Pub Date : 2025-07-01DOI: 10.1016/j.fas.2025.06.006
Carlos A. Sánchez-Correa , Daniel Poggio-Cano , Albert Ginés-Cespedosa , Fernando Álvarez-Goenaga
Background
Long term survival of different ankle prosthesis implanted by non-designer surgeons has not been reported.
Methods
Cross-sectional study in three centers. Revision and reoperation were studied as markers of survival for different prosthetic models between 2002 and 2023. Primary outcomes were analyzed using Kaplan-Meier curves with variables associated with failure reported in literature.
Results
127 prostheses were identified. The revision and reoperation rates over 22 years were 13.4 % and 9.5 %, respectively. Aseptic loosening (n = 14, p < 0.01) and septic loosening (n = 3, p < 0.01) were the most frequent causes associated with revision. Prosthetic failure was managed either with arthrodesis (n = 14, p < 0.01) or with revision and implant replacement (n = 3, p < 0.01). Female biological sex was associated higher risk of revision (PR = 6.7; 95 % CI 1.6 – 28.2; p-value <0.01). Chronic pain was the only variable associated with increased risk of reoperation (PR = 8.2; 95 % CI 3.1 – 22.4; p-value = <0.01).
Conclusions
Results are comparable to those reported in the literature regarding revision and reoperation. Different prosthetic models evaluated in this study provide a broader understanding of how prostheses perform when implanted by surgeons other than their creators.
{"title":"Revision and reoperation in total ankle arthroplasty, a multicenter study of different prosthetic models","authors":"Carlos A. Sánchez-Correa , Daniel Poggio-Cano , Albert Ginés-Cespedosa , Fernando Álvarez-Goenaga","doi":"10.1016/j.fas.2025.06.006","DOIUrl":"10.1016/j.fas.2025.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Long term survival of different ankle prosthesis implanted by non-designer surgeons has not been reported.</div></div><div><h3>Methods</h3><div>Cross-sectional study in three centers. Revision and reoperation were studied as markers of survival for different prosthetic models between 2002 and 2023. Primary outcomes were analyzed using Kaplan-Meier curves with variables associated with failure reported in literature.</div></div><div><h3>Results</h3><div>127 prostheses were identified. The revision and reoperation rates over 22 years were 13.4 % and 9.5 %, respectively. Aseptic loosening<span> (n = 14, p < 0.01) and septic loosening (n = 3, p < 0.01) were the most frequent causes associated with revision. Prosthetic failure was managed either with arthrodesis (n = 14, p < 0.01) or with revision and implant replacement (n = 3, p < 0.01). Female biological sex was associated higher risk of revision (PR = 6.7; 95 % CI 1.6 – 28.2; p-value <0.01). Chronic pain was the only variable associated with increased risk of reoperation (PR = 8.2; 95 % CI 3.1 – 22.4; p-value = <0.01).</span></div></div><div><h3>Conclusions</h3><div>Results are comparable to those reported in the literature regarding revision and reoperation. Different prosthetic models evaluated in this study provide a broader understanding of how prostheses perform when implanted by surgeons other than their creators.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 1","pages":"Pages 66-77"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-27DOI: 10.1016/j.fas.2025.06.005
Christian Rasmussen , Peter Larsen , Christian Pedersen , Rasmus Elsoe
Background
Growing evidence supports a shift from inpatient to outpatient surgical treatment for ankle fractures. The primary aim of this study was to investigate the effect of inpatient versus outpatient surgery of ankle fractures on patient-reported outcome utilizing the Foot and Ankle Outcome Score (FAOS) at 12 weeks following surgery. Secondary aims were to report patients’ satisfaction, adverse events, pain, physical function, and bone healing between inpatient and outpatient treatment.
Patients and Methods
The study design was a non-inferiority randomized controlled, non-blinded trial with a two-groups. Patients were randomized 1:1 to outpatient or inpatient surgical treatment. The primary outcome was the FAOS at 12 weeks. Secondary outcomes included patients’ satisfaction, health-related quality of life, intensity of pain, bone union, and adverse events.
Results
A total of 44 patients were randomized to inpatient surgery and 42 patients to outpatient surgery. The final follow-up at 12 weeks following surgery was completed by 69 patients (80 %). The mean age of patients was 49.2 (SD 16.9), ranging from 18 to 80. Female sex represented 44 % of patients. The primary analysis revealed no statistically significant difference in FAOS subscale scores between inpatient and outpatient surgery at the 12-week follow-up Adjusted mean difference: Pain: −0.8 (95 % CI −10.7–9.0); Symptoms: 2.7 (95 % CI −6.9–12.5); ADL: −4.7 (95 % CI −13.6–4.3); Sport/Rec: 2.9 (95 % CI −15.2–9.3); and QOL: −0.7 (95 % CI −11.8–10.3). Comparable results were observed for secondary outcomes.
Conclusion
This study showed no statistical nor clinically significant difference in FAOS subscale scores between inpatient and outpatient surgery for ankle fractures 12 weeks following surgery. Furthermore, patients’ satisfaction and adverse events were comparable between inpatient and outpatient surgery 12 weeks following treatment. Results indicated that outpatient surgery for ankle fractures is highly feasible for selected patients and may be considered as routine for clinical practice.
