Publications by authors named "Timothy Daniels"

Article Synopsis
  • Study aimed to compare long-term clinical outcomes of total ankle replacement (TAR) and ankle arthrodesis (AA) in patients with end-stage ankle arthritis, using validated scoring tools.
  • A cohort of 211 patients with a minimum follow-up of 10 years found differences in demographics and surgery reoperation rates between the AA and TAR groups; AA patients had fewer subsequent surgeries (70% vs. 58%).
  • Overall, both TAR and AA groups exhibited similar functional outcomes over the long term, suggesting that the choice between these treatments should be tailored to individual patient conditions.
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Article Synopsis
  • Osseous tumors of the foot and ankle are rare, representing only 3% of bone neoplasms, and distinguishing between benign and malignant types can be challenging, leading to misdiagnosis and litigation risks.
  • A study analyzed 288 cases over 10 years, finding most new referrals were benign tumors (52.4%), with notable examples being osteoid osteoma and osteosarcoma, stressing the importance of early and accurate diagnosis as symptoms often persisted for an average of 5 months before referral.
  • The conclusion emphasizes the need for improved understanding and recommended management protocols to help reduce misdiagnoses and improve treatment outcomes for these conditions.
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Fewer than 5 % of soft tissue sarcomas arise in the foot and ankle. It can be difficult to distinguish between benign and malignant lesions which leads to a delay in diagnosis. Initial inappropriate procedures limit options for limb salvage and increasing rates of local recurrence.

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The Cartiva implant is a synthetic polyvinyl alcohol hydrogel cartilage substitute that is used as a treatment of first metatarsophalangeal joint arthritis. The implant was designed to relieve the pain associated with hallux rigidus while preserving or restoring range of motion. A summary of outcomes, reasons for these outcomes, and technique pearls will be reviewed here.

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Background: End-stage ankle osteoarthritis is a condition that can be treated with ankle arthrodesis (AA) or total ankle arthroplasty (TAA). The goal of this study is to estimate the 2016-2017 United States' utilization of TAA and AA in specific ambulatory settings and delineate patient and hospital factors associated with the selection of TAA vs AA for treatment of ankle osteoarthritis.

Methods: TAA and AA procedures performed for ankle osteoarthritis were identified in the 2016-2017 Nationwide Ambulatory Surgery Sample (NASS) Database.

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Article Synopsis
  • Treatment for Freiberg's disease is mainly conservative, but a modified Weil osteotomy was evaluated for advanced cases in a study of 12 patients over 5 years.
  • The study found significant improvement in patient outcomes as measured by the AOFAS scoring system, with a mean score increase of 40.8 and 92% satisfaction rate among patients.
  • The surgery demonstrated effective results with all patients achieving radiological union and only one instance of a mild infection, indicating it’s a promising option for treatment.
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Introduction: Metal hypersensitivity affects 10-15% of individuals. Orthopaedic implants contain various metals and, therefore, metal hypersensitivity may impact patient outcomes.

Purpose: We report a systematic review of the literature on metal hypersensitivity in patients undergoing foot and ankle (F&A) surgery.

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Aims: This study aimed to investigate the risk of postoperative complications in COVID-19-positive patients undergoing common orthopaedic procedures.

Methods: Using the National Surgical Quality Improvement Programme (NSQIP) database, patients who underwent common orthopaedic surgery procedures from 1 January to 31 December 2021 were extracted. Patient preoperative COVID-19 status, demographics, comorbidities, type of surgery, and postoperative complications were analyzed.

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Article Synopsis
  • The study investigates how kinesiophobia, or the fear of reinjury, affects patient-reported outcomes and physical performance in individuals with chronic Achilles tendinopathy.
  • Three databases were reviewed for relevant studies up to May 2023, focusing on variables like pain, activity levels, and quality of life, while maintaining research quality standards.
  • The findings indicate that higher kinesiophobia scores correlate with worse patient outcomes, such as increased pain and lower quality of life, along with poor physical performance, particularly in heel raises.
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Background: There is currently a scarcity of information and consensus for transportal (arthroscopic or fluoroscopic) joint preparation during tibiotalocalcaneal (TTC) fusion, and therefore this review aims to summarize the available techniques and to evaluate the outcomes after this procedure.

Methods: A systematic electronic search of MEDLINE, EMBASE, and Web of Science was performed for all English-language studies published from their inception to April 4, 2022. All articles addressing arthroscopy in TTC nailing were eligible for inclusion.

