Journal of Foot & Ankle Surgery最新文献_第6页

Can an isolated modified Lapidus procedure alter hindfoot alignment? a retrospective radiographic study 分离改良Lapidus手术能改变后足对中吗？回顾性影像学研究。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-01-01 DOI: 10.1053/j.jfas.2025.09.002

Ramy Samargandi , Aimery Sabelle , Jean Brilhault , Julien Berhouet , Rayane Benhenneda

Purpose

The study aimed to evaluate the effect of first tarsometatarsal joint (TMT-1) arthrodesis using the modified Lapidus procedure on coronal hindfoot alignment, given the potential influence of medial column stabilization on talar positioning.

Study Design

A retrospective radiographic analysis was performed.

Methods

We reviewed 54 feet in 40 patients (mean age 60.6 ± 9.78 years) who underwent an isolated modified Lapidus procedure with an average follow-up of 29.6 ± 13.9 months. Fixation was achieved using a compression screw and plantar plate. Preoperative and 12-month postoperative weight-bearing dorsoplantar, lateral, and Méary views were analyzed. Radiographic measurements were independently performed by two senior surgeons and assessed for inter-observer reliability. Importantly, only radiographic outcomes were evaluated.

Results

On Méary view, hindfoot valgus decreased significantly using the Méary’s circle angle method (-2.0 ± 2.0° for observer 1 and -2.44 ± 1.84° for observer 2; p < 0.001 for both). Djian’s hindfoot valgus angle also decreased significantly (-1.44 ± 0.98°, p < 0.001 for observer 1; -1.67 ± 4.09°, p = 0.004 for observer 2). Inter-observer reliability was good (ICC = 0.87 and 0.80, respectively).

Conclusion

The modified Lapidus procedure resulted in a significant radiographic reduction in hindfoot valgus, suggesting a stabilizing effect on the medial column and hindfoot. These radiographic findings may inform surgical planning in patients with hallux valgus and concomitant flatfoot, although further clinical validation is required.

目的：考虑到内侧柱稳定对距骨定位的潜在影响，本研究旨在评估采用改良Lapidus手术进行第一跗跖关节（TMT-1）融合术对后足冠状位的影响。研究设计：进行回顾性影像学分析。方法：我们回顾了40例54英尺的患者（平均年龄60.6±9.78岁），他们接受了孤立的改良Lapidus手术，平均随访29.6±13.9个月。使用加压螺钉和足底钢板进行固定。术前和术后12个月的负重足底背、侧位和体表视图进行分析。影像学测量由两名资深外科医生独立完成，并评估了观察者间的可靠性。重要的是，仅评估了影像学结果。结果：采用m诈骗犯的圆角法，m诈骗犯的后足外翻明显减小（观察者1为-2.0±2.0°，观察者2为-2.44±1.84°，p均< 0.001）。Djian的后足外翻角也显著减小（观察者1为-1.44±0.98°，p < 0.001；观察者2为-1.67±4.09°，p = 0.004）。观察者间信度良好（ICC = 分别为0.87和0.80）。结论：改良Lapidus手术可显著减少后足外翻，表明其对内侧柱和后足有稳定作用。尽管需要进一步的临床验证，但这些影像学结果可以为拇外翻合并平足患者的手术计划提供参考。

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引用次数: 0

Comparative study of concurrent arthroscopic anterior talofibular ligament repair and posterior ankle debridement: Novel adjustable lateral floating position versus traditional repositioning with re-preparation 并发关节镜下距腓骨前韧带修复及踝关节后清创的比较研究：新型可调外侧浮动体位与传统重新定位与重新准备。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-01-01 DOI: 10.1053/j.jfas.2025.08.015

Fan Ding , Kuankuan Yu , Jie Zhang , Sha Li , Yan Chen , Shijun Wei

Purpose

The goal of this study was to compare our novel adjustable lateral floating position with traditional repositioning and re-prepping for concurrent arthroscopic anterior talofibular ligament (ATFL) repair and posterior ankle debridement.

Study Design

Retrospective control study.

Methods

From 2019 to 2022, fifty-four cases underwent concurrent arthroscopic ATFL repair and posterior ankle debridement were retrospectively analyzed. According to the intraoperative position, 26 cases were assigned to group A (novel adjustable lateral floating position) and 28 to group B (traditional repositioning). The Foot and Ankle Ability Measure scales [FAAM, including activities of daily living (FAAM-ADL) and sports subscales (FAAM-SS)] and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores were compared. The surgical time and complications were also evaluated.

