{"title":"Response to letter to the editor to comment on : Prevalence and risk factors of ankle osteoarthritis in a population-based study","authors":"Akinobu Nishimura, Yoshiyuki Senga, Yuki Fujikawa, Chihiro Konno, Akihiro Sudo","doi":"10.1016/j.fas.2025.07.001","DOIUrl":"10.1016/j.fas.2025.07.001","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 6","pages":"Pages 558-559"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668732","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 : 2025-08-01DOI: 10.1016/j.fas.2025.02.006
Henrique César Temóteo Ribeiro , José Alberto Dias Leite , Marcos Vinícius Lopes de Queiroz , João Felipe Martins Tomaz , Maria Luzete Costa Cavalcante , Diego Ariel de Lima
Background
Peroneal tendon injuries, particularly of the peroneus longus, contribute to lateral ankle pain and instability. However, limited literature addresses the anatomical influence of the cuboid tunnel and the os peroneum on such injuries. This study investigates histological changes in the peroneus longus tendon and their relationship to cuboid tunnel dimensions, os peroneum presence, and age.
Methods
This cross-sectional study examined 60 peroneus longus tendons from 30 cadavers (ages 15–71). Tendons were sectioned and histologically analyzed for cellularity and collagen composition. Cuboid tunnel dimensions were measured, and the presence of os peroneum, an accessory ossicle located within the peroneus longus tendon, was recorded. Statistical correlations were performed.
Results
Increased type III collagen and cellularity were significantly associated with advanced age, reduced tunnel width, and increased tunnel height (p < 0.05). No significant association was found with tunnel length or os peroneum presence.
Conclusions
Age, reduced cuboid tunnel width, and increased tunnel height are associated with peroneus longus tendon degeneration, with collagen type I replacement by type III, predisposing factors for tendinosis.
{"title":"Anatomohistological study of the peroneus longus tendon in the cuboid bone tunnel: Correlation with tunnel dimensions and the presence of os peroneum","authors":"Henrique César Temóteo Ribeiro , José Alberto Dias Leite , Marcos Vinícius Lopes de Queiroz , João Felipe Martins Tomaz , Maria Luzete Costa Cavalcante , Diego Ariel de Lima","doi":"10.1016/j.fas.2025.02.006","DOIUrl":"10.1016/j.fas.2025.02.006","url":null,"abstract":"<div><h3>Background</h3><div><span>Peroneal tendon injuries, particularly of the peroneus longus, contribute to lateral ankle pain and instability. However, limited literature addresses the anatomical influence of the cuboid tunnel and the </span><em>os peroneum</em> on such injuries. This study investigates histological changes in the peroneus longus tendon and their relationship to cuboid tunnel dimensions, <em>os peroneum</em> presence, and age.</div></div><div><h3>Methods</h3><div>This cross-sectional study examined 60 peroneus longus tendons from 30 cadavers (ages 15–71). Tendons were sectioned and histologically analyzed for cellularity and collagen composition. Cuboid tunnel dimensions were measured, and the presence of <em>os peroneum</em>, an accessory ossicle located within the peroneus longus tendon, was recorded. Statistical correlations were performed.</div></div><div><h3>Results</h3><div><span>Increased type III collagen and cellularity were significantly associated with advanced age, reduced tunnel width, and increased tunnel height (p < 0.05). No significant association was found with tunnel length or </span><em>os peroneum</em> presence.</div></div><div><h3>Conclusions</h3><div>Age, reduced cuboid tunnel width, and increased tunnel height are associated with peroneus longus tendon degeneration, with collagen type I<span> replacement by type III, predisposing factors for tendinosis.</span></div></div><div><h3>Level of Evidence</h3><div>Level IV (Anatomical Study)</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 6","pages":"Pages 521-524"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426528","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}
Traditionally, metatarsal Ewing sarcoma (ES) is managed with disarticulation above the tarsometatarsal joint and ray amputation. In this study, we evaluate the outcomes of a less invasive approach in patients with metatarsal ES and good response to neoadjuvant chemotherapy.
Methods
Eleven patients with metatarsal ES (mean age: 11.5 ± 3) and complete radiologic response to neoadjuvant chemotherapy who underwent resection and reconstruction with fibular strut allograft were included.