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Background: Diabetic foot ulcers are associated with significant morbidity and mortality while posing a challenge for healthcare professionals. Offloading is considered the mainstay of treatment. Total contact casting (TCC) is widely used but does not effectively offload the hindfoot.

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Background: Total ankle arthroplasty (TAA) is a surgical procedure commonly reserved for patients suffering from symptomatic end-stage ankle arthritis. As the number of TAAs increases, so does the associated economic burden. Given these economic constraints, there has been interest in the feasibility of outpatient TAA.

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Case: A 54-year-old type 2 diabetic man with a diabetic forefoot ulcer and osteomyelitis successfully underwent a staged reconstruction to salvage his foot. An antibiotic-carrying bone void filler was used to decrease the infection burden after initial debridement. The fifth toe fillet flap was performed to cover the large soft-tissue defect.

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Background: We investigated the influence of sex on patient-reported outcomes preoperatively and following total ankle replacement and ankle arthrodesis.

Methods: Patients who had undergone total ankle replacement or ankle arthrodesis for the treatment of end-stage ankle arthritis and who had ≥2 years of follow-up were identified from the Canadian Orthopaedic Foot and Ankle Society Prospective Ankle Reconstruction Database. Standard surgical techniques and implantation methods were followed, and STAR, Hintegra, Mobility, and Agility prostheses were used.

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Aims: In 2020, the COVID-19 pandemic meant that proceeding with elective surgery was restricted to minimize exposure on wards. In order to maintain throughput of elective cases, our hospital (St Michaels Hospital, Toronto, Canada) was forced to convert as many cases as possible to same-day procedures rather than overnight admission. In this retrospective analysis, we review the cases performed as same-day arthroplasty surgeries compared to the same period in the previous 12 months.

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Background & Aim: Utilization of augmented reality (AR) and heads-up displays (HUD) to aid orthopaedic surgery has the potential to benefit surgeons and patients alike through improved accuracy, safety, and educational benefits. With the COVID-19 pandemic, the opportunity for adoption of novel technology is more relevant. The aims are to assess the technology available, to understand the current evidence regarding the benefit and to consider challenges to implementation in clinical practice.

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Background: The Integra Cadence total ankle replacement (TAR) is a fourth-generation anatomic, fixed-bearing implant requiring minimal tibial and talar resection, which has been in clinical use since June 2016. The primary purpose of this study is to assess its short-term clinical and radiographic outcomes after TAR using this prosthesis.

Methods: This is a prospective case series of consecutive patients that underwent TAR using this novel fourth-generation prosthesis between June 2016 and November 2017.

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Background: Total ankle replacement (TAR) and ankle fusion are effective treatments for end-stage ankle arthritis. Comparative studies elucidate differences in treatment outcomes; however, the literature lacks evidence demonstrating what outcomes are important to patients. The purpose of this study was to investigate patients' experiences of living with both a TAR and ankle fusion.

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Unlabelled: A recent survey of orthopaedic surgeons asking about risk factors for nonunion following foot and ankle arthrodesis revealed that patient age is considered to be a relatively low risk factor, despite the potential for autologous graft quality to deteriorate with increasing age. The purpose of the current study was to evaluate the impact of patient age and graft type on fusion rates following hindfoot and ankle arthrodesis.

Methods: In this study, we analyzed data from a previously published clinical trial, comparing fusion success in 397 subjects who underwent hindfoot or ankle arthrodesis (597 joints) supplemented with either autograft or an osteoinductive autograft alternative, recombinant human platelet-derived growth factor-BB homodimer carried in beta-tricalcium phosphate (rhPDGF-BB/β-TCP).

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Aims: Preoperative talar valgus deformity ≥ 15° is considered a contraindication for total ankle arthroplasty (TAA). We compared operative procedures and clinical outcomes of TAA in patients with talar valgus deformity ≥ 15° and < 15°.

Methods: A matched cohort of patients similar for demographics and components used but differing in preoperative coronal-plane tibiotalar valgus deformity ≥ 15° (valgus, n = 50; 52% male, mean age 65.

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Background: Ankle arthrodesis (AA) and replacement (TAA) are widely accepted options in managing end-stage ankle arthritis (ESAA). We hypothesize that clinical outcomes would be similar for both interventions.

Methods: We conducted a multicenter randomized controlled trial that collected data on patient demographics, complication rates, Ankle Osteoarthritis Scale (AOS) and Short Form-36 (SF-36) scores.

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