Results

The average follow-up time was 26.2 ± 2.5 months (range, 24-28 months) without significant differences between the groups. There was no significant difference between FAAM-ADL, FAAM-SS, and AOFAS scores at the final follow-ups. No significant difference in complication rates was found. However, there is a significant difference in median and interquartile range (IQR) of the surgical time between both groups [58.0 (50.0, 74.0) vs. 78.0 (68.5, 88.5)], with a large effects size (Cohen's d = -0.75). It is notable that the surgical times of patients with postoperative deep vein thrombosis exceeded 110 minutes in both groups.

Conclusion

For the concurrent arthroscopic ATFL repair and posterior ankle debridement, the novel adjustable lateral floating position is time-saving and reliable. This novel surgical positioning is also suitable for a younger or more junior surgeon.

目的：本研究的目的是比较我们的新型可调节的外侧浮动体位与传统的重新定位和重新准备进行关节镜下距腓骨前韧带（ATFL）修复和踝关节后清创。研究设计：回顾性对照研究。方法：回顾性分析2019年至2022年54例同时行关节镜下ATFL修复及踝关节后清创的病例。根据术中体位，将26例患者分为A组（新型可调节侧卧体位），28例患者分为B组（传统复位体位）。比较足踝能力量表[FAAM，包括日常生活活动量表（FAAM- adl）和运动量表（FAAM- ss）]和美国矫形足踝学会（AOFAS）踝关节-后足评分。评估手术时间及并发症。结果：两组患者平均随访时间为26.2±2.5个月（24 ~ 28个月），差异无统计学意义。FAAM-ADL、FAAM-SS和AOFAS评分在最后随访时无显著差异。并发症发生率无明显差异。然而，两组手术时间的中位数和四分位数范围（IQR）存在显著差异[58.0 (50.0,74.0)vs. 78.0(68.5, 88.5)]，且效应量较大（Cohen's d = -0.75）。值得注意的是，两组术后深静脉血栓患者手术时间均超过110分钟。结论：关节镜下并发ATFL修复及踝关节后清创，新型可调外侧浮动体位节省时间，可靠。这种新颖的手术体位也适用于较年轻或较初级的外科医生。证据等级：三级。

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引用次数: 0

Cover 1 -- cover prints black and PMS 261 封面1 -封面印刷黑色和PMS 261

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-01-01 DOI: 10.1053/S1067-2516(25)00345-X

引用次数: 0

Short-term risk of subtalar joint arthritis after stemmed total ankle replacement 全踝置换术后距下关节关节炎的短期风险。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-01-01 DOI: 10.1053/j.jfas.2025.08.012

Jae Yoon Kim DPM, AACFAS , Cameron Meyer DPM, AACFAS , Lauren Christie DPM, AACFAS , Orlando Martinez DPM , Gregory C Berlet MD, FRCS ©, FAOA, FAAOS

Background

Ankle osteoarthritis (OA) can significantly impact mobility and quality of life. Total ankle replacement (TAR) has emerged as an alternative to ankle arthrodesis due to its potential for preserving natural joint kinematics. However, it remains unclear if this maintained motion also limits progression of adjacent joint degeneration.

Objective

This study aims to evaluate the influence of stemmed implants on the progression of subtalar (STJ) osteoarthritis and delayed secondary STJ fusion.

Methods

A retrospective analysis was performed on 115 patients who underwent primary Stryker Inbone® fixed-bearing, stemmed TAR between December 2018 and February 2024. Patients with pre-existing STJ fusion or less than one year of postoperative follow-up were excluded. The final cohort of 72 patients, with a mean follow-up of 2.43 years, underwent radiographic and clinical evaluation of STJ osteoarthritis. The Kellgren-Lawrence Score (KLS) was utilized to assess changes in STJ arthritis preoperatively and postoperatively.

Results

Radiographic progression of STJ arthritis was seen in 6.94 % of patients, with only 1.39 % requiring secondary STJ fusion. Only one patient underwent fusion due to avascular necrosis of the talus, resulting in a case of nonunion. Seven patients reported postoperative STJ pain, despite stable radiographic findings, each of which was managed conservatively without additional surgical intervention.

Conclusion

These findings support and add to the limited body of literature on the use of stemmed ankle implants in limiting progressive adjacent joint arthritis to the STJ in the short term.

