Pub Date : 2017-08-01DOI: 10.1177/1938640016681070
Eric So, Lee M. Hlad
Neurogenic contracture often results in spastic, nonreducible equinovarus deformity. Rigid contracture leads to pain, instability, and bracing difficulties. This case report details the utilization of the modified Lambrinudi triple arthrodesis intended to create a plantigrade, functional limb that is amenable to an extremity brace in a case of an acquired neurologic clubfoot. Levels of Evidence: Therapeutic, Level IV: Case Report
{"title":"Modified Lambrinudi Arthrodesis for the Acute Treatment of Neurogenic Clubfoot: A Case Report","authors":"Eric So, Lee M. Hlad","doi":"10.1177/1938640016681070","DOIUrl":"https://doi.org/10.1177/1938640016681070","url":null,"abstract":"Neurogenic contracture often results in spastic, nonreducible equinovarus deformity. Rigid contracture leads to pain, instability, and bracing difficulties. This case report details the utilization of the modified Lambrinudi triple arthrodesis intended to create a plantigrade, functional limb that is amenable to an extremity brace in a case of an acquired neurologic clubfoot. Levels of Evidence: Therapeutic, Level IV: Case Report","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"10 1","pages":"372 - 376"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640016681070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47537682","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 : 2017-08-01DOI: 10.1177/1938640016675410
A. Jurina, D. Dimnjaković, T. Smoljanović, I. Bojanić
Intra-articular calcaneal osteoid osteoma is a very rare condition and the diagnosis as well as the treatment is extremely challenging. We report a case of a 19-year-old male with intra-articular osteoid osteoma of the calcaneus, initially treated for peroneal tenosynovitis with unsatisfactory results. Thorough diagnostic procedure revealed the superolateral location of a calcaneal osteoid osteoma, near the sinus tarsi. A cherry-red elevated lesion typical of an osteoid osteoma nidus was completely removed arthroscopically using the anterolateral portal and the middle portal for subtalar arthroscopy. Histopathology confirmed the suspected diagnosis. The postoperative clinical course was uneventful with immediate pain relief and full weightbearing and movement allowed soon. The patient had no recurrent pain and normal joint mobility 8 months postoperatively. Considering the accessibility of the lesion, intra-articular osteoid osteoma of the calcaneus can be successfully treated arthroscopically using lateral approach for subtalar arthroscopy. Levels of Evidence: Therapeutic, Level IV: Retrospective, Case report
{"title":"Removal of Osteoid Osteoma of the Calcaneus Using Subtalar Arthroscopy","authors":"A. Jurina, D. Dimnjaković, T. Smoljanović, I. Bojanić","doi":"10.1177/1938640016675410","DOIUrl":"https://doi.org/10.1177/1938640016675410","url":null,"abstract":"Intra-articular calcaneal osteoid osteoma is a very rare condition and the diagnosis as well as the treatment is extremely challenging. We report a case of a 19-year-old male with intra-articular osteoid osteoma of the calcaneus, initially treated for peroneal tenosynovitis with unsatisfactory results. Thorough diagnostic procedure revealed the superolateral location of a calcaneal osteoid osteoma, near the sinus tarsi. A cherry-red elevated lesion typical of an osteoid osteoma nidus was completely removed arthroscopically using the anterolateral portal and the middle portal for subtalar arthroscopy. Histopathology confirmed the suspected diagnosis. The postoperative clinical course was uneventful with immediate pain relief and full weightbearing and movement allowed soon. The patient had no recurrent pain and normal joint mobility 8 months postoperatively. Considering the accessibility of the lesion, intra-articular osteoid osteoma of the calcaneus can be successfully treated arthroscopically using lateral approach for subtalar arthroscopy. Levels of Evidence: Therapeutic, Level IV: Retrospective, Case report","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"10 1","pages":"359 - 363"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640016675410","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45761138","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 : 2017-08-01DOI: 10.1177/1938640016679698
Ashleen R. Knutsen, J. Fleming, E. Ebramzadeh, Nathan C. Ho, Tibor Warganich, Thomas G. W. Harris, S. Sangiorgio