背景：越来越多的证据支持踝关节骨折从住院到门诊手术治疗的转变。本研究的主要目的是利用足部和踝关节预后评分（FAOS）在手术后12周调查踝关节骨折住院和门诊手术对患者报告结果的影响。次要目的是报告住院和门诊治疗期间患者的满意度、不良事件、疼痛、身体功能和骨愈合。患者和方法：研究设计为两组非劣效性随机对照、非盲法试验。患者按1:1随机分为门诊或住院手术治疗。主要终点是12周时的FAOS。次要结局包括患者满意度、健康相关生活质量、疼痛强度、骨愈合和不良事件。结果：44例患者随机分为住院手术组，42例患者随机分为门诊手术组。术后12周的最终随访有69例（80% %）完成。患者平均年龄49.2岁（SD 16.9），年龄范围18 ~ 80岁。女性占44% %。初步分析显示，住院和门诊手术患者在随访12周后的FAOS亚量表评分无统计学差异，调整后的平均差异：疼痛：-0.8(95 % CI -10.7-9.0)；症状：2.7(95 % CI -6.9-12.5)；Adl: -4.7(95 % ci -13.6-4.3)；体育/体育：2.9(95 % CI -15.2-9.3)；生活质量：-0.7（95 % CI -11.8-10.3）。次要结果也观察到类似的结果。结论：本研究显示踝关节骨折术后12周住院与门诊FAOS亚量表评分无统计学差异，且无临床意义。此外，治疗后12周住院和门诊手术患者的满意度和不良事件具有可比性。结果表明，门诊手术治疗踝关节骨折对部分患者是可行的，可作为临床常规治疗。
{"title":"Outpatient versus inpatient surgery for ankle fractures: A randomized controlled non-inferiority trial","authors":"Christian Rasmussen , Peter Larsen , Christian Pedersen , Rasmus Elsoe","doi":"10.1016/j.fas.2025.06.005","DOIUrl":"10.1016/j.fas.2025.06.005","url":null,"abstract":"<div><h3>Background</h3><div>Growing evidence supports a shift from inpatient to outpatient surgical treatment for ankle fractures. The primary aim of this study was to investigate the effect of inpatient versus outpatient surgery of ankle fractures on patient-reported outcome utilizing the Foot and Ankle Outcome Score (FAOS) at 12 weeks following surgery. Secondary aims were to report patients’ satisfaction, adverse events, pain, physical function, and bone healing between inpatient and outpatient treatment.</div></div><div><h3>Patients and Methods</h3><div>The study design was a non-inferiority randomized controlled, non-blinded trial with a two-groups. Patients were randomized 1:1 to outpatient or inpatient surgical treatment. The primary outcome was the FAOS at 12 weeks. Secondary outcomes included patients’ satisfaction, health-related quality of life, intensity of pain, bone union, and adverse events.</div></div><div><h3>Results</h3><div>A total of 44 patients were randomized to inpatient surgery and 42 patients to outpatient surgery. The final follow-up at 12 weeks following surgery was completed by 69 patients (80 %). The mean age of patients was 49.2 (SD 16.9), ranging from 18 to 80. Female sex represented 44 % of patients. The primary analysis revealed no statistically significant difference in FAOS subscale scores between inpatient and outpatient surgery at the 12-week follow-up Adjusted mean difference: Pain: −0.8 (95 % CI −10.7–9.0); Symptoms: 2.7 (95 % CI −6.9–12.5); ADL: −4.7 (95 % CI −13.6–4.3); Sport/Rec: 2.9 (95 % CI −15.2–9.3); and QOL: −0.7 (95 % CI −11.8–10.3). Comparable results were observed for secondary outcomes.</div></div><div><h3>Conclusion</h3><div>This study showed no statistical nor clinically significant difference in FAOS subscale scores between inpatient and outpatient surgery for ankle fractures 12 weeks following surgery. Furthermore, patients’ satisfaction and adverse events were comparable between inpatient and outpatient surgery 12 weeks following treatment. Results indicated that outpatient surgery for ankle fractures is highly feasible for selected patients and may be considered as routine for clinical practice.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 1","pages":"Pages 59-65"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-18DOI: 10.1016/j.fas.2025.06.004
Philipp Friederichsen , Melissa Wilhelmi , Pascal Rippstein
Background
Overlength of the lesser toes can lead to pain at the distal toe end and painful hammer and claw deformities. Fusion or resection of proximal interphalangeal joints are commonly used to address overlength, while sacrificing joint mobility. A Z-type shortening osteotomy of the proximal phalanx (SOPP) was developed as a joint-sparing alternative.
Methods
We outline this novel technique and retrospectively analyzed preliminary data from 13 patients (including 9 women) with a mean age of 42 years who underwent Z-type SOPP. Patients rated their postoperative satisfaction and assessments of radiographs and complications were made up to 1-year post-SOPP.
Results
Of 29 toes in total, mean postoperative shortening was 6.4 mm (range, 4–11 mm) and all showed complete union at 1 year. All patients were satisfied with the surgery and only two reported limited joint mobility. There were no reports of infection and delayed wound healing.
Conclusion
Z-type SOPP appears to be an effective and safe joint sparing treatment for lesser toe overlength in the short term.