背景：踝关节骨关节炎（OA）可以显著影响活动能力和生活质量。全踝关节置换术（TAR）已成为踝关节融合术的替代方法，因为它具有保留关节自然运动学的潜力。然而，尚不清楚这种维持的运动是否也限制了邻近关节退变的进展。目的：探讨带根假体对距下（STJ）骨关节炎进展及延迟继发性STJ融合的影响。方法：回顾性分析2018年12月至2024年2月期间接受原发性Stryker Inbone®固定轴承治疗的115例患者。排除已有STJ融合或术后随访少于1年的患者。最后一组72例患者，平均随访2.43年，接受了STJ骨关节炎的影像学和临床评估。Kellgren-Lawrence评分（KLS）用于评估STJ关节炎术前和术后的变化。结果：6.94%的患者有STJ关节炎的影像学进展，只有1.39%的患者需要继发STJ融合。仅有1例患者因距骨无血管坏死而行骨融合，导致骨不愈合。7例患者报告术后STJ疼痛，尽管影像学表现稳定，但均采用保守治疗，没有额外的手术干预。结论：这些发现支持并补充了有限的文献，这些文献在短期内使用带柄踝关节植入物来限制进行性邻近关节关节炎对STJ的影响。

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引用次数: 0

More than meets the eye? evaluating 3D printing for progressive collapsing foot deformity classification 不只是看起来那么简单？评估3D打印进行性塌陷足畸形分类。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-01-01 DOI: 10.1053/j.jfas.2025.09.004

Wolfram Grün MD , Enrico Pozzessere MD , Emily J. Luo MHSc , Nacime Salomão Barbachan Mansur MD PhD , Antoine Acker MD , Pierre-Henri Vermorel MD , Francois Lintz MD PhD , Cesar de Cesar Netto MD PhD

Background

Progressive collapsing foot deformity (PCFD) is a complex, multiplanar condition involving the ankle, hindfoot, midfoot, and forefoot. The 2020 classification system introduced a structured framework, distinguishing two stages (flexible vs. rigid) and five deformity classes. Diagnosing certain classes, particularly Class D, remains challenging. Three-dimensional (3D) printing provides a novel tool for anatomical assessment. This study evaluated the inter- and intraobserver reliability of PCFD classification using 3D-printed models.

Methods

A retrospective analysis was performed on 60 patients (37 females, 23 males; mean age 53 ± 17.2 years; body mass index (BMI) 31.9 ± 7.0) who underwent WBCT prior to surgical correction of PCFD. WBCT data were segmented using Bonelogic™ software, and 3D-printed models were created at 80 % scale. Five fellowship-trained foot and ankle surgeons, blinded to clinical data, independently assessed the presence of PCFD classes A–E. Classifications were repeated after several weeks to assess intra-observer reliability. Percent agreement and reliability were analyzed using Fleiss’ and Cohen’s Kappa.

Results

The most frequent class combinations were ABCD (30 %) and ABC (23 %). Intra-observer reliability was highest for Class A (Kappa = 1.00) and lowest for Class B (Kappa = 0.40). Interobserver reliability ranged from slight (Class B, Kappa = 0.10) to fair (Class D, Kappa = 0.38), with perfect agreement for Class A.

Conclusions

3D-printed models demonstrated moderate-to-perfect intraobserver but variable interobserver agreement in PCFD classification. While they enhance spatial understanding, their use without WBCT may limit diagnostic consistency. Further studies should explore the additive value of 3D printing alongside WBCT.

背景：进行性塌陷足畸形（PCFD）是一种复杂的、多平面的疾病，涉及踝关节、后脚、足中部和前脚。2020年的分类系统引入了一个结构化的框架，区分了两个阶段（柔性与刚性）和五个畸形类别。诊断某些类别，特别是D类，仍然具有挑战性。三维（3D）打印为解剖评估提供了一种新的工具。本研究利用3d打印模型评估了PCFD分类在观察者之间和观察者内部的可靠性。方法：回顾性分析60例患者（女性37例，男性23例，平均年龄53±17.2岁，体重指数（BMI） 31.9±7.0）行WBCT手术矫正PCFD的临床资料。使用Bonelogic™软件对WBCT数据进行分割，并以80%的比例创建3d打印模型。5名接受过奖学金培训的足部和踝关节外科医生，对临床数据不知情，独立评估了A-E级PCFD的存在。几周后重复分类以评估观察者内部的可靠性。采用Fleiss和Cohen的Kappa分析一致性百分比和信度。结果：ABCD（30%）和ABC（23%）是最常见的药物组合。A类观察者内信度最高（Kappa = 1.00），B类观察者内信度最低（Kappa = 0.40）。观察者之间的信度范围从轻微（B类，Kappa = 0.10）到一般（D类，Kappa = 0.38），与a类完全一致。结论：3d打印模型在PCFD分类中表现出中度至完美的观察者内部一致性，但观察者之间的一致性是可变的。虽然它们增强了空间理解，但如果不使用WBCT，可能会限制诊断的一致性。进一步的研究应该与WBCT一起探索3D打印的附加价值。证据等级：IV级，回顾性病例系列。