Results
At a mean follow-up of 8.5 ± 4 years, the mean Musculoskeletal Tumor Society (MSTS) score of the patients was 29 ± 1.7. Patients with metatarsophalangeal joint fusion had limitations in reactional activities. One patient had a local recurrence. Postoperative complications included wound dehiscence (n = 1), superficial infection (n = 1), and allograft fracture (n = 1). Only one patient required revision surgery.
Conclusion
Fibular allograft reconstruction after resection of metatarsal ES can be regarded as a valuable alternative to amputation in patients who respond well to neoadjuvant chemotherapy.
{"title":"Outcomes of metatarsal Ewing sarcoma following the resection and intercalary reconstruction with fibular strut allograft: A retrospective case series","authors":"Khodamorad Jamshidi , Abolfazl Bagherifard , Seyyed Saeed Khabiri , Alireza Mirzaei","doi":"10.1016/j.fas.2025.02.001","DOIUrl":"10.1016/j.fas.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Traditionally, metatarsal Ewing sarcoma<span><span> (ES) is managed with disarticulation above the </span>tarsometatarsal joint<span> and ray amputation. In this study, we evaluate the outcomes of a less invasive approach in patients with metatarsal ES and good response to neoadjuvant chemotherapy.</span></span></div></div><div><h3>Methods</h3><div>Eleven patients with metatarsal ES (mean age: 11.5 ± 3) and complete radiologic response to neoadjuvant chemotherapy who underwent resection and reconstruction with fibular strut allograft were included.</div></div><div><h3>Results</h3><div><span><span><span>At a mean follow-up of 8.5 ± 4 years, the mean Musculoskeletal Tumor Society (MSTS) score of the patients was 29 ± 1.7. Patients with metatarsophalangeal </span>joint fusion had limitations in reactional activities. One patient had a local recurrence. </span>Postoperative complications included </span>wound dehiscence (n = 1), superficial infection (n = 1), and allograft fracture (n = 1). Only one patient required revision surgery.</div></div><div><h3>Conclusion</h3><div>Fibular allograft reconstruction after resection of metatarsal ES can be regarded as a valuable alternative to amputation in patients who respond well to neoadjuvant chemotherapy.</div></div><div><h3>Level of evidence</h3><div>IV</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 6","pages":"Pages 492-497"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371187","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 : 2025-08-01DOI: 10.1016/j.fas.2025.02.009
Tomas Urrutia, Jorge Faundez, Catalina Vidal, Joaquín Palma, Jorge Filippi
Background
Pilon fractures, constituting 3–10 % of all tibia fractures, present significant challenges due to their complex nature and frequent involvement of soft tissue damage. Effective management necessitates careful preoperative planning and strategic surgical approach selection. This study aims to provide a comprehensive cadaveric analysis comparing eight distinct surgical approaches to tibial pilon fractures, focusing on the consistently exposed segment and the extent of the exposed bone area for each approach.
Methods
Sixteen foot and ankle specimens, obtained through our university's body donation program, were utilized for this study. Each specimen underwent two different approaches, resulting in four repetitions for each assessed method. The approaches analyzed included anteromedial, anterolateral, lateral, posterolateral, posteromedial, posterior modified posteromedial, anterior modified posteromedial, and medial approaches. Standardized incisions and retraction techniques were employed to measure the exposed bone area using ImageJ software, while the consistently exposed segment was determined through axial cuts and photographic analysis.
Results
The anteromedial approach yielded the largest exposed area (18.36 cm²), whereas the anterolateral approach provided the greatest exposed segment (72°). The posteromedial approach proved most effective for exposing the Volkmann fragment, and the anterolateral approach was optimal for accessing the Chaput fragment and comminution areas. Combining the posteromedial and posterior modified posteromedial approaches could be suggested for extensive posterior malleolus fractures to maximize bone surface exposure while minimizing soft tissue damage.
Conclusion
This study offers objective data on the exposed area and segment for various surgical approaches, providing a valuable resource for orthopedic surgeons in preoperative planning and decision-making. By enhancing the understanding of the capabilities and limitations of each approach, this research aims to improve surgical outcomes for patients with complex tibial pilon fractures.