{"title":"Z-type shortening osteotomy of the proximal phalanx: A novel and safe joint sparing intervention to shorten lesser toes with good short-term outcome","authors":"Philipp Friederichsen , Melissa Wilhelmi , Pascal Rippstein","doi":"10.1016/j.fas.2025.06.004","DOIUrl":"10.1016/j.fas.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div><span>Overlength of the lesser toes can lead to pain at the distal </span>toe<span><span> end and painful hammer and claw deformities. Fusion or resection of proximal interphalangeal joints are commonly used to address overlength, while sacrificing joint mobility. A Z-type shortening </span>osteotomy<span> of the proximal phalanx (SOPP) was developed as a joint-sparing alternative.</span></span></div></div><div><h3>Methods</h3><div>We outline this novel technique and retrospectively analyzed preliminary data from 13 patients (including 9 women) with a mean age of 42 years who underwent Z-type SOPP. Patients rated their postoperative satisfaction and assessments of radiographs and complications were made up to 1-year post-SOPP.</div></div><div><h3>Results</h3><div>Of 29 toes in total, mean postoperative shortening was 6.4 mm (range, 4–11 mm) and all showed complete union at 1 year. All patients were satisfied with the surgery and only two reported limited joint mobility. There were no reports of infection and delayed wound healing.</div></div><div><h3>Conclusion</h3><div>Z-type SOPP appears to be an effective and safe joint sparing treatment for lesser toe overlength in the short term.</div></div><div><h3>Level of Evidence</h3><div>Retrospective case series, Level IV</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 1","pages":"Pages 53-58"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-14DOI: 10.1016/j.fas.2025.06.001
Tevfik Çatal , İbrahim Esad Sapmaz , Mustafa Görkem Kaya , Alkan Bayrak , Murat Tıngır , Cemal Kural , Altuğ Duramaz
Purpose
This study aimed to evaluate the diagnostic importance of ultrasonic imaging by assessing the thickness of the plantar fascia (F) and fat pad (FP) at different locations in the plantar region for the diagnosis of plantar fasciitis. Furthermore, the study sought to determine the correlation between angular measurements derived from direct radiography and measurements obtained via ultrasound imaging.
Methods
The study measured the intermetatarsal angle(IMA), 1st metatarsophalangeal angle(MTPA), 1st interphalangeal angle(IPA), and medial longitudinal arch angle(MLAA) in weight-bearing foot radiographs of 94 patients (23 males and 71 females) with unilateral plantar fasciitis. The control group comprised asymptomatic feet from the same individuals. Fat pad and plantar fascia thicknesses were assessed with ultrasonic imaging(USG) at three different points. A proportion was established between fascia(F) and fat pad(FP) thicknesses. The study examined the correlations between USG and direct radiography measurements, both within and between groups.
Results
A statistically significant difference was observed between the study group and the control group in various measurements. These include IMA measurements, plantar fascia thickness, and F/FP ratio measured at the calcaneal tubercle, as well as fascia thickness, fat pad thickness, and F/FP ratio measured in the midpoint of the medial arch (p = 0.024; p = 0.001; p = 0.001; p = 0.001; p = 0.008; p = 0.001 p<0.05 respectively). A significant correlation was discovered in the study group between F/FP measures in the calcaneal tubercle and MLAA.
Conclusion
Our study revealed a noteworthy correlation between plantar fasciitis and an increase in plantar fascia thickness, an increase in the plantar fascia/fat pad ratio, and a decrease in the fat pad thickness measured at three distinct points. In our study, it was seen that the diagnosis of plantar fasciitis can be made with USG alone, which is a fast, cost-effective and easy-to-apply method by evaluating the thickening of the plantar fascia, the reduction in fat pad thickness, and their relative proportions.
Level of evidence
Level III, Cross-Sectional Prospective Observational Study.
{"title":"Plantar fascia thickness and fat-pad measurement at target points: A cost-beneficial and fast method in the diagnosis of plantar fasciitis","authors":"Tevfik Çatal , İbrahim Esad Sapmaz , Mustafa Görkem Kaya , Alkan Bayrak , Murat Tıngır , Cemal Kural , Altuğ Duramaz","doi":"10.1016/j.fas.2025.06.001","DOIUrl":"10.1016/j.fas.2025.06.001","url":null,"abstract":"<div><h3>Purpose</h3><div><span>This study aimed to evaluate the diagnostic importance of ultrasonic imaging by assessing the thickness of the plantar </span>fascia<span><span> (F) and fat pad (FP) at different locations in the plantar region for the diagnosis of plantar fasciitis. Furthermore, the study sought to determine the correlation between angular measurements derived from direct radiography and measurements obtained via </span>ultrasound imaging.</span></div></div><div><h3>Methods</h3><div><span><span>The study measured the intermetatarsal angle(IMA), 1st metatarsophalangeal angle(MTPA), 1st interphalangeal angle(IPA), and medial longitudinal arch angle(MLAA) in weight-bearing foot radiographs of 94 patients (23 males and 71 females) with unilateral </span>plantar fasciitis. The control group comprised asymptomatic feet from the same individuals. Fat pad and plantar </span>fascia thicknesses were assessed with ultrasonic imaging(USG) at three different points. A proportion was established between fascia(F) and fat pad(FP) thicknesses. The study examined the correlations between USG and direct radiography measurements, both within and between groups.</div></div><div><h3>Results</h3><div>A statistically significant difference was observed between the study group and the control group in various measurements. These include IMA measurements, plantar fascia thickness, and F/FP ratio measured at the calcaneal tubercle, as well as fascia thickness, fat pad thickness, and F/FP ratio measured in the midpoint of the medial arch (p = 0.024; p = 0.001; p = 0.001; p = 0.001; p = 0.008; p = 0.001 p<0.05 respectively). A significant correlation was discovered in the study group between F/FP measures in the calcaneal tubercle and MLAA.</div></div><div><h3>Conclusion</h3><div>Our study revealed a noteworthy correlation between plantar fasciitis and an increase in plantar fascia thickness, an increase in the plantar fascia/fat pad ratio, and a decrease in the fat pad thickness measured at three distinct points. In our study, it was seen that the diagnosis of plantar fasciitis can be made with USG alone, which is a fast, cost-effective and easy-to-apply method by evaluating the thickening of the plantar fascia, the reduction in fat pad thickness, and their relative proportions.</div></div><div><h3>Level of evidence</h3><div>Level III, Cross-Sectional Prospective Observational Study.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 1","pages":"Pages 33-39"},"PeriodicalIF":2.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-13DOI: 10.1016/j.fas.2025.06.003
Min Gyu Kyung , Jahyung Kim , Joonhee Kim , Kyoung Min Lee , Dong Yeon Lee
Background
This study aimed to compare various ankle alignment parameters in the hip-to-calcaneus (H-C) view and conventional whole-leg standing radiographs.