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引用次数: 0

Postoperative complications after hammertoe correction: the influence of tobacco and non-tobacco nicotine 锤状趾矫正术后并发症：烟草和非烟草尼古丁的影响。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-01-01 DOI: 10.1053/j.jfas.2025.09.007

Joshua Wang MS , Apurvakumar Patel BS , Philong Nguyen BS , Megna Panchbhavi BS , Vinod K. Panchbhavi MD, FACS

Background

Nicotine use is associated with impaired wound healing and heightened perioperative risks. However, non-tobacco sources such as e-cigarettes and its impact on postoperative complications following hammertoe correction surgery remains underexplored.

Purpose

To evaluate the association between nicotine use and postoperative complications after hammertoe correction, comparing outcomes among tobacco-derived nicotine users, non-tobacco nicotine users, and non-nicotine users.

Study design

Retrospective cohort study.

Methods

A multi-institutional database (TriNetX) was queried to identify adult patients undergoing hammertoe correction. Patients were stratified into three cohorts: (1) nicotine users, (2) non-tobacco nicotine users (e.g., e-cigarette users), and (3) non-nicotine users. Propensity score matching was performed to control for confounders such as age, sex,race, and comorbities. Postoperative complications within 30 days were assessed, including wound disruption, infection, sepsis, deep vein thrombosis (DVT), and pulmonary embolism (PE).

Results

Compared to non-nicotine users, both nicotine-exposed cohorts exhibited higher postoperative complication rates. Among tobacco nicotine users, complication rates were: wound disruption (2.7 %), infection (1.7 %), sepsis (0.4 %), DVT (1.1 %), and PE (0.5 %). Non-tobacco nicotine users also demonstrated increased complications: wound disruption (2.3 %), infection (1.7 %), sepsis (0.4 %), DVT (1.2 %), and PE (0.5 %).

Conclusion

Nicotine exposure, whether from tobacco or alternative sources, is associated with significantly increased postoperative risks following hammertoe surgery. These findings highlight the importance of preoperative nicotine cessation strategies to reduce surgical complications and improve patient outcomes.

背景：尼古丁使用与伤口愈合受损和围手术期风险增加有关。然而，电子烟等非烟草来源及其对锤状趾矫正手术术后并发症的影响仍未得到充分研究。目的：评估尼古丁使用与锤状趾矫正术后并发症之间的关系，比较烟草来源尼古丁使用者、非烟草尼古丁使用者和非尼古丁使用者的结果。研究设计：回顾性队列研究。方法：查询多机构数据库（TriNetX）以确定接受槌状趾矫正的成年患者。患者被分为三组：(1)尼古丁使用者，(2)非烟草尼古丁使用者（如电子烟使用者），(3)非尼古丁使用者。进行倾向评分匹配以控制混杂因素，如年龄、性别、种族和合并症。评估术后30天内的并发症，包括伤口破裂、感染、败血症、深静脉血栓形成（DVT）和肺栓塞（PE）。结果：与非尼古丁使用者相比，两组尼古丁暴露组的术后并发症发生率均较高。在烟草尼古丁使用者中，并发症发生率为：伤口破裂（2.7%）、感染（1.7%）、败血症（0.4%）、DVT（1.1%）和PE（0.5%）。非烟草尼古丁使用者也表现出增加的并发症：伤口破裂（2.3%）、感染（1.7%）、败血症（0.4%）、DVT（1.2%）和PE（0.5%）。结论：无论是来自烟草还是其他来源的尼古丁暴露，都与锤状趾手术后的术后风险显著增加有关。这些发现强调了术前戒烟策略对减少手术并发症和改善患者预后的重要性。临床证据等级：3级，回顾性比较研究。

