Analysis of Wheeled Knee Walker Use following Foot and Ankle Surgery or Injury.

To determine patient satisfaction and safety with wheeled knee walkers, we performed a retrospective, observational, and descriptive study. Inclusion criteria were age ≥18 years, unilateral foot or ankle surgery, non-weightbearing status, and being given the option of using the knee walker. Surveys were sent to eligible patients, and chart review included only those patients who returned surveys.

Effect of Ankle Position on Tibiotalar Motion With Screw Fixation of the Distal Tibiofibular Syndesmosis in a Fracture Model.

Background: Anatomic reduction and fixation of the syndesmosis in traumatic injuries is paramount in restoring function of the tibiotalar joint. While overcompression is a potential error, recent work has called into question whether ankle position during fixation really matters in this regard. Our study aimed to corroborate more recent findings using a fracture model that, to our knowledge, has not been previously tested.

Preoperative Risk Factors for Complications in Elective Ankle and Hindfoot Reconstruction.

Background: The purpose of this study was to examine medical, social, and psychological factors associated with complications and reoperation after foot and ankle reconstruction.

Methods: A retrospective chart review was conducted of 132 patients (135 feet; 139 operative cases) who had elective foot and ankle reconstruction. Medical, social, and psychological variables were documented.

Psychosocial Risk Factors for Postoperative Pain in Ankle and Hindfoot Reconstruction.

Background: The purpose of this study was to examine factors associated with pain after elective ankle and hindfoot reconstruction.

Methods: Patients who underwent major ankle or hindfoot reconstruction over a 3-year period were identified. Retrospective chart review determined patient demographics, comorbidities, surgeries, tobacco, alcohol, and narcotic use, chronic pain, and mood disorders.

Effect of Obesity on Outcomes of Forefoot Surgery.

Background: Forefoot surgery typically is elective, so it is important to define risk factors to educate patients on potential complications. The purpose of this study was to determine if obesity is an independent risk factor that contributes to increased complication rates after forefoot surgery.

Methods: Through a retrospective review of records, 633 patients were identified who had forefoot surgery at one institution between 2008 and 2010.

Cigarette smoking increases complication rate in forefoot surgery.

Background: Cigarette smoking is known to increase perioperative complication rates, but no study to date has examined its effect specifically in forefoot surgery. The purpose of this study was to determine whether cigarette smoking increased complications after forefoot surgery.

Methods: The records of 602 patients who had forefoot surgery between 2008 and 2010, and for whom smoking status was known, were reviewed.

The Orthopaedic Foot and Ankle Outcomes Research (OFAR) network: feasibility of a multicenter network for patient outcomes assessment in foot and ankle.

Introduction: There is an increasing need for orthopaedic practitioners to measure and collect patient-reported outcomes data. In an effort to better understand outcomes from operative treatment, the American Orthopaedic Foot & Ankle Society (AOFAS) established the Orthopaedic Foot and Ankle Outcomes Research (OFAR) Network, a national consortium of foot and ankle orthopaedic surgeons. We hypothesized that the OFAR Network could successfully collect, aggregate, and report patient-reported outcome (PRO) data using the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS).

The effects of conventional physical therapy and eccentric strengthening for insertional achilles tendinopathy.

Study Design: Single-blind, randomized, clinical trial.

Background: The effect of eccentric training for mid-portion Achilles tendinopathy is well documented; however, its effect on insertional Achilles tendinopathy is inconclusive. The primary purpose of this study was to investigate the effect of eccentric training on pain and function for individuals with insertional Achilles tendinopathy.

Psychometric Comparison of the PROMIS Physical Function CAT With the FAAM and FFI for Measuring Patient-Reported Outcomes.

Background: Selecting optimal patient-reported outcome (PRO) instruments is critical to improving the quality of health care. The purpose of this study was to compare the reliability, responsiveness, and efficiency of three PRO measures: the Foot and Ankle Ability Measure-Activity of Daily Living subscale (FAAM_ADL), the Foot Function Index 5-point verbal rating scale (FFI-5pt), and the PROMIS Physical Function computerized adaptive test (PF CAT).

Methods: Data were aggregated from 10 clinical sites in the AOFAS's National Orthopaedic Foot and Ankle Research (OFAR) Network from 311 patients who underwent elective surgery for a disorder of the foot or ankle.

Conservative treatment of Achilles tendinopathy: emerging techniques.

Achilles tendinopathy is a painful condition that occurs commonly in both active and inactive individuals. It seems that this condition is painful as a result of ingrowth of neural structures and neovessels leading to poor healing, rather than from inflammatory mediators. Traditional conservative measures are often successful.

First metatarsophalangeal arthrodesis.

Arthrodesis of the first metatarsophalangeal joint is a highly successful treatment for patients with symptomatic hallux rigidus who have failed conservative management. Before arthrodesis, the importance of host factors, such as use of nicotine, local blood supply, medical comorbidites, and use of systemic immunosuppressive agents, must be considered. Arthrodesis is currently considered the gold standard treatment for end-stage arthritis of the metatarsophalangeal joint.

Long-term evaluation of interdigital neuroma treated by surgical excision.

Background: We examined a large cohort of patients who had interdigital neurectomy and evaluated their clinical outcomes by using a previously developed scoring system as well as a visual analog scale (VAS). In addition, we wanted to identify risk factors that may lead to poorer outcomes.

Materials And Methods: A retrospective review identified 232 patients who had neuroma excision between 1994 and 2004, after failure of conservative treatment.

Conditions of the calcaneus in skeletally immature patients.

Most conditions of the calcaneus in children, including calcaneal apophysitis, calcaneal fractures, and even intra-articular displaced fractures can be treated successfully with nonoperative methods. Calcaneal bone cysts require surgery only if symptomatic or at risk for pathologic fracture. Calcaneal osteomyelitis must be recognized and treated promptly to prevent severe complications.

The effect of cigarette smoking on hindfoot fusions.

In a group of 160 patients who had hindfoot fusions (isolated subtalar, talonavicular, and calcaneocuboid fusions and double and triple arthrodeses), smokers had a significantly higher rate of nonunion than did nonsmokers (18.6% vs. 7.