Methods
We retrospectively reviewed 61 patients with end-stage ankle arthritis (Takakura stage 3b/4) who underwent ankle arthrodesis. Preoperative H-C views and conventional radiographs were used to measure the hip-knee-ankle angle, weight-bearing line percentage, talar tilt, and medial distal tibial angle. The percentage of the H-C axis crossing the talus was also analyzed for asymmetry and correlated with the tibiocalcaneal angle, talar tilt, and hip-knee-ankle angle.
Results
Strong correlations were observed between the H-C view and conventional radiographs for the hip-knee-ankle angle (r = 0.88), weight-bearing line percentage (r = 0.90), and talar tilt (r = 0.87). The H-C axis asymmetry showed a strong correlation with tibiocalcaneal angle (r = -0.96).
Conclusions
The H-C view is a reliable tool for assessing hindfoot and lower limb alignment in end-stage ankle arthritis.
{"title":"Radiographic evaluation of ankle alignment using the hip-to-calcaneus view in patients with end-stage ankle arthritis","authors":"Min Gyu Kyung , Jahyung Kim , Joonhee Kim , Kyoung Min Lee , Dong Yeon Lee","doi":"10.1016/j.fas.2025.06.003","DOIUrl":"10.1016/j.fas.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to compare various ankle alignment parameters in the hip-to-calcaneus (H-C) view and conventional whole-leg standing radiographs.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 61 patients with end-stage ankle arthritis (Takakura stage 3b/4) who underwent ankle arthrodesis. Preoperative H-C views and conventional radiographs were used to measure the hip-knee-ankle angle, weight-bearing line percentage, talar tilt, and medial distal tibial angle. The percentage of the H-C axis crossing the talus was also analyzed for asymmetry and correlated with the tibiocalcaneal angle, talar tilt, and hip-knee-ankle angle.</div></div><div><h3>Results</h3><div>Strong correlations were observed between the H-C view and conventional radiographs for the hip-knee-ankle angle (<em>r</em> = 0.88), weight-bearing line percentage (<em>r</em> = 0.90), and talar tilt (<em>r</em> = 0.87). The H-C axis asymmetry showed a strong correlation with tibiocalcaneal angle (<em>r</em> = -0.96).</div></div><div><h3>Conclusions</h3><div>The H-C view is a reliable tool for assessing hindfoot and lower limb alignment in end-stage ankle arthritis.</div></div><div><h3>Level of Evidence</h3><div>III</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 1","pages":"Pages 45-52"},"PeriodicalIF":2.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-03DOI: 10.1016/j.fas.2025.05.009
Tiago Soares Baumfeld , Victor Roberto Borges Barbosa , Breno Souza dos Santos , Daniel Soares Baumfeld , Alexandre Leme Godoy-Santos , Stefan Rammelt
Introduction
Achilles tendon rupture (ATR) is one of the most common injuries to the musculoskeletal system. Recently, endoscopic FHL transfer has been successfully used to treat acute injuries in soccer players, with good return to play rates and good functional outcomes. The aim of this study is to analyze patient-reported questionnaires, functional capacity assessment (FCA), and re-rupture rates following endoscopic FHL transfer for acute ATR.
Methods
This is a prospective case series with 26 patients (15 men, 11 women, mean age 47.7 years) who suffered an ATR and underwent surgical reconstruction with a FHL endoscopic transfer, between March 2022 and December 2023. The minimum follow-up was 12 months. Postoperative assessments included the visual analogue pain scale (VAS), Victorian Institute of Sports Assessment – Achilles (VISA-A) score, Achilles total tendon rupture score (ATRS), AOFAS, EVA, as well as plantar flexion strength, hallux flexion strength, ankle mobility, single heel rise test and Lunge test and Achilles tendon resting angle.
Results
Five out of 26 patients (19,2 %) had a re-rupture of the Achilles tendon between the second and the fourth postoperative week. Twelve months postoperatively, the pain measured by VAS was 0.5, the mean VISA-A score was 94.4 (95 % CI: 90.8–100), and the mean ATRS was 5.1. The plantar flexion strength and ankle mobility were significantly lower in the affected side when compared to the formerly unaffected side (p = 0.015 and p < 0.001, respectively). No wound healing problems or neurovascular or complications were observed.
Discussion
Despite a cautious rehabilitation program, we observed an unacceptably re-rupture rate of 19.2 % in our sample when compared to other techniques. We therefore believe that this technique should not be used in very active patients who desire fast recovery after acute ATR because the risks may be too high.