{"title":"Postoperative complications after hammertoe correction: the influence of tobacco and non-tobacco nicotine","authors":"Joshua Wang MS , Apurvakumar Patel BS , Philong Nguyen BS , Megna Panchbhavi BS , Vinod K. Panchbhavi MD, FACS","doi":"10.1053/j.jfas.2025.09.007","DOIUrl":"10.1053/j.jfas.2025.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Nicotine use is associated with impaired wound healing and heightened perioperative risks. However, non-tobacco sources such as e-cigarettes and its impact on postoperative complications following hammertoe correction surgery remains underexplored.</div></div><div><h3>Purpose</h3><div>To evaluate the association between nicotine use and postoperative complications after hammertoe correction, comparing outcomes among tobacco-derived nicotine users, non-tobacco nicotine users, and non-nicotine users.</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>A multi-institutional database (TriNetX) was queried to identify adult patients undergoing hammertoe correction. Patients were stratified into three cohorts: (1) nicotine users, (2) non-tobacco nicotine users (e.g., e-cigarette users), and (3) non-nicotine users. Propensity score matching was performed to control for confounders such as age, sex,race, and comorbities. Postoperative complications within 30 days were assessed, including wound disruption, infection, sepsis, deep vein thrombosis (DVT), and pulmonary embolism (PE).</div></div><div><h3>Results</h3><div>Compared to non-nicotine users, both nicotine-exposed cohorts exhibited higher postoperative complication rates. Among tobacco nicotine users, complication rates were: wound disruption (2.7 %), infection (1.7 %), sepsis (0.4 %), DVT (1.1 %), and PE (0.5 %). Non-tobacco nicotine users also demonstrated increased complications: wound disruption (2.3 %), infection (1.7 %), sepsis (0.4 %), DVT (1.2 %), and PE (0.5 %).</div></div><div><h3>Conclusion</h3><div>Nicotine exposure, whether from tobacco or alternative sources, is associated with significantly increased postoperative risks following hammertoe surgery. These findings highlight the importance of preoperative nicotine cessation strategies to reduce surgical complications and improve patient outcomes.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"65 1","pages":"Pages 33.e1-33.e5"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2026-01-01 DOI: 10.1053/S1067-2516(25)00347-3

引用次数: 0

Impact of lower extremity mechanical axis alignment on clinical outcomes following mosaicplasty for medial talar osteochondral lesions: A retrospective comparative study. 下肢机械轴对准对距骨内侧软骨病变马赛克成形术后临床结果的影响：回顾性比较研究。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2025-12-25 DOI: 10.1053/j.jfas.2025.12.012

Murat Onder, Anıl Erbas, Abdurrahman Aydin, M Bilal Kurk, Abdulhamit Misir

Background: The impact of proximal lower extremity malalignment on mosaicplasty outcomes for medial talar osteochondral lesions remains unclear.

Purpose: To determine whether knee-origin varus malalignment of the mechanical axis affects clinical outcomes and cartilage repair quality after mosaicplasty for medial talar osteochondral lesions.

Methods: Forty-four patients who underwent mosaicplasty for medial talar osteochondral lesions (2020-2023) were stratified into Group 1 (varus malalignment, n = 21) and Group 2 (neutral/mild valgus, n = 23) based on standing long-leg radiographs. Visual analog scale (VAS) pain scores, American Orthopaedic Foot and Ankle Society (AOFAS) scores, and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 scores were compared. Mean follow-up was 49.3 ± 26.2 months.

Results: Group 1 demonstrated significantly higher postoperative VAS scores (4.4 ± 2.0 vs. 1.5 ± 0.7, p < 0.001) and less pain improvement (ΔVAS: 4.2 ± 2.0 vs. 5.7 ± 1.1, p < 0.05) compared with Group 2. AOFAS scores were similar postoperatively (81.8 ± 9.8 vs. 85.5 ± 8.6, p = 0.075). MOCART 2.0 scores showed no significant difference (75±19 vs. 77±18, p = 0.859). Strong correlations existed between mechanical axis deviation and postoperative VAS (ρ=0.804, p < 0.001). Although some patients developed radiographically visible arthritic changes during follow-up, no patient underwent revision surgery or arthrodesis due to advanced osteoarthritis.

Conclusions: Varus malalignment was associated with higher postoperative pain scores and less pain improvement following mosaicplasty for medial talar osteochondral lesions, despite similar functional outcomes and cartilage repair quality. These findings suggest that surgical planning should consider mechanical axis alignment and that corrective realignment procedures may be warranted in select patients with significant varus deformity to optimize pain outcomes.

