts, which may be caused by the hydroxyapatite coating and polyethylene particles, be bone grafted prophylactically. We found hindfoot function to be preserved. Level of Evidence IV; Therapeutic Studies; Case Series.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79043551","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 : 2020-12-21DOI: 10.30795/jfootankle.2020.v14.1215
C. de César Netto, S. Ahrenholz, C. Iehl, Victoria Y. Vivtcharenko, E. Schmidt, H. Lee, K. Dibbern, N. Mansur
We present a technical surgical description of a 36-year-old female diagnosed with Progressive Collapsing Foot Deformity (PCFD) treated with a medial displacement calcaneus osteotomy, a lateral column lengthening, and a modified Lapidus fusion. In order to increase the plantar flexion power of this arthrodesis and minimize the loss in ray length with joint preparation, a bone block structured graft was used. Fixation was performed using a post implant in the medial cuneiform with crossing screws though the surfaces and the graft. Forefoot varus was properly corrected intraoperatively by using the described surgical technique. Satisfactory functional short-term results and an excellent alignment was accomplished. Level of Evidence V; Therapeutic Studies; Expert Opinion.
{"title":"Lapicotton technique in the treatment of progressive collapsing foot deformity","authors":"C. de César Netto, S. Ahrenholz, C. Iehl, Victoria Y. Vivtcharenko, E. Schmidt, H. Lee, K. Dibbern, N. Mansur","doi":"10.30795/jfootankle.2020.v14.1215","DOIUrl":"https://doi.org/10.30795/jfootankle.2020.v14.1215","url":null,"abstract":"We present a technical surgical description of a 36-year-old female diagnosed with Progressive Collapsing Foot Deformity (PCFD) treated with a medial displacement calcaneus osteotomy, a lateral column lengthening, and a modified Lapidus fusion. In order to increase the plantar flexion power of this arthrodesis and minimize the loss in ray length with joint preparation, a bone block structured graft was used. Fixation was performed using a post implant in the medial cuneiform with crossing screws though the surfaces and the graft. Forefoot varus was properly corrected intraoperatively by using the described surgical technique. Satisfactory functional short-term results and an excellent alignment was accomplished. Level of Evidence V; Therapeutic Studies; Expert Opinion.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88052699","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 : 2020-12-21DOI: 10.30795/jfootankle.2020.v14.1200
G. Arrondo, D. Gomez, German Joannas, X. Martín-Oliva, M. Iglesias, L. Casola
Objective: Impingement syndromes are recognized as an important cause of chronic ankle pain, which results from the entrapment of an inflamed soft-tissue component between the osteophytes. The predominant site of occurrence is the anterolateral aspect of the ankle for soft-tissue impingement, and anteromedial aspect for bony impingement. Symptoms related to the physical impact of bone or soft-tissue pain often result in limited ankle range of motion. Methods: We conducted a retrospective study of 34 patients (34 ankles) with anteromedial bony impingement. All patients underwent arthroscopy, with a mean follow-up of 34 months. Results: All osteophytes were removed, and the ankle range of motion improved. The AOFAS score improved from 73 preoperatively to 95 postoperatively. Conclusion: The arthroscopic removal of the anteromedial osteophytes of the ankle had excellent functional results. It is an effective procedure that allows rapid patient recovery. Level of Evidence IV; Therapeutic Studies; Case Series.
{"title":"Arthroscopic treatment of anteromedial ankle impingement","authors":"G. Arrondo, D. Gomez, German Joannas, X. Martín-Oliva, M. Iglesias, L. Casola","doi":"10.30795/jfootankle.2020.v14.1200","DOIUrl":"https://doi.org/10.30795/jfootankle.2020.v14.1200","url":null,"abstract":"Objective: Impingement syndromes are recognized as an important cause of chronic ankle pain, which results from the entrapment of an inflamed soft-tissue component between the osteophytes. The predominant site of occurrence is the anterolateral aspect of the ankle for soft-tissue impingement, and anteromedial aspect for bony impingement. Symptoms related to the physical impact of bone or soft-tissue pain often result in limited ankle range of motion. Methods: We conducted a retrospective study of 34 patients (34 ankles) with anteromedial bony impingement. All patients underwent arthroscopy, with a mean follow-up of 34 months. Results: All osteophytes were removed, and the ankle range of motion improved. The AOFAS score improved from 73 preoperatively to 95 postoperatively. Conclusion: The arthroscopic removal of the anteromedial osteophytes of the ankle had excellent functional results. It is an effective procedure that allows rapid patient recovery. Level of Evidence IV; Therapeutic Studies; Case Series.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79669696","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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