Mon, 27 November 2017
FAI December 2017 Podcast: Midterm Outcomes of a Fixed-Bearing Total Ankle Arthroplasty With Deformity Analysis

We present our results with an INBONE I (Wright Medical, Memphis, TN) prosthesis that have a minimum of 4 to 10 years of follow-up and include a preoperative deformity analysis on outcomes.

Patients who underwent INBONE I fixed-bearing total ankle arthroplasty demonstrated significant improvement in outcomes at a mean of 5.9 years. Catastrophic talar component collapse did occur (2.7% of cases), but relatively rarely. The patients with preoperative coronal plane tibiotalar deformity had similar pain relief, function, and need for revision of implant components. Despite the presumed shortcomings of the INBONE I’s design, this implant showed promising results, with or without deformity, at midterm follow-up with survivorship of 90.6%.

 

To view the article, click here.

Direct download: FAI_December_2017.mp3
Category:Foot and Ankle -- posted at: 2:31pm EST

Thu, 2 November 2017
FAI November 2017 Podcast: Correlation of Hallux Rigidus Grade With Motion, VAS Pain, Intraoperative Cartilage Loss, and Treatment Success for First MTP Joint Arthrodesis and Synthetic Cartilage Implant

Grading systems are used to assess severity of any condition and as an aid in guiding treatment. This study examined the relationship of baseline motion, pain, and observed intraoperative cartilage loss with hallux rigidus grade.

Irrespective of the grade, positive outcomes were demonstrated for both fusion and synthetic cartilage implant. Clinical symptoms and signs should be used to guide treatment, rather than a grade consisting of radiographic, symptoms, and range of motion factors.

 

To view the article, click here.

Direct download: FAI_November_2017.mp3
Category:Foot and Ankle -- posted at: 5:54pm EST

Mon, 2 October 2017
FAI October 2017 Podcast: Measuring the Operative Treatment Effect in End-Stage Ankle Arthritis: Are We Asking the Right Questions? A COFAS Multicenter Study

Foot and ankle surgeons are increasingly relying on patient-reported outcome measures (PROMs) such as the Ankle Osteoarthritis Scale (AOS) to evaluate treatment options. The objectives of this retrospective cohort study were 2-fold: (1) to examine the AOS instrument using psychometric analysis and (2) to revise the questions on the AOS to improve the effect of questions on the score and remove redundancies.

The AAS is shorter and has improved psychometric properties as compared to the AOS. Further investigation is required to better characterize the clinical utility of this proposed new patient-reported outcome score.

 

To view the article, click here.

Direct download: FAI_October_2017.mp3
Category:Foot and Ankle -- posted at: 11:47am EST

Tue, 29 August 2017
FAI September 2017 Podcast: Association of Ankle Arthritis Score With Need for Revision Surgery

The Ankle Arthritis Score (AAS) is a new patient-reported outcome derived from the Ankle Osteoarthritis Scale (AOS). This study analyzed longitudinally collected data from a cohort of patients in the Canadian Orthopaedic Foot and Ankle Society (COFAS) Ankle Arthritis Study in order to evaluate whether the postoperative AAS is associated with need for revision surgery.

TAR patients who reported higher levels of postoperative functional impairment, as indicated by a higher AAS, were more likely to require metal-component revision surgery. After adjustment for other patient factors, the risk of revision surgery increased with length of follow-up after TAR. This study provides further evidence for the utility of the AAS in the clinical setting.

 

To view the article, click here.

Direct download: FAI_September_2017.mp3
Category:Foot and Ankle -- posted at: 1:16pm EST

Tue, 1 August 2017
FAI August 2017 Podcast: Safety of Outpatient Total Ankle Arthroplasty vs Traditional Inpatient Admission or Overnight Observation

Total joint surgeons have successfully performed hip, knee, and shoulder arthroplasty procedures in the outpatient setting without compromising safety, satisfaction, or results. The purpose of this study was to evaluate outpatient total ankle arthroplasty (TAA) as compared with overnight or extended inpatient stay, with regard to 90-day medical and operative complications, reoperations, readmissions or emergency room visits, and pain control.

Eighty-one patients underwent TAA who met inclusion criteria, and 8 had a complication (10%). A significant difference in complication rate was seen among groups (P = .01) but not rate of readmission or reoperation. Of 16 patients, 5 (31%) who were admitted for 2 or more nights following surgery had a complication, as opposed to 3 of 65 (5%) who were outpatient or admitted overnight (P = .01). There were no differences in frequency of postoperative phone calls, narcotic refills, or visual analog scale pain scores at the first postoperative visit. There were no adverse medical events.

 

To view the article, click here.