背景：下肢近端畸形对距骨内侧软骨病变嵌合成形术效果的影响尚不清楚。目的：探讨膝关节源性内翻机械轴错位对距骨内侧软骨病变镶嵌成形术后的临床疗效和软骨修复质量的影响。方法：根据站立长腿x线片将44例行距骨内侧软骨病变贴片成形术的患者分为1组（内翻错位，n=21）和2组（中性/轻度外翻，n=23）。比较视觉模拟量表（VAS）疼痛评分、美国骨科足踝学会（AOFAS）评分、软骨修复组织磁共振观察（MOCART） 2.0评分。平均随访49.3±26.2个月。结果：第1组术后VAS评分明显高于第1组（4.4±2.0比1.5±0.7）。结论：尽管功能结果和软骨修复质量相似，但距骨内侧软骨病变嵌合成形术后，内翻错位与术后疼痛评分较高和疼痛改善程度较低相关。这些研究结果表明，手术计划应考虑机械轴对准，对于有明显内翻畸形的患者，可能需要进行矫正调整手术，以优化疼痛结果。证据等级：III级，回顾性队列研究。

{"title":"Impact of lower extremity mechanical axis alignment on clinical outcomes following mosaicplasty for medial talar osteochondral lesions: A retrospective comparative study.","authors":"Murat Onder, Anıl Erbas, Abdurrahman Aydin, M Bilal Kurk, Abdulhamit Misir","doi":"10.1053/j.jfas.2025.12.012","DOIUrl":"10.1053/j.jfas.2025.12.012","url":null,"abstract":"<p><strong>Background: </strong>The impact of proximal lower extremity malalignment on mosaicplasty outcomes for medial talar osteochondral lesions remains unclear.</p><p><strong>Purpose: </strong>To determine whether knee-origin varus malalignment of the mechanical axis affects clinical outcomes and cartilage repair quality after mosaicplasty for medial talar osteochondral lesions.</p><p><strong>Methods: </strong>Forty-four patients who underwent mosaicplasty for medial talar osteochondral lesions (2020-2023) were stratified into Group 1 (varus malalignment, n = 21) and Group 2 (neutral/mild valgus, n = 23) based on standing long-leg radiographs. Visual analog scale (VAS) pain scores, American Orthopaedic Foot and Ankle Society (AOFAS) scores, and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 scores were compared. Mean follow-up was 49.3 ± 26.2 months.</p><p><strong>Results: </strong>Group 1 demonstrated significantly higher postoperative VAS scores (4.4 ± 2.0 vs. 1.5 ± 0.7, p < 0.001) and less pain improvement (ΔVAS: 4.2 ± 2.0 vs. 5.7 ± 1.1, p < 0.05) compared with Group 2. AOFAS scores were similar postoperatively (81.8 ± 9.8 vs. 85.5 ± 8.6, p = 0.075). MOCART 2.0 scores showed no significant difference (75±19 vs. 77±18, p = 0.859). Strong correlations existed between mechanical axis deviation and postoperative VAS (ρ=0.804, p < 0.001). Although some patients developed radiographically visible arthritic changes during follow-up, no patient underwent revision surgery or arthrodesis due to advanced osteoarthritis.</p><p><strong>Conclusions: </strong>Varus malalignment was associated with higher postoperative pain scores and less pain improvement following mosaicplasty for medial talar osteochondral lesions, despite similar functional outcomes and cartilage repair quality. These findings suggest that surgical planning should consider mechanical axis alignment and that corrective realignment procedures may be warranted in select patients with significant varus deformity to optimize pain outcomes.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incision healing and time to weightbearing with and without use of adhesive retention suture device in total ankle arthroplasty. 全踝关节置换术中切口愈合及负重时间的比较。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2025-12-24 DOI: 10.1053/j.jfas.2025.12.011

James M Cottom, Tyler J Verdoni, Jay S Badell, Joshua Ekladios

Background: Total ankle arthroplasty (TAA) is a useful treatment for ankle arthritis. A common complication however is incisional dehiscence. Adhesive suture retention devices (ASRDs) can assist with closure of surgical and traumatic wounds under tension.

Purpose: This retrospective comparative study evaluates the use of ASRDs on TAA patients' incision healing time and time to full weightbearing.

Study design: Fifty TAA patients between 2021 and 2023 were divided equally into 2 groups. Demographics included age, BMI, implant, comorbidities and complications.

