Total Ankle Arthroplasty Templating: Preoperative Computer Templating Correlates Highly with Intraoperative Component Selection.

Proper alignment and sizing are critical to the performance of a successful total ankle arthroplasty. While it is common practice in preoperative planning prior to total knee and total hip arthroplasty, preoperative computer templating has not been well established in the setting of total ankle arthroplasty. A retrospective review of all total ankle arthroplasties performed during a 10-year period by a single fellowship-trained orthopaedic surgeon was conducted.

Age Influence on Total Ankle Arthroplasty Outcomes: A Systematic Review.

Total ankle arthroplasty has gained popularity as advancing technology has resulted in higher survivorship and lower complication rates. In the past, total ankle replacement candidates have been reserved for patients greater than 50 years old with low physical demands and minimal deformity. However, with newer designs, surgeons have begun to expand their patient inclusion criteria.

Dorsal Cheilectomy.

Dorsal cheilectomy refers to a surgical resection of the dorsal osteophyte from the first metatarsal head. It is most often performed in patients with hallux rigidus, who have little to no midrange pain of the first metatarsophalangeal joint. The procedure is simple, quick, and maintains range of motion.

Predictive Factors of Postoperative Pain in Patients With Tibiotalocalcaneal Arthrodesis With an Intramedullary Nail: A Retrospective Review.

Tibiotalocalcaneal arthrodesis has been shown in literature to have good results in regards to low complication rates and deformity correction. While previous studies have investigated functional outcomes and complication rates, no large-scale studies have looked at pain outcomes. The present study performed a retrospective review of 154 extremities to analyze how a patient's comorbidities and characteristics influence pain outcomes following a tibiotalocalcaneal arthrodesis.

Primary Arthrodesis versus Open Reduction and Internal Fixation for Lisfranc Joint Fracture-Dislocations in Adults: A Systematic Review.

Background: The Lisfranc joint is an intricate podiatric medical structure that when injured can prove difficult to treat. No consensus has been established on optimal surgical management for this injury. It is widely debated whether open reduction and internal fixation or primary arthrodesis provides better outcomes for patients.

Liver-Directed Therapy in Neuroendocrine Neoplasms Metastatic to Both Liver and Bone.

Bone metastases from gastroenteropancreatic neuroendocrine neoplasms (GEPNENs) have been associated with poor prognosis, but it is unclear whether patients with concurrent bone metastases who receive liver-directed therapy (LDT) would derive survival benefit. The California Cancer Registry dataset, merged with data from the California Office of Statewide Health Planning and Development, was used to perform a retrospective study of GEPNENs metastatic to both liver and bone between 2000 and 2012. A total of 203 patients were identified.

Comparison of Loss of Bone Height Following Total Ankle Arthroplasty Versus Tibiotalocalcaneal Arthrodesis.

Ankle arthrodesis and total ankle arthroplasty are both well-accepted surgical treatment options for end-stage ankle arthrosis. However, total ankle arthroplasty has gained popularity as the survivability of implants is improving. It is understood that there is loss of bone height following tibiotalocalcaneal arthrodesis, but to our knowledge, this has not been investigated in the setting of total ankle arthroplasty.

Retrospective Comparison of Isolated Haglund's Deformity Surgery Versus Combined With Gastrocnemius Recession.

Insertional Achilles tendonitis is a common pathology treated by foot and ankle surgeons that may require surgical intervention. Literature has shown good outcomes following detachment and reattachment of the Achilles for removal of the exostosis. However, there is minimal literature showing the impact of adding a gastrocnemius recession to the Haglund's resection.

Incidence of Nonunion Following First Metatarsophalangeal Joint Arthrodesis for Hallux Valgus Deformity: A Retrospective Analysis of Four Different Constructs.