Conclusion
Endoscopic FHL transfer appears to be associated with a high re-rupture rate when used to treat acute Achilles tendon ruptures.
Evidence level
IV, Case Series.
简介：跟腱断裂（ATR）是肌肉骨骼系统最常见的损伤之一。最近，内窥镜下FHL移植已成功用于治疗足球运动员的急性损伤，具有良好的恢复率和良好的功能预后。本研究的目的是分析患者报告的问卷、功能容量评估（FCA）和内镜下FHL转移治疗急性ATR后的再破裂率。方法：这是一个前瞻性病例系列，包括2022年3月至2023年12月期间26名患者（15名男性，11名女性，平均年龄47.7岁），他们患有ATR并接受了FHL内镜转移手术重建。最短随访时间为12个月。术后评估包括视觉模拟疼痛量表（VAS）、victoria Institute of Sports Assessment - Achilles （VISA-A）评分、跟腱总断裂评分（ATRS）、AOFAS、EVA，以及足底屈曲强度、拇屈曲强度、踝关节活动度、单跟上升试验、弓步试验和跟腱静息角。结果：26例患者中有5例（19.2 %）在术后第2周至第4周之间再次发生跟腱断裂。术后12个月，VAS测量疼痛为0.5，VISA-A平均评分为94.4(95 % CI: 90.8 ~ 100)， ATRS平均为5.1。与以前未受影响的一侧相比，患侧的足底屈曲强度和踝关节活动明显降低（p = 0.015和p ）讨论：尽管采取了谨慎的康复计划，但与其他技术相比，我们观察到样本中不可接受的再破裂率为19.2% %。因此，我们认为这种技术不应该用于急性ATR后希望快速恢复的非常活跃的患者，因为风险可能太高。结论：内镜下FHL转移治疗急性跟腱断裂的再破裂率较高。证据等级：IV，案例系列。
{"title":"Endoscopic flexor hallucis longus transfer for acute Achilles tendon ruptures is associated with a high re-rupture rate: A prospective case series","authors":"Tiago Soares Baumfeld , Victor Roberto Borges Barbosa , Breno Souza dos Santos , Daniel Soares Baumfeld , Alexandre Leme Godoy-Santos , Stefan Rammelt","doi":"10.1016/j.fas.2025.05.009","DOIUrl":"10.1016/j.fas.2025.05.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Achilles tendon rupture<span><span> (ATR) is one of the most common injuries to the </span>musculoskeletal system<span>. Recently, endoscopic FHL transfer has been successfully used to treat acute injuries in soccer players, with good return to play rates and good functional outcomes. The aim of this study is to analyze patient-reported questionnaires, functional capacity assessment (FCA), and re-rupture rates following endoscopic FHL transfer for acute ATR.</span></span></div></div><div><h3>Methods</h3><div><span>This is a prospective case series with 26 patients (15 men, 11 women, mean age 47.7 years) who suffered an ATR and underwent surgical reconstruction<span> with a FHL endoscopic transfer, between March 2022 and December 2023. The minimum follow-up was 12 months. Postoperative assessments included the visual analogue pain scale (VAS), Victorian Institute of Sports Assessment – Achilles (VISA-A) score, Achilles total tendon rupture score (ATRS), </span></span>AOFAS<span><span>, EVA, as well as plantar flexion strength, hallux flexion strength, ankle mobility, single heel rise test and Lunge test and </span>Achilles tendon resting angle.</span></div></div><div><h3>Results</h3><div>Five out of 26 patients (19,2 %) had a re-rupture of the Achilles tendon between the second and the fourth postoperative week. Twelve months postoperatively, the pain measured by VAS was 0.5, the mean VISA-A score was 94.4 (95 % CI: 90.8–100), and the mean ATRS was 5.1. The plantar flexion strength and ankle mobility were significantly lower in the affected side when compared to the formerly unaffected side (p = 0.015 and p < 0.001, respectively). No wound healing problems or neurovascular or complications were observed.</div></div><div><h3>Discussion</h3><div>Despite a cautious rehabilitation program, we observed an unacceptably re-rupture rate of 19.2 % in our sample when compared to other techniques. We therefore believe that this technique should not be used in very active patients who desire fast recovery after acute ATR because the risks may be too high.</div></div><div><h3>Conclusion</h3><div>Endoscopic FHL transfer appears to be associated with a high re-rupture rate when used to treat acute Achilles tendon ruptures.</div></div><div><h3>Evidence level</h3><div>IV, Case Series.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 8","pages":"Pages 755-760"},"PeriodicalIF":2.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-02DOI: 10.1016/j.fas.2025.05.013
Weijia Song, Qianting Huang, Zhuyu Jiang
Background
Plantar fasciitis is a common sports injury with long-term chronic pain in the heel as the main symptom, and athletic taping has achieved certain therapeutic effects to improve it, but the clinical efficacy of the problem is still controversial, which was evaluated by Meta-analysis to evaluate the clinical efficacy of the athletic taping technique on patients with plantar fasciitis.
Methods
The Cochrane Library, Embase, PubMed, Web of Science, CNKI, Wanfang, and Vip databases were searched by computer for randomized controlled trial on the clinical efficacy of exercise taping in patients with PF from the time of construction to 1 September 2024, and the PRISMA 2020 checklist was strictly followed. Quality was assessed using the cochrane 2.0 randomized controlled trials scale by two independent reviewers. Endings were meta-analysis using RevMan 5.4.1 analysis software to analyse the data.