Methods: Results included healing time of the incision, time to full weightbearing, and incision length (cm). Preoperative and postoperative AOFAS, FFI, and VAS scores were also recorded.

Results: Mean follow-up for the group without ASRDs was 27.7 months, and 24.3 months in the group with ASRDs. Mean incision healing time and return to weightbearing was 37.1 days (Range 28-44 days; SD 4.65) in the group without ASRDs, with average incision length 9.1 cm (Range 5-14 cm; SD 2.00). Mean healing time was 19.9 days (Range 16-27 days; SD 3.29), with average incision length 7.4 cm (Range 6-9 cm; SD 0.76), in the group with ASRDs. This shows a statistically-significant decrease in incision length (p = 0.0065) and return to weightbearing (p < 0.001) in the ASRD group. There was statistically-significant improvement of postoperative AOFAS (p < 0.001; p < 0.001 VAS (p < 0.001; p < 0.001), and FFI (p < 0.001; p < 0.001) scores when compared to preoperative values within either group, no ASRD and ASRD, respectively.

Conclusion: Utilization of ASRDs on TAA incisions can greatly decrease time to full weightbearing and incision healing time.

背景：全踝关节置换术是治疗踝关节关节炎的有效方法。一个常见的并发症是切口开裂。粘接缝合保持装置（asrd）可以帮助外科和创伤性伤口在张力下闭合。目的：本回顾性比较研究评估asrd对TAA患者切口愈合时间和完全负重时间的影响。研究设计：50例2021 - 2023年TAA患者平均分为两组。人口统计包括年龄、体重指数、植入物、合并症和并发症。方法：观察切口愈合时间、完全负重时间、切口长度（cm）。同时记录术前、术后AOFAS、FFI、VAS评分。结果：无asrd组平均随访27.7个月，有asrd组平均随访24.3个月。无asrd组平均切口愈合时间37.1天（范围28-44天；SD 4.65），平均切口长度9.1 cm（范围5-14 cm； SD 2.00）。asrd组平均愈合时间19.9天（范围16 ~ 27天，SD 3.29），平均切口长度7.4 cm（范围6 ~ 9cm， SD 0.76）。这表明ASRD组的切口长度减少（p=0.0065）和恢复负重（p< 0.001）具有统计学意义。结论：在TAA切口上应用asrd可显著缩短TAA切口至完全负重时间和切口愈合时间。临床证据等级：3，回顾性比较研究。

{"title":"Incision healing and time to weightbearing with and without use of adhesive retention suture device in total ankle arthroplasty.","authors":"James M Cottom, Tyler J Verdoni, Jay S Badell, Joshua Ekladios","doi":"10.1053/j.jfas.2025.12.011","DOIUrl":"10.1053/j.jfas.2025.12.011","url":null,"abstract":"<p><strong>Background: </strong>Total ankle arthroplasty (TAA) is a useful treatment for ankle arthritis. A common complication however is incisional dehiscence. Adhesive suture retention devices (ASRDs) can assist with closure of surgical and traumatic wounds under tension.</p><p><strong>Purpose: </strong>This retrospective comparative study evaluates the use of ASRDs on TAA patients' incision healing time and time to full weightbearing.</p><p><strong>Study design: </strong>Fifty TAA patients between 2021 and 2023 were divided equally into 2 groups. Demographics included age, BMI, implant, comorbidities and complications.</p><p><strong>Methods: </strong>Results included healing time of the incision, time to full weightbearing, and incision length (cm). Preoperative and postoperative AOFAS, FFI, and VAS scores were also recorded.</p><p><strong>Results: </strong>Mean follow-up for the group without ASRDs was 27.7 months, and 24.3 months in the group with ASRDs. Mean incision healing time and return to weightbearing was 37.1 days (Range 28-44 days; SD 4.65) in the group without ASRDs, with average incision length 9.1 cm (Range 5-14 cm; SD 2.00). Mean healing time was 19.9 days (Range 16-27 days; SD 3.29), with average incision length 7.4 cm (Range 6-9 cm; SD 0.76), in the group with ASRDs. This shows a statistically-significant decrease in incision length (p = 0.0065) and return to weightbearing (p < 0.001) in the ASRD group. There was statistically-significant improvement of postoperative AOFAS (p < 0.001; p < 0.001 VAS (p < 0.001; p < 0.001), and FFI (p < 0.001; p < 0.001) scores when compared to preoperative values within either group, no ASRD and ASRD, respectively.</p><p><strong>Conclusion: </strong>Utilization of ASRDs on TAA incisions can greatly decrease time to full weightbearing and incision healing time.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient reported outcomes after cheilectomy versus cheilectomy and Moberg osteotomy. 患者报告了颧骨切除术后与颧骨切除术和Moberg截骨术后的结果。