Arthrodesis of the great toe joint is a valuable procedure for hallux valgus deformities. The primary aim of this study was to determine nonunion rates of a first metatarsophalangeal joint (MTPJ) arthrodesis for bunion deformity. This was a retrospective review of 166 consecutive limbs that underwent a first metatarsal phalangeal joint arthrodesis at Wake Forest Baptist Medical Center (WFBMC).

Change in Height Following Tibiotalocalcaneal Arthrodesis: Retrospective Radiographic Analysis.

Tibiotalocalcaneal arthrodesis (TTCA) with an intramedullary rod is a viable treatment option for a myriad of pathologies involving the foot and ankle. While the current literature has focused on fixation techniques, deformity correction, and clinical outcomes, we are unaware of any studies specifically examining change in height following a TTCA. In the present study, we retrospectively analyzed radiographs with novel radiographic techniques to determine the change in height from preoperative to postoperative radiographs following TTCA.

Intermediate to Long-Term Follow-up of the Salto Talaris Fixed-Bearing Total Ankle Prosthesis.

Background: Total ankle arthroplasty (TAA) remains a viable option for recalcitrant, end-stage ankle arthritis. Among the various Food and Drug Administration (FDA)-approved prosthetic options is the fixed-bearing Salto Talaris implant. The aim of the present study was to evaluate the intermediate to long-term clinical outcomes and radiographic complications following implantation of the Salto Talaris TAA.

Review of Achilles Tendon Reattachment Using Double-Row Knotted and Knotless Techniques in the Management of Insertional Achilles Tendinopathy.

Insertional Achilles tendinopathy represents a chronic degenerative condition affecting the insertion of the Achilles. Surgery is indicated in recalcitrant cases and often involves extensive debridement followed by subsequent repair of the insertion. In the present study, we evaluate the results of knotted and knotless double-row suture systems for Achilles reattachment.

Presacral neuroendocrine tumors associated with the Currarino syndrome.

Currarino syndrome (CS) is an autosomal dominant syndrome caused by mutations in MNX1 and characterized by anorectal abnormalities, partial sacral agenesis, and presacral masses. The presacral masses are typically benign; however, malignant degeneration can occur, and presacral neuroendocrine tumors (NETs) have been reported in six cases. We report three individuals from two families affected by CS in which multiple individuals developed presacral NETs.

It Is Time to Rethink Biomarkers for Surveillance of Small Bowel Neuroendocrine Tumors.

Background: Tumor biomarkers (TBMs) reflect disease burden and correlate with survival for small bowel neuroendocrine tumors (SBNETs). This study sought to determine the performance of chromogranin A (CgA), pancreastatin (PST), neurokinin A (NKA), and serotonin (5HT) during follow-up assessment of resected SBNETs.

Methods: An institutional database identified patients undergoing surgery for SBNETs.

Metastatic pancreatic neuroendocrine tumors have decreased somatostatin expression and increased Akt signaling.

Background: Patients with pancreatic neuroendocrine tumors often present with metastases, which reduce survival. Molecular features associated with pancreatic neuroendocrine tumor tumorigenesis have been reported, but mechanisms of metastasis remain incompletely understood.

Methods: RNA sequencing was performed on primary and metastatic pancreatic neuroendocrine tumors from 43 patients.

Bone xenotransplantation: A review of the history, orthopedic clinical literature, and a single-center case series.

Background: One-half of all orthopedic surgeries require bone grafting for successful outcomes in fusions, reconstructive procedures, and the treatment of osseous defects resulting from trauma, tumor, infection, or congenital deformity. Autologous bone grafts are taken from the patient's own body and remain the "gold standard" graft choice but are limited in supply and impart significant patient morbidity. Xenograft bone is an attractive alternative from donors with controlled biology, in large supply and at a theoretically lower cost.

Management of Small Bowel Neuroendocrine Tumors.