Results
Eleven randomized controlled trial with a total of 395 patients were included. On VAS scores, KT effectively reduced VAS pain scores (MD=-0.79,95 % CI −1.10,-0.48, P < 0.00001); on AOFAS scores, KT improved AOFAS function scores (MD=6.58, 95 % CI 5.03,8.13, P < 0.00001) and the results remained consistent across intervention durations; on plantar fascia thickness measurements, KT significantly reduced plantar fascia thickness (MD=-0.33, 95 % CI −0.56,-0.10, P = 0.005); on BBS scores, KT significantly improved BBS scores [MD= 4.75, 95 % CI (3.17, 6.32), P < 0.00001]; on FFI-FPS scores, KT effectively improved FFI-FPS scores [MD = -2.59, 95 % CI (-3.50, −1.69), P < 0.00001]; on FFI-FDS scores, there was a significant improvement on FFI-FDS scores; on FFI-ALS scores, KT had a significant improvement on the FFI-ALS score had a significant effect [MD= -11.03, 95 % CI (-14.79, −7.27), P < 0.00001]; and on VAS scores after follow-up, the pain relief effect was sustained (MD=-1.03, 95 % CI −1.21, −0.85, P < 0.00001).
Conclusion
Based on the available evidence, preliminary analyses suggest that KT combined with conventional rehabilitation may have some advantages in improving pain, ankle-hindfoot function, and plantar fascia thickness in patients with plantar fasciitis, and some of the efficacy is short-term sustained. However, due to the heterogeneity and sample size of the included studies, the above conclusions need to be further validated by more high-quality studies.
背景：足底筋膜炎是一种常见的以足跟长期慢性疼痛为主要症状的运动损伤，运动贴敷在改善足底筋膜炎方面取得了一定的治疗效果，但对该问题的临床疗效仍存在争议，本文采用Meta-analysis评价运动贴敷技术对足底筋膜炎患者的临床疗效。方法：计算机检索Cochrane Library、Embase、PubMed、Web of Science、CNKI、万方、Vip等数据库，严格按照PRISMA 2020检查表，从建库之日起至2024年9月1日，对运动贴片治疗PF患者的临床疗效进行随机对照试验。质量评估采用cochrane 2.0随机对照试验量表，由两名独立审稿人进行。采用RevMan 5.4.1分析软件对数据进行meta分析。结果：纳入11项随机对照试验，共395例患者。在VAS评分上，KT有效降低了VAS疼痛评分（MD=-0.79,95 % CI -1.10,-0.48, P ）结论：根据现有证据，初步分析表明，KT联合常规康复在改善足底筋膜炎患者的疼痛、踝关节-后足功能、足底筋膜厚度方面可能具有一定优势，且部分疗效是短期持续的。然而，由于纳入研究的异质性和样本量，上述结论需要更多高质量研究的进一步验证。
{"title":"Clinical efficacy of athletic taping-assisted physiotherapy for plantar fasciitis: A systematic evaluation and meta-analysis","authors":"Weijia Song, Qianting Huang, Zhuyu Jiang","doi":"10.1016/j.fas.2025.05.013","DOIUrl":"10.1016/j.fas.2025.05.013","url":null,"abstract":"<div><h3>Background</h3><div>Plantar fasciitis<span> is a common sports injury with long-term chronic pain in the heel as the main symptom, and athletic taping has achieved certain therapeutic effects to improve it, but the clinical efficacy of the problem is still controversial, which was evaluated by Meta-analysis to evaluate the clinical efficacy of the athletic taping technique on patients with plantar fasciitis.</span></div></div><div><h3>Methods</h3><div><span>The Cochrane Library<span>, Embase, PubMed, Web of Science, CNKI, Wanfang, and Vip databases were searched by computer for </span></span>randomized controlled trial<span> on the clinical efficacy of exercise taping in patients with PF from the time of construction to 1 September 2024, and the PRISMA<span> 2020 checklist was strictly followed. Quality was assessed using the cochrane 2.0 randomized controlled trials scale by two independent reviewers. Endings were meta-analysis using RevMan 5.4.1 analysis software to analyse the data.</span></span></div></div><div><h3>Results</h3><div><span>Eleven randomized controlled trial<span> with a total of 395 patients were included. On VAS scores, KT effectively reduced VAS pain scores (MD=-0.79,95 % CI −1.10,-0.48, P < 0.00001); on AOFAS scores, KT improved AOFAS function scores (MD=6.58, 95 % CI 5.03,8.13, P < 0.00001) and the results remained consistent across intervention durations; on plantar fascia thickness measurements, KT significantly reduced plantar fascia thickness (MD=-0.33, 95 % CI −0.56,-0.10, P = 0.005); on </span></span>BBS<span><span> scores, KT significantly improved BBS scores [MD= 4.75, 95 % CI (3.17, 6.32), P < 0.00001]; on FFI-FPS scores, KT effectively improved FFI-FPS scores [MD = -2.59, 95 % CI (-3.50, −1.69), P < 0.00001]; on FFI-FDS scores, there was a significant improvement on FFI-FDS scores; on FFI-ALS scores, KT had a significant improvement on the FFI-ALS score had a significant effect [MD= -11.03, 95 % CI (-14.79, −7.27), P < 0.00001]; and on VAS scores after follow-up, the </span>pain relief effect was sustained (MD=-1.03, 95 % CI −1.21, −0.85, P < 0.00001).</span></div></div><div><h3>Conclusion</h3><div>Based on the available evidence, preliminary analyses suggest that KT combined with conventional rehabilitation may have some advantages in improving pain, ankle-hindfoot function, and plantar fascia thickness in patients with plantar fasciitis, and some of the efficacy is short-term sustained. However, due to the heterogeneity and sample size of the included studies, the above conclusions need to be further validated by more high-quality studies.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 1","pages":"Pages 11-25"},"PeriodicalIF":2.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Progressive collapsing foot deformity (PCFD) represents a progressive medial longitudinal arch collapse of the foot. This study reviewed the clinical and biomechanical efficacy of orthotic interventions for PCFD.