{"title":"Visualizing access in pilon fractures: A comparative study of eight approaches","authors":"Tomas Urrutia, Jorge Faundez, Catalina Vidal, Joaquín Palma, Jorge Filippi","doi":"10.1016/j.fas.2025.02.009","DOIUrl":"10.1016/j.fas.2025.02.009","url":null,"abstract":"<div><h3>Background</h3><div>Pilon fractures, constituting 3–10 % of all tibia fractures, present significant challenges due to their complex nature and frequent involvement of soft tissue damage. Effective management necessitates careful preoperative planning and strategic surgical approach selection. This study aims to provide a comprehensive cadaveric analysis comparing eight distinct surgical approaches to tibial pilon fractures, focusing on the consistently exposed segment and the extent of the exposed bone area for each approach.</div></div><div><h3>Methods</h3><div>Sixteen foot and ankle specimens, obtained through our university's body donation program, were utilized for this study. Each specimen underwent two different approaches, resulting in four repetitions for each assessed method. The approaches analyzed included anteromedial, anterolateral, lateral, posterolateral, posteromedial, posterior modified posteromedial, anterior modified posteromedial, and medial approaches. Standardized incisions and retraction techniques were employed to measure the exposed bone area using ImageJ software, while the consistently exposed segment was determined through axial cuts and photographic analysis.</div></div><div><h3>Results</h3><div>The anteromedial approach yielded the largest exposed area (18.36 cm²), whereas the anterolateral approach provided the greatest exposed segment (72°). The posteromedial approach proved most effective for exposing the Volkmann fragment, and the anterolateral approach was optimal for accessing the Chaput fragment and comminution areas. Combining the posteromedial and posterior modified posteromedial approaches could be suggested for extensive posterior malleolus fractures to maximize bone surface exposure while minimizing soft tissue damage.</div></div><div><h3>Conclusion</h3><div>This study offers objective data on the exposed area and segment for various surgical approaches, providing a valuable resource for orthopedic surgeons in preoperative planning and decision-making. By enhancing the understanding of the capabilities and limitations of each approach, this research aims to improve surgical outcomes for patients with complex tibial pilon fractures.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 6","pages":"Pages 539-546"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558380","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 : 2025-08-01DOI: 10.1016/j.fas.2024.09.006
Katherine Ning Li
{"title":"Letter to the editor to comment on: Prevalence and risk factors of ankle osteoarthritis in a population-based study","authors":"Katherine Ning Li","doi":"10.1016/j.fas.2024.09.006","DOIUrl":"10.1016/j.fas.2024.09.006","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 6","pages":"Page 557"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356531","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}
The aim of this study was to investigate if the numbers of cells and platelets in the bone marrow aspirate concentrate (BMAC) added to a hyaluronic acid membrane influence the clinical outcome up to long-term follow-up in the treatment of osteochondral lesions of the talus (OLTs).
Methods
A total of 102 patients with symptomatic OLTs underwent this one-step treatment. Eighty-five patients (53 men, 32 women, age 32.3 ± 10.6 years, lesion size 2.7 ± 1.6 cm2) were prospectively evaluated at baseline and at 2–5–10 years using the AOFAS ankle-hindfoot score, the NRS for pain, and the Tegner score. Satisfaction and failures were documented as well. Laboratory analysis of BMAC was performed for the count of mononucleated cells (MNCs) and platelets.
Results
The AOFAS improved from baseline (59.1 ± 13.7) to the final follow-up (82.3 ± 14.9, p < 0.0005). NRS improved from 7.1 ± 1.1 at baseline to 3.9 ± 2.8 at the final follow-up (p < 0.0005). Tegner improved from a pre-op 2.0 median to 3.0 at the final follow-up (p < 0.0005), not reaching the pre-injury level. MNCs and platelets in BMAC were 148.2 ± 54.2 × 109/L and 454.3 ± 277.5 × 109/L, respectively. MNCs correlated with NRS at 2 years (p = 0.018; rho=-0.260). However, MNCs number, as well as platelet number, did not influence the improvement from baseline of the clinical scores at all follow-up evaluations.