Common surgical treatment of first tarsal-metatarsal arthritis is by first metatarsocuneiform joint arthrodesis. While crossed-screw and locking plate fixation are the most widely used methods, a novel construct was designed to alleviate soft tissue irritation while still providing stable fixation. Using anatomic first metatarsal and medial cuneiform composites, we compared 3 arthrodesis implants (crossed-screw, dorsal locking plate, and IO Fix) under 2 cyclic bending loading scenarios (cantilever and 4-point bending). Additionally, the optimal orientation (plantar-dorsal or dorsal-plantar) of the IO Fix construct was determined. Failure load, diastasis, joint space angle, and axial and angular stiffness were determined. Both crossed-screw fixation and the IO Fix constructs experienced significantly higher failure loads than the dorsal locking plate during both loading scenarios. Additionally, they had lower plantar diastasis and joint space angle at failure than the plate. Moreover, the plantar-dorsal IO Fix construct was significantly stiffer than the crossed-screw during cantilever bending. Finally, the plantar-dorsal orientation of the IO Fix device had higher failure load and lower diastasis and angle at failure than in the dorsal-plantar orientation. The results suggest that the IO Fix system can reduce motion at the interfragmentary site and ensure compression for healing comparable to that of the crossed-screw fixation. Levels of Evidence: Level V: Bench testing
{"title":"Biomechanical Comparison of Fixation Devices for First Metatarsocuneiform Joint Arthrodesis","authors":"Ashleen R. Knutsen, J. Fleming, E. Ebramzadeh, Nathan C. Ho, Tibor Warganich, Thomas G. W. Harris, S. Sangiorgio","doi":"10.1177/1938640016679698","DOIUrl":"https://doi.org/10.1177/1938640016679698","url":null,"abstract":"Common surgical treatment of first tarsal-metatarsal arthritis is by first metatarsocuneiform joint arthrodesis. While crossed-screw and locking plate fixation are the most widely used methods, a novel construct was designed to alleviate soft tissue irritation while still providing stable fixation. Using anatomic first metatarsal and medial cuneiform composites, we compared 3 arthrodesis implants (crossed-screw, dorsal locking plate, and IO Fix) under 2 cyclic bending loading scenarios (cantilever and 4-point bending). Additionally, the optimal orientation (plantar-dorsal or dorsal-plantar) of the IO Fix construct was determined. Failure load, diastasis, joint space angle, and axial and angular stiffness were determined. Both crossed-screw fixation and the IO Fix constructs experienced significantly higher failure loads than the dorsal locking plate during both loading scenarios. Additionally, they had lower plantar diastasis and joint space angle at failure than the plate. Moreover, the plantar-dorsal IO Fix construct was significantly stiffer than the crossed-screw during cantilever bending. Finally, the plantar-dorsal orientation of the IO Fix device had higher failure load and lower diastasis and angle at failure than in the dorsal-plantar orientation. The results suggest that the IO Fix system can reduce motion at the interfragmentary site and ensure compression for healing comparable to that of the crossed-screw fixation. Levels of Evidence: Level V: Bench testing","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"10 1","pages":"322 - 328"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640016679698","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47897045","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 : 2017-08-01DOI: 10.1177/1938640016677811
Richard M. Hinds, Natalie R. Danna, J. Capo, K. Mroczek
Background. The Internet has been reported to be the first informational resource for many fellowship applicants. The objective of this study was to assess the accessibility of orthopaedic foot and ankle fellowship websites and to evaluate the quality of information provided via program websites. Methods. The American Orthopaedic Foot and Ankle Society (AOFAS) and the Fellowship and Residency Electronic Interactive Database (FREIDA) fellowship databases were accessed to generate a comprehensive list of orthopaedic foot and ankle fellowship programs. The databases were reviewed for links to fellowship program websites and compared with program websites accessed from a Google search. Accessible fellowship websites were then analyzed for the quality of recruitment and educational content pertinent to fellowship applicants. Results. Forty-seven orthopaedic foot and ankle fellowship programs were identified. The AOFAS database featured direct links to 7 (15%) fellowship websites with the independent Google search yielding direct links to 29 (62%) websites. No direct website links were provided in the FREIDA database. Thirty-six accessible websites were analyzed for content. Program websites featured a mean 44% (range = 5% to 75%) of the total assessed content. The most commonly presented recruitment and educational content was a program description (94%) and description of fellow operative experience (83%), respectively. Conclusions. There is substantial variability in the accessibility and quality of orthopaedic foot and ankle fellowship websites. Clinical Relevance. Recognition of deficits in accessibility and content quality may assist foot and ankle fellowships in improving program information online. Levels of Evidence: Level IV