Methods
A systematic search was performed on Web of Science, PubMed, and Scopus, resulting in 14 studies. We used the ROBINS-I tool to evaluate the methodological quality. For the narrative synthesis, we summarized the results in a textual format, while for the meta-analysis, Standardized Mean Differences were computed from the results whenever feasible.
Results
Major improvements were recorded in disability scores, pain intensity, and patient satisfaction. Orthotics decreased hindfoot eversion by 3–5° and increased forefoot plantarflexion by 6–9°. An ankle-foot orthosis with lateral extensions or an articulated design enhanced forefoot adduction and hindfoot inversion. Meta-analysis results indicate a 56.84 % improvement in the Foot Functional Index (95 % CI: 41.1–72.58) alongside a 28.53-point increase in the American Orthopedic Foot and Ankle Society Ankle/Hindfoot Scale (95 % CI: 22.66–34.4).
Conclusions
Orthotic interventions are effective treatments for PCFD, reducing pain, improving function, and correcting pathological kinematics.
Level of evidence
2
背景：进行性塌陷足畸形（PCFD）代表一种进行性内侧纵足弓塌陷。本研究综述了矫形干预治疗PCFD的临床和生物力学效果。方法：系统检索Web of Science、PubMed、Scopus，共纳入14篇研究。我们使用ROBINS-I工具来评估方法学质量。对于叙述性综合，我们以文本格式总结结果，而对于元分析，在可行的情况下，从结果中计算标准化平均差异。结果：残疾评分、疼痛强度和患者满意度均有显著改善。矫形使后脚外翻3-5°，使前脚跖屈6-9°。踝足矫形器与外侧延伸或铰接式设计增强前足内收和后足内翻。荟萃分析结果显示，足部功能指数改善了56.84 %(95 % CI: 41.1-72.58)，美国骨科足踝协会踝关节/后足量表增加了28.53点（95 % CI: 22.66-34.4）。结论：矫形干预是治疗PCFD的有效方法，可减轻疼痛，改善功能，纠正病理运动学。证据等级:2;
{"title":"Clinical and biomechanical outcomes of orthotic devices for progressive collapsing foot deformity: a systematic review and meta-analysis","authors":"Hanieh Khaliliyan , Amir Reza Vosoughi , Mahmood Bahramizadeh , Amirhossein Zare , Majid Ansari , Farhad Ghaffari , Arash Sharafatvaziri","doi":"10.1016/j.fas.2025.05.012","DOIUrl":"10.1016/j.fas.2025.05.012","url":null,"abstract":"<div><h3>Background</h3><div><span>Progressive collapsing foot deformity (PCFD) represents a progressive medial longitudinal arch collapse of the foot. This study reviewed the clinical and biomechanical efficacy of </span>orthotic interventions for PCFD.</div></div><div><h3>Methods</h3><div>A systematic search was performed on Web of Science, PubMed, and Scopus, resulting in 14 studies. We used the ROBINS-I tool to evaluate the methodological quality. For the narrative synthesis, we summarized the results in a textual format, while for the meta-analysis, Standardized Mean Differences were computed from the results whenever feasible.</div></div><div><h3>Results</h3><div><span>Major improvements were recorded in disability scores, pain intensity, and patient satisfaction. Orthotics decreased hindfoot eversion by 3–5° and increased forefoot<span> plantarflexion by 6–9°. An ankle-foot orthosis with lateral extensions or an articulated design enhanced forefoot adduction and hindfoot inversion. Meta-analysis results indicate a 56.84 % improvement in the Foot Functional Index (95 % CI: 41.1–72.58) alongside a 28.53-point increase in the American </span></span>Orthopedic Foot and Ankle Society Ankle/Hindfoot Scale (95 % CI: 22.66–34.4).</div></div><div><h3>Conclusions</h3><div>Orthotic interventions are effective treatments for PCFD, reducing pain, improving function, and correcting pathological kinematics.</div></div><div><h3>Level of evidence</h3><div>2</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 1","pages":"Pages 1-10"},"PeriodicalIF":2.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-29DOI: 10.1016/j.fas.2025.05.014
Jin Su Kim , Chul Hyun Park
Background
To the best of our knowledge, no study has investigated complete calcaneal-side calcaneofibular ligament (CFL) rupture. This study was performed to compare the clinical and radiographic results of conservative and surgical treatments for acute ankle sprains with complete calcaneal-side CFL rupture.
Methods
This study included 36 patients diagnosed with acute ankle sprain and complete calcaneal-side CFL rupture. The first 14 patients were treated conservatively (group C), and the remaining 22 underwent surgery (group S). Clinical results between the two groups were compared regarding their scores on the Cumberland Ankle Instability Tool (CAIT) and patient satisfaction with the treatment. Radiographic results were evaluated for the rupture status of the CFL on preoperative magnetic resonance imaging and stability of the ankle joint using a stress radiographs with Telos and manual anterior drawer test.