Conclusion
This study demonstrated, in a large series of patients evaluated up to a long-term follow-up, that the number of MNCs and platelets present in BMAC does not influence the overall clinical outcomes in patients affected by OLTs treated with a one-step hyaluronic acid scaffold implantation augmented with BMAC.
{"title":"The influence of cell and platelet number on clinical outcomes provided by a one-step scaffold transplantation with bone marrow concentrate for the treatment of osteochondral lesions of the talus","authors":"Luca Berveglieri , Francesca Vannini , Laura Ramponi , Angelo Boffa , Carola Cavallo , Annarita Cenacchi , Giuseppe Filardo , Roberto Buda , Cesare Faldini","doi":"10.1016/j.fas.2025.01.014","DOIUrl":"10.1016/j.fas.2025.01.014","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to investigate if the numbers of cells and platelets in the bone marrow aspirate concentrate (BMAC) added to a hyaluronic acid membrane influence the clinical outcome up to long-term follow-up in the treatment of osteochondral lesions of the talus (OLTs).</div></div><div><h3>Methods</h3><div>A total of 102 patients with symptomatic OLTs underwent this one-step treatment. Eighty-five patients (53 men, 32 women, age 32.3 ± 10.6 years, lesion size 2.7 ± 1.6 cm<sup>2</sup><span>) were prospectively evaluated at baseline and at 2–5–10 years using the AOFAS<span><span> ankle-hindfoot score, the NRS for pain, and the </span>Tegner score. Satisfaction and failures were documented as well. Laboratory analysis of BMAC was performed for the count of mononucleated cells (MNCs) and platelets.</span></span></div></div><div><h3>Results</h3><div>The AOFAS improved from baseline (59.1 ± 13.7) to the final follow-up (82.3 ± 14.9, p < 0.0005). NRS improved from 7.1 ± 1.1 at baseline to 3.9 ± 2.8 at the final follow-up (p < 0.0005). Tegner improved from a pre-op 2.0 median to 3.0 at the final follow-up (p < 0.0005), not reaching the pre-injury level. MNCs and platelets in BMAC were 148.2 ± 54.2 × 10<sup>9</sup>/L and 454.3 ± 277.5 × 10<sup>9</sup>/L, respectively. MNCs correlated with NRS at 2 years (p = 0.018; rho=-0.260). However, MNCs number, as well as platelet number, did not influence the improvement from baseline of the clinical scores at all follow-up evaluations.</div></div><div><h3>Conclusion</h3><div>This study demonstrated, in a large series of patients evaluated up to a long-term follow-up, that the number of MNCs and platelets present in BMAC does not influence the overall clinical outcomes in patients affected by OLTs treated with a one-step hyaluronic acid scaffold implantation augmented with BMAC.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 6","pages":"Pages 486-491"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472978","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}
Our purpose was to evaluate the reliability and validity of the Persian version of the visual analog scale foot and ankle (VAS-FA) among patients with foot and ankle problems and healthy subjects.
Methods
The VAS-FA was translated and adapted into Persian (Farsi). Then, 82 participants, including 41 healthy subjects and 41 patients with foot and ankle problems, fulfilled the questionnaire in two sessions. The validity was assessed by correlating VAS-FA with the Persian version of the foot and ankle outcome score (FAOS) and the foot and ankle ability measure (FAAM). Intraclass correlation coefficient (ICC) and Cronbach's α were used to assess test-retest reliability and internal consistency.
Results
There was a statistically significant difference between healthy participants and patients regarding the total VAS-FA score and its subscales (P < 0.001). The test-retest reliability was excellent, and the internal consistency was good to excellent. The correlation between the total VAS-FA score and FAAM and FAOS scores was good for the healthy subjects and good to excellent for patients.
Conclusion
The Persian version of VAS-FA is valid and reliable.