{"title":"Foot and Ankle Fellowship Websites: An Assessment of Accessibility and Quality","authors":"Richard M. Hinds, Natalie R. Danna, J. Capo, K. Mroczek","doi":"10.1177/1938640016677811","DOIUrl":"https://doi.org/10.1177/1938640016677811","url":null,"abstract":"Background. The Internet has been reported to be the first informational resource for many fellowship applicants. The objective of this study was to assess the accessibility of orthopaedic foot and ankle fellowship websites and to evaluate the quality of information provided via program websites. Methods. The American Orthopaedic Foot and Ankle Society (AOFAS) and the Fellowship and Residency Electronic Interactive Database (FREIDA) fellowship databases were accessed to generate a comprehensive list of orthopaedic foot and ankle fellowship programs. The databases were reviewed for links to fellowship program websites and compared with program websites accessed from a Google search. Accessible fellowship websites were then analyzed for the quality of recruitment and educational content pertinent to fellowship applicants. Results. Forty-seven orthopaedic foot and ankle fellowship programs were identified. The AOFAS database featured direct links to 7 (15%) fellowship websites with the independent Google search yielding direct links to 29 (62%) websites. No direct website links were provided in the FREIDA database. Thirty-six accessible websites were analyzed for content. Program websites featured a mean 44% (range = 5% to 75%) of the total assessed content. The most commonly presented recruitment and educational content was a program description (94%) and description of fellow operative experience (83%), respectively. Conclusions. There is substantial variability in the accessibility and quality of orthopaedic foot and ankle fellowship websites. Clinical Relevance. Recognition of deficits in accessibility and content quality may assist foot and ankle fellowships in improving program information online. Levels of Evidence: Level IV","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"10 1","pages":"302 - 307"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640016677811","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43832722","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 : 2017-08-01DOI: 10.1177/1938640016679701
Abhijeet B. Kadam, A. Dhamangaonkar
Giant cell tumor (GCT) or osteoclastoma is a benign, locally aggressive tumor with a tendency to recur. Giant cell tumors typically occur in the epiphysis of long bones, including the distal femur and proximal tibia. They are uncommonly found in the small bones of the foot or ankle, and involvement of talus is rare. The authors present a case of GCT of the talar body in a 21-year-old man, which was diagnosed radiologically by the presence of a well-defined osteolytic lesion involving more than half of the talar body with thinning of the cortices. An intralesional curettage and chemical cauterization with phenol was done using a medial approach following an osteotomy of the medial malleolus for adequate exposure. Intraoperative frozen section of curetted tissue was sent and was reported as benign GCT. The residual cavity was packed with autologous corticocancellous bone grafts fashioned in a T-construct like manner. A protective cast was applied for a period of 2 months and patient was subsequently gradually mobilized to full weightbearing status. At 2-year follow-up, there was no clinical or radiologically evident signs of recurrence. There was good consolidation of the bone graft in the talus with no signs of collapse of the weightbearing articular surface. Levels of Evidence: Therapeutic, Level IV: Case Study
{"title":"Giant Cell Tumor of Talus: T-Construct Method of Bone Grafting","authors":"Abhijeet B. Kadam, A. Dhamangaonkar","doi":"10.1177/1938640016679701","DOIUrl":"https://doi.org/10.1177/1938640016679701","url":null,"abstract":"Giant cell tumor (GCT) or osteoclastoma is a benign, locally aggressive tumor with a tendency to recur. Giant cell tumors typically occur in the epiphysis of long bones, including the distal femur and proximal tibia. They are uncommonly found in the small bones of the foot or ankle, and involvement of talus is rare. The authors present a case of GCT of the talar body in a 21-year-old man, which was diagnosed radiologically by the presence of a well-defined osteolytic lesion involving more than half of the talar body with thinning of the cortices. An intralesional curettage and chemical cauterization with phenol was done using a medial approach following an osteotomy of the medial malleolus for adequate exposure. Intraoperative frozen section of curetted tissue was sent and was reported as benign GCT. The residual cavity was packed with autologous corticocancellous bone grafts fashioned in a T-construct like manner. A protective cast was applied for a period of 2 months and patient was subsequently gradually mobilized to full weightbearing status. At 2-year follow-up, there was no clinical or radiologically evident signs of recurrence. There was good consolidation of the bone graft in the talus with no signs of collapse of the weightbearing articular surface. Levels of Evidence: Therapeutic, Level IV: Case Study","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"10 1","pages":"364 - 367"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640016679701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49146415","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 : 2017-06-01DOI: 10.1177/1938640016685152