Results
At the last follow-up, the mean CAIT score was significantly higher in group S than in group C (P < 0.001). The treatment dissatisfaction rate was significantly higher in group C (P = 0.003). In all cases, the proximal migration distance of the ruptured CFL significantly correlated with the incidence of Stener’s-like lesions, in which the distal stump of the CFL was displaced over the peroneal tendons (R=0.721, P < 0.001). Stress radiographs showed no significant difference in postoperative instability between groups. In the manual anterior drawer test at the last follow-up, the proportion of stable ankles was significantly higher in group S than in group C (P = 0.02).
Conclusion
Surgical treatment could improve clinical results and satisfaction in patients with acute ankle sprains and complete calcaneal-side CFL rupture.
{"title":"Surgical intervention yields superior results over conservative management in calcaneal-side calcaneofibular ligament rupture","authors":"Jin Su Kim , Chul Hyun Park","doi":"10.1016/j.fas.2025.05.014","DOIUrl":"10.1016/j.fas.2025.05.014","url":null,"abstract":"<div><h3>Background</h3><div>To the best of our knowledge, no study has investigated complete calcaneal-side calcaneofibular ligament (CFL) rupture. This study was performed to compare the clinical and radiographic results of conservative and surgical treatments for acute ankle sprains with complete calcaneal-side CFL rupture.</div></div><div><h3>Methods</h3><div>This study included 36 patients diagnosed with acute ankle sprain and complete calcaneal-side CFL rupture. The first 14 patients were treated conservatively (group C), and the remaining 22 underwent surgery (group S). Clinical results between the two groups were compared regarding their scores on the Cumberland Ankle Instability Tool (CAIT) and patient satisfaction with the treatment. Radiographic results were evaluated for the rupture status of the CFL on preoperative magnetic resonance imaging and stability of the ankle joint using a stress radiographs with Telos and manual anterior drawer test.</div></div><div><h3>Results</h3><div>At the last follow-up, the mean CAIT score was significantly higher in group S than in group C (P < 0.001). The treatment dissatisfaction rate was significantly higher in group C (P = 0.003). In all cases, the proximal migration distance of the ruptured CFL significantly correlated with the incidence of Stener’s-like lesions, in which the distal stump of the CFL was displaced over the peroneal tendons (R=0.721, P < 0.001). Stress radiographs showed no significant difference in postoperative instability between groups. In the manual anterior drawer test at the last follow-up, the proportion of stable ankles was significantly higher in group S than in group C (P = 0.02).</div></div><div><h3>Conclusion</h3><div>Surgical treatment could improve clinical results and satisfaction in patients with acute ankle sprains and complete calcaneal-side CFL rupture.</div></div><div><h3>Level of evidence</h3><div>III, Retrospective cohort study</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"32 1","pages":"Pages 26-32"},"PeriodicalIF":2.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-28DOI: 10.1016/j.fas.2025.05.011
Bi O Jeong, Jin Hyung Kim, Min Gyu Kyung
Background
This study investigated radiological changes in syndesmotic injuries after suture-button fixation, from the immediate postoperative period to the resumption of daily activities.
Methods
We retrospectively analyzed 38 patients who underwent syndesmosis fixation using a suture-button. Anterior difference (AD), posterior difference (PD), fibular translation (FT), and fibular rotation (FR) were measured on computed tomography scans and compared across time points and with the contralateral side.
Results
AD and PD significantly increased preoperatively, decreased immediately postoperatively, and were slightly increased or maintained at 6 months, resembling the normal side. FT showed no significant changes over time. FR decreased immediately after surgery and slightly increased at 6 months, approaching values of the contralateral side.
Conclusions
Suture-button fixation initially over-narrowed the syndesmosis compared to the normal side. However, with weightbearing and daily activities, the overcorrected syndesmosis gradually adjusted to resemble the uninjured side.
{"title":"Analysis of radiological changes using computed tomography after treatment with suture-button fixation in syndesmosis injury","authors":"Bi O Jeong, Jin Hyung Kim, Min Gyu Kyung","doi":"10.1016/j.fas.2025.05.011","DOIUrl":"10.1016/j.fas.2025.05.011","url":null,"abstract":"<div><h3>Background</h3><div>This study investigated radiological changes in syndesmotic injuries after suture-button fixation, from the immediate postoperative period to the resumption of daily activities.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 38 patients who underwent syndesmosis fixation using a suture-button. Anterior difference (AD), posterior difference (PD), fibular translation (FT), and fibular rotation (FR) were measured on computed tomography scans<span> and compared across time points and with the contralateral side.</span></div></div><div><h3>Results</h3><div>AD and PD significantly increased preoperatively, decreased immediately postoperatively, and were slightly increased or maintained at 6 months, resembling the normal side. FT showed no significant changes over time. FR decreased immediately after surgery and slightly increased at 6 months, approaching values of the contralateral side.</div></div><div><h3>Conclusions</h3><div>Suture-button fixation initially over-narrowed the syndesmosis compared to the normal side. However, with weightbearing and daily activities, the overcorrected syndesmosis gradually adjusted to resemble the uninjured side.</div></div><div><h3>Level of evidence</h3><div>III</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 8","pages":"Pages 768-773"},"PeriodicalIF":2.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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