Foot & Ankle Reconstruction Journal Scan

BACKGROUND: Gap-balancing is an alignment method for total knee arthroplasty with the goal of creating uniform tension in the periarticular soft-tissue restraints and equal laxities throughout the arc of flexion. However, there is little evidence that achieving equal laxities prevents either overly tight or overly loose soft-tissue restraints after total knee arthroplasty. Accordingly, the purpose of the present study was to determine whether the laxities at 0°, 45°, and 90° of flexion are equal in the native knee.

METHODS: Seven different laxities were measured at 0°, 45°, and 90° of flexion in ten fresh-frozen native cadaveric knees (with intact menisci, cartilage, and ligaments) by applying loads of ±5 Nm in varus-valgus rotation, ±3 Nm in internal-external rotation, 100 N in distraction, and ±45 N in anterior-posterior translation with use of a six-degrees-of-freedom load application system.

BACKGROUND: Mental health status has been shown to influence functional outcome in a number of orthopaedic disorders. The purpose of this retrospective cohort study was to assess whether a diminished baseline Mental Component Summary (MCS) score on the Short Form-36 (SF-36) is predictive of less improvement in the Ankle Osteoarthritis Scale (AOS) score at the time of midterm follow-up after arthroplasty or arthrodesis for end-stage ankle arthritis.

METHODS: Preoperative and postoperative patient scores on the SF-36 MCS and AOS questionnaires were obtained from the Canadian Orthopaedic Foot and Ankle Society (COFAS) End-Stage Ankle Arthritis Database. The relationship between the preoperative MCS score and the change in the total AOS score at the time of final follow-up was summarized with use of a Pearson correlation coefficient (r).

BACKGROUND: The purpose of our study was to describe and compare extensor mechanism injuries with regard to age, sex, body mass index (BMI), and comorbidities.

METHODS: We identified patients who had undergone surgical management of an extensor mechanism injury at two institutions between 1986 and 2012. Data analyzed included age at the time of surgery, sex, height, weight, and the presence of medical comorbidities. Patients with chronic disruption of the quadriceps or patellar tendon, those undergoing revision surgery, or those with injuries in the setting of total knee arthroplasty were excluded.

RESULTS: Seven hundred and twenty-six patients were included. There were 427 (58.8%) patellar fractures, 210 (28.9%) quadriceps tendon ruptures, and eighty-nine (12.3%) patellar tendon ruptures.

BACKGROUND: Aseptic prosthetic loosening is known to be an inflammatory, cellular process. We hypothesized that the synovial cell count would significantly differ among normal controls, patients with aseptic loosening, and patients with other etiologies of aseptic failure after total knee arthroplasty and thus that the cell count would be useful in the diagnosis of aseptic loosening.

METHODS: Over a six-year time period, all patients undergoing revision total knee arthroplasties at our institution underwent prospective intraoperative aspiration by the two senior authors. Each patient was assigned to a failure category on the basis of a priori criteria: aseptic loosening, periprosthetic infection, component wear, periprosthetic fracture, component malposition, instability, stiffness, and extensor mechanism failure.

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Mobility of the first metatarsal-cuneiform joint in patients with and without hallux valgus: in vivo three-dimensional analysis using computerized tomography scan.

Geng X, Wang C, Ma X, Wang X, Huang J, Zhang C, Xu J, Yang J.

J Orthop Surg Res. 2015 Sep 15;10(1):140. doi: 10.1186/s13018-015-0289-2.

BACKGROUND:

Improving health-related quality of life (HRQoL) necessitates an understanding of the influence of patient characteristics on, and interrelationship among, HRQoL domains. In osteoarthritis (OA), these associations have predominantly been examined in hip/knee populations. We investigated whether there were differences in these associations between foot/ankle and knee OA samples.

METHODS:

Individuals seeking orthopedic care for foot/ankle or knee OA completed a questionnaire pre-consultation, including HRQoL domains (bodily pain [BP], physical [PF] and social functioning [SF], and mental [MH] and general health [GH]), obesity, comorbidity, and sociodemographic characteristics. Associations were examined via stratified path analysis (foot/ankle vs knee). Foot/ankle: n = 180, mean age = 55 (range: 25 to 82), 52% female.

Treating diabetic foot infection is costly, time consuming and challenging for the patient and clinician alike. It requires a multidisciplinary approach to provide a favourable outcome but all too often results in amputation. We present a patient with Type 2 diabetes who attended clinic with a limb threatening foot infection complicated by osteomyelitis and requiring emergency surgery and antibiotic administration. Our patient underwent surgery by means of an incision and drainage procedure with local antibiotic administration to augment systemic antibiotics. The wound was packed with calcium sulphate (Stimulan^® Biocomposites Ltd.) impregnated with gentamicin and vancomycin to enable high antibiotic concentrations at the site of infection.

PURPOSE:

The fifth metatarsal Jones fracture is a unique injury. Previous studies have identified possible biomechanical risk factors related to this fracture, as well as potential subsequent effects on bone healing complications. The purpose of this retrospective study was to determine the effect of metatarsus adductus (MAA) on bone healing in patients following intramedullary screw fixation of the Jones fracture.

METHODS:

This study reviewed 14 Jones fractures that underwent intramedullary screw fixation. Serial radiographs taken approximately every two weeks were evaluated to determine bone healing time (BHT). Weight-bearing antero-posterior radiographs were used to determine the MAA using standard osseous landmarks.

BACKGROUND:

The modified Broström procedure is commonly used for anatomic repair of chronic lateral ankle instability. However, no studies have compared outcomes of gender-based differences after the modified Broström procedure. We compared outcomes of the modified Broström procedure in men and women.

METHODS:

A total of 155 patients (155 ankles) treated with the modified Broström procedure for chronic lateral ankle instability constituted the study cohort. The 155 ankles were divided into 2 groups: a men's group (94 ankles) and a women's group (61 ankles). The Karlsson score, American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, talar tilt, and anterior talar translation were used to evaluate clinical and radiographic outcomes.