Association Between Postoperative Medial-Middle Intercuneiform Joint Widening and Recurrence Rates in Hallux Valgus Treated With Modified Lapidus Procedure.

Background: Although an association between intercuneiform (C1-C2) joint instability and the recurrence of hallux valgus (HV) deformity after the modified Lapidus procedure has been suggested, there is currently no radiographic evidence to support it. This study aims to investigate radiographic changes in the C1-C2 joint after the modified Lapidus procedure for HV correction, using weightbearing computed tomography (WBCT).

Methods: This retrospective cohort study included 52 feet (50 patients) with HV who underwent modified Lapidus procedure and had preoperative and postoperative WBCT.

Comparing the Clinical Outcomes of Percutaneous Cheilectomy to Open Cheilectomy With Moberg Osteotomy for the Treatment of Hallux Rigidus.

Background: Both an open cheilectomy with a Moberg osteotomy and percutaneous cheilectomy have been successfully used to treat hallux rigidus and preserve motion.However, there have been no studies that have compared these 2 procedures using validated patient-reported outcomes such as the Patient Reported Outcome Measurement Information System.

Methods: A retrospective review of hallux rigidus patients between January 2016 and July 2021 collected 48 percutaneous cheilectomy (PC) patients and 71 open cheilectomy with Moberg (OCM) patients.

Nitinol Staple Use in Primary Arthrodesis of Lisfranc Fracture-Dislocations.

Background: Primary arthrodesis of Lisfranc fracture-dislocations is a reliable treatment option, yet concerns remain about nonunion. Nitinol staple use has recently proliferated in midfoot arthrodesis. The purpose of this study is to examine the union rate of primary arthrodesis of acute Lisfranc fracture-dislocations treated with nitinol staples compared with traditional plate-and-screw fixation.

Preoperative Degenerative Changes at the Tibial Sesamoid-Metatarsal Joint in Hallux Valgus: Association With Postoperative Patient-Reported Outcomes After Modified Lapidus Procedure.

Background: Degenerative changes at the sesamoid-metatarsal joints (SMJs) may be a source of pain following hallux valgus surgery. The aims of this study were to describe degenerative changes at the SMJs on weightbearing computed tomography (WBCT) scans and, secondarily, investigate their association with 1-year patient-reported outcome scores following a modified Lapidus procedure for hallux valgus. We hypothesized that reduced joint space in the SMJs would correlate with worse patient-reported outcomes.

Defining the Patient Acceptable Symptom State (PASS) for PROMIS After Total Ankle Replacement.

Background: Although patient-reported outcomes (PROs), such as the Patient-Reported Outcomes Measurement Information System (PROMIS), are a key element of evaluating success after total ankle replacement (TAR), many do not explicitly state a key factor of postoperative success: is the patient satisfied with their outcome after TAR? The patient acceptable symptom state (PASS) represents the symptom threshold beyond which patients consider themselves well. This study aimed to establish the PROMIS thresholds for the PASS in a primary cohort of TAR patients.

Methods: This single-institution study included 127 primary TAR patients with preoperative and 2-year postoperative PROMIS scores.

Defining the patient acceptable symptom state using PROMIS following reconstruction of the progressive collapsing foot deformity.

Background: The patient acceptable symptom state (PASS) represents the threshold beyond which patients are satisfied with their outcome. This study aimed to define PASS thresholds for progressive collapsing foot deformity (PCFD) reconstruction using Patient-Reported Outcomes Measurement Information System (PROMIS) scores and anchor question responses.

Methods: This retrospective study consisted of 109 patients who underwent flexible PCFD reconstruction, had preoperative and 2-year postoperative PROMIS scores, and 2-year postoperative anchor question responses.

Safety of Same-Day Discharge Following Total Ankle Arthroplasty: A Retrospective Cohort Analysis.

Background: Joint replacement procedures have traditionally been performed in an inpatient setting to minimize complication rates. There is growing evidence that total ankle arthroplasty (TAA) can safely be performed as an outpatient procedure, with the potential benefits of decreased health care expenses and improved patient satisfaction. Prior studies have not reliably made a distinction between outpatient TAA defined as length of stay <1 day and same-day discharge.

Peroneus Brevis to Longus Tendon Transfer in the Treatment of Flexible Progressive Collapsing Foot Deformity: A Cadaveric Study.

