Suitability of Minced Cartilage From Osteochondral Lesions of the Talus for Immediate Autograft Reimplantation.

Background: Particulated autograft cartilage implantation is a surgical technique that has been previously described for the repair of osteochondral lesions of the talus (OLT). It uses cartilage fragments harvested from the OLT that are minced into 1-2-mm fragments and then immediately reimplanted back into the chondral defect and sealed with fibrin glue during a single-stage surgery. The purpose of this study was to characterize the suitability of these minced cartilage fragments as immediate autograft for the treatment of OLTs.

A Novel Simulation Model and Training Program for Minimally Invasive Surgery of Hallux Valgus.

Background: Minimally invasive surgery (MIS) for hallux valgus (HV) has gained popularity. However, adopting this technique faces the challenges of a pronounced learning curve. This study aimed to address these challenges by developing and validating an innovative simulation model and training program, targeting enhanced proficiency in HV MIS.

Minimally Invasive Cheilectomy for Hallux Rigidus.

Hallux metatarsophalangeal joint cheilectomy is a joint-sparing technique that involves resection of the dorsal metatarsal head osteophytes; this may be achieved through minimally invasive and arthroscopic techniques. General indications for minimally invasive surgery (MIS) cheilectomy are mild-to-moderate hallux rigidus (Grades I-II) with symptomatic dorsal osteophytes causing dorsal impingement and/or shoe wear irritation in those who have failed extensive nonoperative management. The literature confirms equivalent outcomes to open cheilectomy; however, it is somewhat inconsistent regarding superiority.

The Effect of Tibiotalar Joint Line Level Alterations on Tibiotalar Range of Motion Following Total Ankle Arthroplasty.

Background: The effect of tibiotalar joint line level (TTJL) on patient outcomes following total ankle arthroplasty (TAA) remains unclear. It was previously reported that patients with end-stage ankle arthritis have an elevated TTJL compared with nonarthritic ankles, and the TTJL post-TAA remains elevated compared with nonarthritic ankles. The objectives of this study were to (1) propose a reliable radiographic method to measure the TTJL absolute value and (2) determine the effect of TTJL alterations on tibiotalar range of motion (ROM) following TAA.

The Hallux Metatarsophalangeal Capsule: An Anatomic Study With Respect to Percutaneous Hallux Valgus Correction.

Background: Minimally invasive surgery for the treatment of hallux valgus deformities has become increasingly popular. Knowledge of the location of the hallux metatarsophalangeal (MTP) proximal capsular origin on the metatarsal neck is essential for surgeons in planning and executing extracapsular corrective osteotomies. A cadaveric study was undertaken to further study this anatomic relationship.

Effect of Achilles Tendon Lengthening and Gastrocnemius Recession on Radiographic Tibiotalar Motion Following Total Ankle Replacement.

Background: Surgeons frequently add an Achilles tendon lengthening or gastrocnemius recession to increase dorsiflexion following total ankle replacement. Previous studies have looked at the effects of these procedures on total tibiopedal motion. However, tibiopedal motion includes motion of the midfoot and hindfoot as well as the ankle replacement.

Factors influencing treatment recommendations for base of 5th metatarsal fractures in orthopaedic residency programs.

Background: Management of proximal 5th metatarsal fractures remains a controversial topic in orthopaedic surgery. Both operative and non-operative approaches have been described in the clinical setting. This confusion has led to non-standardized treatment recommendations for proximal 5th metatarsal fractures.

Assessment of Bony Subfibular Impingement in Flatfoot Patients Using Weight-Bearing CT Scans.

Background:: Lateral hindfoot pain in patients with flatfoot deformity is frequently attributed to subfibular impingement. It remains unclear whether this is primarily due to bony or soft-tissue impingement. No studies have used weight-bearing CT scans to evaluate subfibular impingement.

Measuring Visualized Joint Surface in Hallux Metatarsophalangeal Arthroscopy.

Background: Arthroscopy has been increasingly used to evaluate small joints in the foot and ankle. In the hallux metatarsophalangeal (MTP) joint, little data exist evaluating the efficacy of arthroscopy to visualize the articular surface. The goal of this cadaveric study was to determine how much articular surface of the MTP joint could be visualized during joint arthroscopy.