Small bowel neuroendocrine tumors (SBNETS) are slow-growing neoplasms with a noted propensity toward metastasis and comparatively favorable prognosis. The presentation of SBNETs is varied, although abdominal pain and obstructive symptoms are the most common presenting symptoms. In patients with metastases, hypersecretion of serotonin and other bioactive amines results in diarrhea, flushing, valvular heart disease, and bronchospasm, termed carcinoid syndrome.

Gene Expression Signatures Identify Novel Therapeutics for Metastatic Pancreatic Neuroendocrine Tumors.

Purpose: Pancreatic neuroendocrine tumors (pNETs) are uncommon malignancies noted for their propensity to metastasize and comparatively favorable prognosis. Although both the treatment options and clinical outcomes have improved in the past decades, most patients will die of metastatic disease. New systemic therapies are needed.

Effect of the Strengthening Opioid Misuse Prevention (STOP) Act on Opioid Prescription Practices After Ankle Fracture Fixation.

Background: In North Carolina, the Strengthen Opioid Misuse Prevention Act of 2017 (STOP Act) went into effect on January 1, 2018, intending to increase oversight over opioid prescriptions. This study compares postoperative narcotic prescription practices following operative fixation of ankle fractures before and after the STOP Act.

Methods: This study was a retrospective review of patients 18 years and older who underwent operative fixation of ankle fractures between January 1 and June 30, 2017 (before STOP Act), and between January 1 and June 30, 2018 (after STOP Act).

Smartphone Applications for Assessing Ankle Range of Motion in Clinical Practice.

Background: Measuring ankle range of motion (ROM) following injury or intervention is necessary for monitoring recovery as well as for calculating permanent impairment ratings in workers' compensation cases. In recent years, smartphone application developers have created applications (apps) that emulate ROM measurement tools like the universal goniometer. This study assessed the correlation between smartphone ROM measurements and universal goniometer measurements, as well as the reliability and usability of these apps in clinical practice.

Evaluation and Management of Neuroendocrine Tumors of the Pancreas.

Pancreatic neuroendocrine tumors are a diverse group of neoplasms with a generally favorable prognosis. Although they exhibit indolent growth, metastases are seen in roughly 60% of patients. Pancreatic neuroendocrine tumors may produce a wide variety of hormones, which are associated with dramatic symptoms, but the majority are nonfunctional.

European Association of Nuclear Medicine Practice Guideline/Society of Nuclear Medicine and Molecular Imaging Procedure Standard 2019 for radionuclide imaging of phaeochromocytoma and paraganglioma.

Purpose: Diverse radionuclide imaging techniques are available for the diagnosis, staging, and follow-up of phaeochromocytoma and paraganglioma (PPGL). Beyond their ability to detect and localise the disease, these imaging approaches variably characterise these tumours at the cellular and molecular levels and can guide therapy. Here we present updated guidelines jointly approved by the EANM and SNMMI for assisting nuclear medicine practitioners in not only the selection and performance of currently available single-photon emission computed tomography and positron emission tomography procedures, but also the interpretation and reporting of the results.

The Pancreas as a Site of Metastasis or Second Primary in Patients with Small Bowel Neuroendocrine Tumors.

Background: The small bowel and pancreas are the most common primary sites of neuroendocrine tumors (NETs) giving rise to metastatic disease. Some patients with small bowel NETs (SBNETs) present with synchronous or metachronous pancreatic NETs (PNETs), and it is unclear whether these are separate primaries or metastases from one site to the other.

Methods: A surgical NET database including patients undergoing operations for SBNETs or PNETs was reviewed.

Comparison of Anal Versus Rectal Staging in the Prognostication of Rectal Squamous Cell Carcinoma: A Population-Based Analysis.

Background: Rectal squamous cell carcinoma is a rare malignancy with limited data regarding management and prognosis. It is also unknown whether a rectal squamous cell cancer staging system should be based on size, as for anal squamous cell carcinoma, or depth of invasion, as for rectal adenocarcinoma.

Objective: The aims of the current study were to determine the optimal management strategy, prognostic factors, and staging system for rectal squamous cell carcinoma.