Background: Although operative treatment of the flexible progressive collapsing foot deformity (PCFD) remains controversial, correction of residual forefoot varus and stabilization of the medial column are important components of reconstruction. A peroneus brevis (PB) to peroneus longus (PL) tendon transfer has been proposed to address these deformities. The aim of our study was to determine the effect of an isolated PB-to-PL transfer on medial column kinematics and plantar pressures in a simulated PCFD (sPCFD) cadaveric model.

Flatfoot Reconstruction for Painful Pediatric Idiopathic Flexible Flatfoot: Prospective Study Demonstrates Improved Alignment, Function, and Patient-reported Outcomes.

Background: This prospective study was undertaken to report outcomes following reconstructive surgery for patients with painful pediatric idiopathic flexible flatfoot.

Methods: Twenty-five patients with pediatric idiopathic flexible flatfoot were evaluated pre- and post flatfoot reconstruction with lateral column lengthening (LCL). All patients had lengthening of the Achilles or gastrocnemius, while 13 patients had medial side soft tissue (MSST) procedures, 7 underwent medial cuneiform plantarflexion osteotomy (MCPO), and 5 had medializing calcaneal osteotomy.

Outpatient Total Ankle Arthroplasty (TAA) as a Rising Alternative to Inpatient TAA: A Database Analysis.

Background: There is growing evidence that total ankle arthroplasty (TAA) can safely be performed as an outpatient procedure, with the benefit of decreased health care expenses and improved patient satisfaction. The purpose of our study was to compare readmissions, arthroplasty failures, infections, and annual trends between outpatient and inpatient TAA using a large publicly available for-fee database.

Methods: The PearlDiver Database was queried to identify outpatient and inpatient TAA-associated claims for several payer types from January 2010 to October 2021.

Midterm Outcomes of the INBONE II Total Ankle Arthroplasty.

As the number of total ankle arthroplasties (TAA) performed continues to increase, understanding midterm outcomes can guide both implant selection and preoperative patient counseling. The purpose of this study was to investigate midterm results including the survival rate and reasons for revision for the INBONE II TAA. Patients undergoing a primary TAA with the study implant and minimum of 4.

Complications, Reoperations, and Patient-Reported Outcomes Following a 2-Stage Revision Total Ankle Arthroplasty for Chronic Periprosthetic Joint Infections.

Background: As total ankle arthroplasty (TAA) becomes more common, chronic periprosthetic joint infections (PJIs) will be encountered more frequently. No studies have reported on patient-reported outcomes following a 2-stage revision procedure for a chronic PJI after a TAA. The primary purpose of this study was to investigate postoperative clinical outcomes at a minimum of 2 years following a 2-stage revision TAA for chronic PJI.

Clinical Outcomes and Rotational Correction of First Metatarso-Cuneiform Fusion With First Metatarsal to Second Cuneiform Fixation.

Background: The modified Lapidus procedure (first metatarso-cuneiform fusion) is a powerful technique for correcting triplanar deformity in hallux valgus. Although traditionally fixed with cross-screws (CS), growing awareness of intercuneiform stability and pronation deformity has led to fixation using a plate and first metatarsal-second cuneiform (1MT-2C) screw fixation (PS). We investigated Lapidus patient cohorts using CS vs PS fixation to understand patient-reported outcomes, angular and rotational correction, and complication rates.

Relationship Between Preoperative PROMIS Scores and Postoperative Outcomes in Hallux Rigidus Patients Undergoing Cheilectomy.

Background: Previous studies have demonstrated that preoperative patient-reported outcome measures are associated with postoperative outcomes in foot and ankle surgery, and also in specific procedures such as bunionectomy, flatfoot reconstruction, and total ankle replacement. The primary purpose of this study was to determine if preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) physical function, pain interference, pain intensity, and depression scores were associated with the ability of patients undergoing cheilectomy for hallux rigidus to achieve a minimal clinically important difference (MCID) of improvement.

Methods: This retrospective study included preoperative and ≥2-year postoperative PROMIS physical function, pain interference, pain intensity, and depression scores for 125 feet in 118 patients undergoing cheilectomy collected from an institutional review board (IRB)-approved foot and ankle registry database.

Preoperative PROMIS Physical Function Scores Predict Postoperative Outcomes Following Total Ankle Replacement.

Background: Despite good evidence that supports significant improvements in pain and physical function following a total ankle replacement (TAR) for end-stage ankle arthritis, there is a subset of patients who do not significantly benefit from surgery. The purpose of this study was to perform a preliminary analysis to determine if preoperative Patient-Reported Outcome Measurement Information System (PROMIS) scores could be used to predict which patients were at risk of not meaningfully improving following a TAR.