{"title":"Visual analog scale foot and ankle (VAS-FA): Reliability and validity of the Persian version","authors":"Hooshmand Zarei , Miad Nosratpour , Seyed Mohammadmisagh Moteshakereh , Mahyar Mahdavi , Amir Sabaghzadeh","doi":"10.1016/j.fas.2025.02.004","DOIUrl":"10.1016/j.fas.2025.02.004","url":null,"abstract":"<div><h3>Background</h3><div>Our purpose was to evaluate the reliability and validity of the Persian version of the visual analog scale foot and ankle (VAS-FA) among patients with foot and ankle problems and healthy subjects.</div></div><div><h3>Methods</h3><div><span>The VAS-FA was translated and adapted into Persian (Farsi). Then, 82 participants, including 41 healthy subjects and 41 patients with foot and ankle problems, fulfilled the questionnaire in two sessions. The validity was assessed by correlating VAS-FA with the Persian version of the foot and ankle outcome score (FAOS) and the foot and ankle ability measure (FAAM). Intraclass correlation coefficient (ICC) and </span>Cronbach's α<span> were used to assess test-retest reliability and internal consistency.</span></div></div><div><h3>Results</h3><div>There was a statistically significant difference between healthy participants and patients regarding the total VAS-FA score and its subscales (P < 0.001). The test-retest reliability was excellent, and the internal consistency was good to excellent. The correlation between the total VAS-FA score and FAAM and FAOS scores was good for the healthy subjects and good to excellent for patients.</div></div><div><h3>Conclusion</h3><div>The Persian version of VAS-FA is valid and reliable.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 6","pages":"Pages 517-520"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371128","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 : 2025-08-01DOI: 10.1016/j.fas.2024.08.005
Nicola Maffulli, Filippo Spiezia,
{"title":"Letter to the editor to comment on “A comparative biomechanical study of the krackow suture technique with three common percutaneous suture techniques in the treatment of Achilles tendon ruptures”","authors":"Nicola Maffulli, Filippo Spiezia,","doi":"10.1016/j.fas.2024.08.005","DOIUrl":"10.1016/j.fas.2024.08.005","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 6","pages":"Pages 555-556"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056960","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 : 2025-08-01DOI: 10.1016/j.fas.2025.02.002
Jacob S. Gandløse , Kristoffer W. Barfod , Rikke Hoeffner , Maria Swennergren Hansen , Marianne Christensen , Henrik Riel
Background
Acute Achilles tendon rupture (ATR) is a common injury associated with a high rate of deep vein thrombosis (DVT) during rehabilitation. This study assessed whether DVT affects long-term self-reported function.
Methods
Data from the Danish Achilles Tendon Database were used to compare Achilles tendon Total Rupture Scores (ATRS) at 6, 12, and 24 months between patients with and without symptomatic DVT, adjusting for covariates.
Results
No significant ATRS difference between DVT and non-DVT groups was observed over time (adjusted mean difference = −0.7, 95 % CI: −4.8–3.3, p = 0.72). However, patients with DVT reported lower ATRS at 24 months (adjusted mean difference = −4.9, 95 % CI: −9.0 to −0.9, p = 0.02).
Conclusions
Symptomatic DVT is not significantly associated with self-reported function over time in patients with ATR. However, patients with DVT may experience a recovery plateau, leading to lower long-term function, though the clinical significance is unclear.
