The role of medial ligaments and tibialis posterior in stabilising the medial longitudinal foot arch: a cadaveric gait simulator study.

Background: Debate exists whether adult acquired flatfoot deformity develops secondary to tibialis posterior (TibPost) tendon insufficiency, failure of the ligamentous structures, or a combination of both.

Aim: The aim of this study is to determine the contribution of the different medial ligaments in the development of acquired flatfoot pathology. Also to standardise cadaveric flatfoot models for biomechanical research and orthopaedic training.

Transverse laxity of the forefoot.

Background: Splay of the forefoot reflects the loss of tension in the soft tissues and indicates failure of the biomechanics of the tie-bar system. By identifying and quantifying the soft tissue structures involved in the destruction of forefoot stability we could increase the understanding of forefoot pathologies.

Methods: We investigated the transverse forefoot laxity on healthy feet, feet with forefoot pathology and cadaveric feet undergoing sequential dissection.

ACL reconstruction combined with lateral monoloop tenodesis can restore intact knee laxity.

Purpose: An anterior cruciate ligament (ACL) injury is often combined with injury to the lateral extra-articular structures, which may cause a combined anterior and rotational laxity. It was hypothesised that addition of a 'monoloop' lateral extra-articular tenodesis (mLET) to an ACL reconstruction would restore anteroposterior, internal rotation and pivot-shift laxities better than isolated ACL reconstruction in combined injuries.

Method: Twelve cadaveric knees were tested, using an optical tracking system to record the kinematics through 0°-100° of knee flexion with no load, anterior and posterior translational forces (90 N), internal and external rotational torques (5 Nm), and a combination of an anterior translational (90 N) plus internal rotational load (5 Nm).

Limited plantar incision for flexor digitorum longus tendon harvest in surgical treatment of tibialis posterior tendon insufficiency.

Background: Surgical correction of stage II tibialis posterior tendon dysfunction (TPTD) commonly utilises the Flexor Digitorum Longus (FDL) tendon to augment the tibialis posterior tendon. The aim of this study is to present our experience and clinical outcomes harvesting the FDL via a limited plantar incision technique.

Methods: 25 flat foot operations for stage II TPTD were performed harvesting the FDL via a limited plantar incision centred half-way between the base of the heel to the base of the 2nd toe and two-thirds from the lateral border of the foot.

Treatment of acute spondylolysis in elite athletes. Literature review and presentation of a new percutaneous grafting technique.

The initial treatment of acute spondylolysis in young elite athletes is conservative. Excellent clinical results are seen when there is osseous healing of the defect. When there is no osseous healing, repetitive and maximal loading of the lumbar spine often remain painful.