Methods: Prospectively collected preoperative and ≥2-year postoperative PROMIS physical function, pain interference, pain intensity, and depression scores for 111 feet in 105 patients were included in the study.

The Association of Crista Volume With Sesamoid Position as Measured From 3D Reconstructions of Weightbearing CT Scans.

Background: Malposition of the sesamoids relative to the first metatarsal head may relate to intersesamoid crista underdevelopment or erosion. Using 3-dimensional models created from weightbearing CT (WBCT) scans, the current work examined crista volume and its relationship to first metatarsal pronation and sesamoid station.

Methods: Thirty-eight hallux valgus (HV) patients and 10 normal subjects underwent weightbearing or simulated WBCT imaging.

Pronation on weightbearing radiographs does not correlate with pronation from weightbearing CT scans.

Introduction: In hallux valgus (HV), first metatarsal pronation is increasingly recognized as an important aspect of the deformity. The purpose of this study was to compare pronation in HV patients determined from the shape of the lateral head of the first metatarsal on AP weightbearing radiographs with pronation calculated from weightbearing CT (WBCT) scans.

Methods: Patients were included in this study if they had preoperative and 5-month postoperative WBCT scans and corresponding weightbearing AP radiographs of the affected foot.

Association of First Metatarsal Pronation Correction With Patient-Reported Outcomes and Recurrence Rates in Hallux Valgus.

Background: The purpose of this study was to determine if a postoperative decrease in first metatarsal pronation on 3-dimensional imaging was associated with changes in patient-reported outcomes as measured by the Patient-Reported Outcomes Measurement Information System (PROMIS) physical function, pain interference, and pain intensity domains or recurrence rates in patients with hallux valgus (HV) who undergo a first tarsometatarsal fusion (modified Lapidus procedure).

Methods: Thirty-nine consecutive HV patients who met the inclusion criteria and underwent a modified Lapidus procedure had preoperative and ≥2-year postoperative PROMIS scores and had first metatarsal pronation measured on preoperative and at least 5-month postoperative weightbearing CT scans were included. Multivariable regression analyses were used to investigate differences in the change in PROMIS domains preoperatively and 2 years postoperatively between patients with "no change/increased first metatarsal pronation" and "decreased first metatarsal pronation.

Spare the Talonavicular Joint! The Role of Isolated Subtalar Joint Fusion in the Treatment of Progressive Collapsing Foot Deformity.

Surgical management of progressive collapsing foot deformity continues to evolve. Previous studies have demonstrated that fusion of the talonavicular joint results in limited hindfoot motion and, therefore, may accelerate adjacent-joint arthrosis. Recent literature has supported using alternative arthrodesis constructs that spare the talonavicular joint, such as naviculocuneiform or isolated subtalar fusions, which may maintain some hindfoot motion through the talonavicular joint yet adequately address a patient's deformity.

Modified Lapidus vs Scarf Osteotomy Outcomes for Treatment of Hallux Valgus Deformity.

Background: The Lapidus procedure and scarf osteotomy are indicated for the operative treatment of hallux valgus; however, no prior studies have compared outcomes between the procedures. The aim of this study was to compare clinical and radiographic outcomes between patients with symptomatic hallux valgus treated with the modified Lapidus procedure versus scarf osteotomy.

Methods: This retrospective cohort study included patients treated by 1 of 7 fellowship-trained foot and ankle surgeons.

Correlation of Different Methods of Measuring Pronation of the First Metatarsal on Weightbearing CT Scans.

Background: There is no consensus in the foot and ankle literature regarding how to measure pronation of the first metatarsal in patients with hallux valgus. The primary purpose of this study was to compare 2 previously published methods for measuring pronation of the first metatarsal and a novel 3-dimensional measurement of pronation to determine if different measurements of pronation are associated with each other.

Methods: Thirty patients who underwent a modified Lapidus procedure for their hallux valgus deformity were included in this study.

Preoperative Patient-Reported Outcome Measures Relationship With Postoperative Outcomes in Flexible Adult-Acquired Flatfoot Deformity.

Background: Previous studies have demonstrated that procedure-specific thresholds using preoperative patient-reported outcome scores may be used to predict postoperative outcomes. The primary purpose of this study was to determine if preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) thresholds could be used to predict which patients would clinically improve at 2 years postoperatively following reconstruction of their flexible adult-acquired flatfoot deformity (AAFD).

Methods: PROMIS physical function, pain interference, and depression scores were prospectively collected preoperatively and at a minimum of 2 years postoperatively for 75 feet with flexible AAFD.