Measuring Visualized Tendon Length in Peroneal Tendoscopy.

Background: Despite multiple studies outlining peroneal tendoscopy, no study exists to evaluate how effective tendoscopy is at visualizing the peroneal tendons without missing a lesion. We sought to measure the length of the peroneal tendons that could be visualized using tendoscopy.

Methods: Ten fresh cadaveric specimens were evaluated using standard peroneal tendoscopy techniques.

Using Arthroscopic Techniques for Achilles Pathology.

Endoscopically assisted procedures have been established to provide the surgeon with minimally invasive techniques to address common Achilles conditions. Modifications to some of these techniques as well as improvements in instrumentation have allowed these procedures to provide similar clinical results to the traditional open surgeries while reducing wound complications and accelerating patient's recoveries. The available literature on these techniques reports consistently good outcomes with few complications, making them appealing for surgeons to adopt.

Oligometastatic prostate cancer to the navicular bone: case report.

This case of oligometastatic prostate cancer to the foot highlights the importance of: 1) metastasis remaining high in the differential for unexplained malady, in the setting of a primary cancer, despite an atypical presentation, and 2) comparing sequential imaging studies to baseline images, especially when remote, because subtle findings can declare themselves over time.

Reproducibility of computed tomography to evaluate ankle and hindfoot fusions.

Background: Although plain radiographs have been historically used to evaluate the status of arthrodesis in the foot and ankle, computed tomography (CT) has gained popularity for evaluation of fusion status. The degree of fusion identified on CT scan has been correlated with functional outcome, with an arthrodesis area of 25-50% necessary for clinical success. In the clinical setting, orthopaedic surgeons often evaluate CT scans independently.

Tibiotalocalcaneal arthrodesis with bulk femoral head allograft for salvage of large defects in the ankle.

Background: Tibiotalocalcaneal arthrodesis in patients with large segmental bony defects presents a substantial challenge to successful reconstruction. These defects typically occur following failed total ankle replacement, avascular necrosis of the talus, trauma, osteomyelitis, Charcot, or failed reconstructive surgery. This study examined the outcomes of tibiotalocalcaneal (TTC) arthrodesis using bulk femoral head allograft to fill this defect.

Particulated juvenile articular cartilage allograft transplantation for osteochondral lesions of the talus.

Osteochondral lesions of the talus can present a challenge to the orthopedic surgeon. Because of its avascular nature, articular cartilage has a poor capacity for self-repair and regeneration. A wide variety of strategies have been developed to restore the structure and function of injured cartilage.

Freiberg's disease.

Freiberg’s disease is a relatively uncommon disorder of the metatarsal head. Although trauma and circulatory disturbances likely contribute major roles in its development, it is widely accepted that Freiberg’s etiology is multifactorial. Conservative treatment, focused on offloading and relieving stress, is uniformly accepted as the appropriate initial management.

Peroneal tendon tears, surgical management and its complications.

Peroneal tendon injuries in the athlete are recognized with increasing frequency as a pathologic entity. Once considered uncommon, they have been attributed to many cases of persistent lateral ankle symptoms after a "typical" ankle sprain. Acute tears of the peroneus brevis, and less commonly the peroneus longus, have been implicated in sport activities and are often coexistent with peroneal instability.

Current management of tarsometatarsal injuries in the athlete.

The frequency of foot injuries is increasing in certain athletes, particularly injuries to the tarsometatarsal joint complex. A high index of suspicion for this injury is required to make the diagnosis because the clinical signs often are subtle. A comprehensive examination along with bilateral weight-bearing plain radiographs of the foot should be obtained in any suspected midfoot injury.

Total ankle replacement: the Agility LP prosthesis.

The original design for the Agility ankle was developed and patented in the late 1970s. DePuy Orthopaedics began manufacturing the implant as the Agility Ankle System. Currently in the United States, the Agility is the most widely used ankle prosthesis.

Plantar fasciitis: evaluation and treatment.

Plantar fasciitis is the most common cause of plantar heel pain. Its characteristic features are pain and tenderness, predominately on the medial aspect of the calcaneus near the sole of the heel. Considering a complete differential diagnosis of plantar heel pain is important; a comprehensive history and physical examination guide accurate diagnosis.