Akilesh Anand Prakash
: Incisura fibularis (IF) is an important landmark in assessing syndesmotic stability radiologically postinjury. The purpose of this review was to explore the anatomy and morphometrics of this widely used anatomical landmark and to further the understanding of the same. A systematic review was conducted online using PubMed and Google Scholar, per PRISMA guidelines. Predefined eligibility criteria were applied, and the data thus compiled were analyzed. Wide variability in morphometrics and, thus, anatomy of IF were observed in the present review, which was influenced by gender. There was no side-to-side variability seen in this study. The study stresses the need to consider the anatomical and gender-based variability while assessing syndesmotic stability and further supports the recommendation of side-to-side comparison. LEVELS OF EVIDENCE: Anatomical, Level V.
{"title":"Is Incisura Fibularis a Reliable Landmark for Assessing Syndesmotic Stability? A Systematic Review of Morphometric Studies.","authors":"Akilesh Anand Prakash","doi":"10.1177/1938640016685152","DOIUrl":"https://doi.org/10.1177/1938640016685152","url":null,"abstract":": Incisura fibularis (IF) is an important landmark in assessing syndesmotic stability radiologically postinjury. The purpose of this review was to explore the anatomy and morphometrics of this widely used anatomical landmark and to further the understanding of the same. A systematic review was conducted online using PubMed and Google Scholar, per PRISMA guidelines. Predefined eligibility criteria were applied, and the data thus compiled were analyzed. Wide variability in morphometrics and, thus, anatomy of IF were observed in the present review, which was influenced by gender. There was no side-to-side variability seen in this study. The study stresses the need to consider the anatomical and gender-based variability while assessing syndesmotic stability and further supports the recommendation of side-to-side comparison. LEVELS OF EVIDENCE: Anatomical, Level V.","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"10 1","pages":"246-251"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640016685152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65809955","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 : 2017-06-01DOI: 10.1177/1938640016669797
M. Sullivan, E. J. Fraser, J. Linklater, C. Harris, Kieran Morgan
Background. Talar osteochondral lesions represent challenging clinical entities, particularly in high-demand athletes. Surgical treatment of large lesions often requires a 2-step procedure, or the use of osteotomy in the case of autologous osteochondral transfer, which can delay return to sport. Methods. A professional rugby league player underwent surgery for a complex injury to the ankle. A talar osteochondral lesion with a maximal diameter of 15 mm was treated in an arthroscopic fashion using the cartilage taken from the completely displaced osteochondral fragment. Cartilage was cut into chips and combined with bone graft product containing platelet-derived growth factor and a porous collagen scaffold. Autologous cartilage was then reimplanted arthroscopically. The patient was allowed full ankle motion from 2 weeks postoperatively, and weightbearing was commenced at 6 weeks. Follow-up imaging and functional outcomes, including return to sport, were assessed at regular intervals. Results. The patient was able to return to professional rugby league by 23 weeks postoperatively. Magnetic resonance imaging at 16 months postoperatively showed restoration of the subchondral plate and osseous infill. At final follow-up, the patient remained pain free and was playing at preinjury level. Conclusion. This report describes good outcomes using a novel, 1-step cartilage repair technique to treat a large talar osteochondral lesion in a professional athlete. Levels of Evidence: Level V: Expert opinion