{"title":"Impact of symptomatic deep vein thrombosis on self-reported function and treatment outcome following an acute Achilles tendon rupture: A register study","authors":"Jacob S. Gandløse , Kristoffer W. Barfod , Rikke Hoeffner , Maria Swennergren Hansen , Marianne Christensen , Henrik Riel","doi":"10.1016/j.fas.2025.02.002","DOIUrl":"10.1016/j.fas.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Acute Achilles tendon rupture (ATR) is a common injury associated with a high rate of deep vein thrombosis (DVT) during rehabilitation. This study assessed whether DVT affects long-term self-reported function.</div></div><div><h3>Methods</h3><div>Data from the Danish Achilles Tendon Database were used to compare Achilles tendon Total Rupture Scores (ATRS) at 6, 12, and 24 months between patients with and without symptomatic DVT, adjusting for covariates.</div></div><div><h3>Results</h3><div>No significant ATRS difference between DVT and non-DVT groups was observed over time (adjusted mean difference = −0.7, 95 % CI: −4.8–3.3, p = 0.72). However, patients with DVT reported lower ATRS at 24 months (adjusted mean difference = −4.9, 95 % CI: −9.0 to −0.9, p = 0.02).</div></div><div><h3>Conclusions</h3><div>Symptomatic DVT is not significantly associated with self-reported function over time in patients with ATR. However, patients with DVT may experience a recovery plateau, leading to lower long-term function, though the clinical significance is unclear.</div></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 6","pages":"Pages 498-504"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416053","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 : 2025-07-31DOI: 10.1016/j.fas.2025.07.006
Ben Efrima, Agustin Barbero, Assaf Albsagly, Amit Benady, Cristian Indino, Camila Maccario, Federico Giuseppe Usuelli
Background: While diagnosing mechanical chronic ankle instability (CAI) is often straightforward, identifying subtle micro-instability remains challenging. A tear of the superior bundle of the lateral ligament complex has been proposed as a contributor to micro-instability, potentially causing increased anterior translation and internal talar rotation under load. Weight-bearing computed tomography (WBCT) offers valuable insight into hindfoot alignment and load-induced deformation, making it a promising tool for assessing suspected micro-instability. This study aims to compare talar axial rotation between symptomatic patients reporting subjective micro-instability and asymptomatic controls.
Methods: Forty ankles from patients with osteochondral lesions of the talus (OLT) and signs of micro-instability were compared to asymptomatic controls. WBCT and image analysis software were used to generate 3D models and perform semi-automated hindfoot alignment measurements. Inter- and intra-observer reliability was also assessed.
Results: The OLT group showed a mean axial rotation difference of -4.5 ± 4.5 degrees compared to controls (P < 0.001), indicating increased external rotation of the talus. Intra-observer reliability was good to excellent (ICC 0.88, 0.92), and inter-observer agreement was excellent (ICC 0.93, 0.90).
Conclusion: WBCT did not reveal abnormal internal rotation in OLT patients with subjective micro-instability. Instead, significant external rotation of the talus was observed. These findings suggest that external rotation may predispose patients to micro-instability. Further studies are needed to clarify its role in functional ankle instability LEVEL OF EVIDENCE: III.
{"title":"Abnormal axial rotation of the Talus on weight-bearing computed tomography in patients with micro-instability of the ankle.","authors":"Ben Efrima, Agustin Barbero, Assaf Albsagly, Amit Benady, Cristian Indino, Camila Maccario, Federico Giuseppe Usuelli","doi":"10.1016/j.fas.2025.07.006","DOIUrl":"https://doi.org/10.1016/j.fas.2025.07.006","url":null,"abstract":"<p><strong>Background: </strong>While diagnosing mechanical chronic ankle instability (CAI) is often straightforward, identifying subtle micro-instability remains challenging. A tear of the superior bundle of the lateral ligament complex has been proposed as a contributor to micro-instability, potentially causing increased anterior translation and internal talar rotation under load. Weight-bearing computed tomography (WBCT) offers valuable insight into hindfoot alignment and load-induced deformation, making it a promising tool for assessing suspected micro-instability. This study aims to compare talar axial rotation between symptomatic patients reporting subjective micro-instability and asymptomatic controls.</p><p><strong>Methods: </strong>Forty ankles from patients with osteochondral lesions of the talus (OLT) and signs of micro-instability were compared to asymptomatic controls. WBCT and image analysis software were used to generate 3D models and perform semi-automated hindfoot alignment measurements. Inter- and intra-observer reliability was also assessed.</p><p><strong>Results: </strong>The OLT group showed a mean axial rotation difference of -4.5 ± 4.5 degrees compared to controls (P < 0.001), indicating increased external rotation of the talus. Intra-observer reliability was good to excellent (ICC 0.88, 0.92), and inter-observer agreement was excellent (ICC 0.93, 0.90).</p><p><strong>Conclusion: </strong>WBCT did not reveal abnormal internal rotation in OLT patients with subjective micro-instability. Instead, significant external rotation of the talus was observed. These findings suggest that external rotation may predispose patients to micro-instability. Further studies are needed to clarify its role in functional ankle instability LEVEL OF EVIDENCE: III.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838325","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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