Direct download: FAI_August_2017.mp3
Category:Foot and Ankle -- posted at: 2:16pm EST

Sat, 1 July 2017
FAI July 2017 Podcast: Functional Impairment of Patients Undergoing Surgical Correction for Charcot Foot Arthropathy

Investigations using the Medical Outcomes Study Short Form 36 Healthy Survey (SF-36) and the American Orthopaedic Foot & Ankle Society Diabetic Foot Questionnaire (AOFAS-DFQ) have demonstrated a poor quality of life in patients with Charcot foot arthropathy. The Short Musculoskeletal Function Assessment (SMFA) questionnaire has been widely used in patients with a broad range of musculoskeletal disorders.

Charcot foot severely impaired the quality of life in patients beyond the impact of morbid obesity. This impairment equally impacted all of the functional and emotional domains measured with the SMFA as compared with population norms. This investigation provides a benchmark for measuring the impact of operative correction of the deformity. In addition, the SMFA appears to be a valid tool for measuring impairment in this complex patient population.

 

To view the article, click here.

Direct download: FAI_July_2017.mp3
Category:Foot and Ankle -- posted at: 12:30am EST

Thu, 1 June 2017
FAI June 2017 Podcast: Operative Treatment of Traumatic Hallux Valgus in Elite Athletes

Traumatic hallux valgus is an increasingly common injury in the athletic population and represents a unique variant of turf toe. Failure to appropriately recognize and treat these injuries can lead to continued pain, decreased performance, progressive deformities, and ultimately degeneration of the hallux metatarsophalangeal joint. Limited literature currently exists to assist in the diagnosis, management, and operative treatment.

Overall, good operative results were obtained, with 74% of patients returning to their preinjury level of play at an average recovery time of 3.4 months. The impact of this injury cannot be overstated, as one-quarter of players were unable to return to play.

 

To view the article, click here.

Direct download: FAI_June_2017.mp3
Category:Foot and Ankle -- posted at: 11:59am EST

Mon, 1 May 2017
FAI May 2017 Podcast: Patient Factors Associated With Higher Expectations From Foot and Ankle Surgery

Few authors have investigated patients’ expectations from foot and ankle surgery. In this study, we aimed to examine relationships between patients’ preoperative expectations and their demographic and clinical characteristics. We hypothesized that patients with more disability and those with anxiety or depressive symptoms would have greater expectations.

The results of this study may help inform surgeons’ preoperative discussions with their patients regarding realistic expectations from surgery. Generally, patients with worse function and more disability had higher expectations from surgery. Addressing these patients’ expectations preoperatively may help improve their ultimate satisfaction with surgery.

 

To view the article, click here.

Direct download: FAI_May_2017.mp3
Category:Foot and Ankle -- posted at: 12:31pm EST

Fri, 31 March 2017
FAI April 2017 Podcast: Histological Analysis of Early Osteolysis in Total Ankle Arthroplasty

The purpose of this study was to perform a histological comparative analysis of tibiotalar joint samples taken from areas of osteolysis adjacent to total ankle arthroplasties vs control synovial specimens to determine the reaction to and presence of polyethylene (PE) particles.

This study is the largest ankle arthroplasty histological analysis to show that areas of osteolysis consist of abundant polyethylene wear particles, present both intracellularly and extracellularly. Furthermore, these areas were associated with a CD163+ macrophage infiltrate and frequently a foreign body reaction with giant cells engulfing PE particles. It is likely that implant wear particles play a significant role in osteolysis based on the histopathology.

 

To view the article, click here.

Direct download: FAI_April_2017.mp3
Category:Foot and Ankle -- posted at: 12:41pm EST

Wed, 1 March 2017
FAI March 2017 Podcast: Plantar Plate Repair for Lesser Metatarsophalangeal Joint Instability

Lesser metatarsophalangeal (MTP) joint instability is a common cause of forefoot pain. Advances in operative technique and instrumentation have made it possible to anatomically treat plantar plate tears through a dorsal approach. Our goal was to evaluate the subjective, functional, and radiographic outcomes of plantar plate repair (PPR) from a dorsal approach.

We found that the plantar plate could be repaired through a dorsal approach with reliable outcomes. PPR was a viable option to anatomically restore the ligamentous support in the unstable lesser MTP joint.

 

To view the article, click here.

Direct download: FAI_March_2017.mp3
Category:Foot and Ankle -- posted at: 12:00pm EST

Tue, 17 January 2017
FAI February 2017 Podcast: Correlation of Physical Performance and Patient-Reported Outcomes Following Total Ankle Arthroplasty

 

Functional recovery following total ankle arthroplasty (TAA) is assessed with patient-reportedmetrics, but physical performance tests may allow for a more accurate assessment of patientfunction. We quantified correlations between patient-reported measures and physicalperformance tests in patients after TAA to determine the usefulness of physical performancetests in post-TAA assessment.

The lack of strong correlations between the 2 sets of metrics indicates that they provide different information about a patient’s recovery following TAA. Therefore, it is important to include both sets of metrics in post-TAA assessments to better understand operative success and functional recovery.

 

To view the article, click here.

Direct download: FAI_February_2017.mp3
Category:Foot and Ankle -- posted at: 7:10pm EST

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