{"title":"Arthroscopic Surgical Technique for an Acute Talar Dome Osteochondral Lesion in a Professional Rugby League Player","authors":"M. Sullivan, E. J. Fraser, J. Linklater, C. Harris, Kieran Morgan","doi":"10.1177/1938640016669797","DOIUrl":"https://doi.org/10.1177/1938640016669797","url":null,"abstract":"Background. Talar osteochondral lesions represent challenging clinical entities, particularly in high-demand athletes. Surgical treatment of large lesions often requires a 2-step procedure, or the use of osteotomy in the case of autologous osteochondral transfer, which can delay return to sport. Methods. A professional rugby league player underwent surgery for a complex injury to the ankle. A talar osteochondral lesion with a maximal diameter of 15 mm was treated in an arthroscopic fashion using the cartilage taken from the completely displaced osteochondral fragment. Cartilage was cut into chips and combined with bone graft product containing platelet-derived growth factor and a porous collagen scaffold. Autologous cartilage was then reimplanted arthroscopically. The patient was allowed full ankle motion from 2 weeks postoperatively, and weightbearing was commenced at 6 weeks. Follow-up imaging and functional outcomes, including return to sport, were assessed at regular intervals. Results. The patient was able to return to professional rugby league by 23 weeks postoperatively. Magnetic resonance imaging at 16 months postoperatively showed restoration of the subchondral plate and osseous infill. At final follow-up, the patient remained pain free and was playing at preinjury level. Conclusion. This report describes good outcomes using a novel, 1-step cartilage repair technique to treat a large talar osteochondral lesion in a professional athlete. Levels of Evidence: Level V: Expert opinion","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"10 1","pages":"263 - 269"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640016669797","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48620220","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 : 2017-06-01DOI: 10.1177/1938640016675412
J. Buza, James X. Liu, Jeffrey M. Jancuska, J. Bosco
Background. Total ankle arthroplasty (TAA) provides an alternative to ankle fusion (AF). The purpose of this study is to (1) determine the extent of TAA regionalization, as well as examine the growth of TAA performed at high-, medium-, and low-volume New York State institutions and (2) compare this regionalization and growth with AF. Methods. The New York Statewide Planning and Research Cooperative System (SPARCS) administrative data were used to identify 737 primary TAA and 7453 AF from 2005 to 2014. The volume of TAA and AF surgery in New York State was mapped according to patient and hospital 3-digit zip code. Results. The number of TAA per year grew 1500% (from 11 to 177) from 2005 to 2014, while there was a 35.6% reduction (from 895 to 576) in yearly AF procedures. TAA recipients were widely distributed throughout the state, while TAA procedures were regionalized to a few select metropolitan centers. AF procedures were performed more uniformly than TAA. The number of TAA has continued to increase at high- (15 to 91) and medium-volume (14 to 67) institutions where it has decreased at low-volume institutions (44 to 19). Conclusion. The increased utilization of TAA is attributed to relatively few high-volume centers located in major metropolitan centers. Levels of Evidence: Level IV: well-designed case-control or cohort studies
{"title":"The Regionalization of Total Ankle Arthroplasties and Ankle Fusions in New York State: A 10-Year Comparative Analysis","authors":"J. Buza, James X. Liu, Jeffrey M. Jancuska, J. Bosco","doi":"10.1177/1938640016675412","DOIUrl":"https://doi.org/10.1177/1938640016675412","url":null,"abstract":"Background. Total ankle arthroplasty (TAA) provides an alternative to ankle fusion (AF). The purpose of this study is to (1) determine the extent of TAA regionalization, as well as examine the growth of TAA performed at high-, medium-, and low-volume New York State institutions and (2) compare this regionalization and growth with AF. Methods. The New York Statewide Planning and Research Cooperative System (SPARCS) administrative data were used to identify 737 primary TAA and 7453 AF from 2005 to 2014. The volume of TAA and AF surgery in New York State was mapped according to patient and hospital 3-digit zip code. Results. The number of TAA per year grew 1500% (from 11 to 177) from 2005 to 2014, while there was a 35.6% reduction (from 895 to 576) in yearly AF procedures. TAA recipients were widely distributed throughout the state, while TAA procedures were regionalized to a few select metropolitan centers. AF procedures were performed more uniformly than TAA. The number of TAA has continued to increase at high- (15 to 91) and medium-volume (14 to 67) institutions where it has decreased at low-volume institutions (44 to 19). Conclusion. The increased utilization of TAA is attributed to relatively few high-volume centers located in major metropolitan centers. Levels of Evidence: Level IV: well-designed case-control or cohort studies","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"10 1","pages":"210 - 215"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640016675412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43600939","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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