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery

Pub Date : 2025-12-22 DOI: 10.1053/j.jfas.2025.11.019

Jessica Littmann, Nicholas Steiner, Katherine Cabrejo-Jones, Sheila McRae, Dan Ogborn, Heather Barske

Background: A Moberg osteotomy is a dorsal closing wedge osteotomy of the base of the first proximal phalanx that is thought to augment the effect of cheilectomy by increasing dorsiflexion and ultimately improve patient outcomes in Hallux Rigidus.

Purpose: The purpose of this study was to evaluate the addition of a Moberg osteotomy to dorsal cheilectomy on patient reported outcomes.

Study design: Retrospective chart review.

Methods: 34 patients were identified who received a dorsal cheilectomy with or without a Moberg osteotomy (n = 17 patients, 18 metatarsophalangeal (MTP) joints per group). The Foot and Ankle Ability Measure (FAAM) was completed pre-operatively with the FAAM and Foot Function Index-Revised (FFI-R) completed post-operatively.

Results: FAAM scores improved post-operatively (isolated cheilectomy pre 64.9 ± 14.7 and post 84.8 ± 15.3; cheilectomy plus osteotomy pre 63.5 ± 11.6 and post 90.5 ± 12.8; p < 0.001), and there was no difference between procedures postoperatively for the FAAM and FFI-R.

Conclusion: Proximal phalanx osteotomy did not enhance patient-reported outcomes in early stage hallux rigidus in addition to dorsal cheilectomy.

背景：Moberg截骨术是一种针对第一近端指骨基部的背侧闭合楔形截骨术，被认为通过增加背屈来增强截骨术的效果，并最终改善拇僵直患者的预后。目的：本研究的目的是评估Moberg截骨术对患者报告的预后的影响。研究设计：回顾性图表回顾。方法：选取34例行背侧颧骨切除术伴或不伴Moberg截骨的患者（n = 17例，每组18个跖趾关节）。术前完成足踝能力测量（FAAM），术后完成FAAM和足功能指数修正（FFI-R）。结果：FAAM评分在术后得到改善（单纯截骨前64.9±14.7分，术后84.8±15.3分；截骨+截骨前63.5±11.6分，术后90.5±12.8分，p < 0.001），术后FAAM与FFI-R无差异。结论：除背侧掌骨切除术外，近端指骨截骨术并不能改善早期拇趾僵硬患者报告的预后。

{"title":"Patient reported outcomes after cheilectomy versus cheilectomy and Moberg osteotomy.","authors":"Jessica Littmann, Nicholas Steiner, Katherine Cabrejo-Jones, Sheila McRae, Dan Ogborn, Heather Barske","doi":"10.1053/j.jfas.2025.11.019","DOIUrl":"https://doi.org/10.1053/j.jfas.2025.11.019","url":null,"abstract":"<p><strong>Background: </strong>A Moberg osteotomy is a dorsal closing wedge osteotomy of the base of the first proximal phalanx that is thought to augment the effect of cheilectomy by increasing dorsiflexion and ultimately improve patient outcomes in Hallux Rigidus.</p><p><strong>Purpose: </strong>The purpose of this study was to evaluate the addition of a Moberg osteotomy to dorsal cheilectomy on patient reported outcomes.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Methods: </strong>34 patients were identified who received a dorsal cheilectomy with or without a Moberg osteotomy (n = 17 patients, 18 metatarsophalangeal (MTP) joints per group). The Foot and Ankle Ability Measure (FAAM) was completed pre-operatively with the FAAM and Foot Function Index-Revised (FFI-R) completed post-operatively.</p><p><strong>Results: </strong>FAAM scores improved post-operatively (isolated cheilectomy pre 64.9 ± 14.7 and post 84.8 ± 15.3; cheilectomy plus osteotomy pre 63.5 ± 11.6 and post 90.5 ± 12.8; p < 0.001), and there was no difference between procedures postoperatively for the FAAM and FFI-R.</p><p><strong>Conclusion: </strong>Proximal phalanx osteotomy did not enhance patient-reported outcomes in early stage hallux rigidus in addition to dorsal cheilectomy.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0