What Is the Risk of Irrigation and Debridement Following Foot and Ankle Surgery? Development of a Risk Severity Scoring System.

Background: Surgical site infection (SSI) after foot and ankle surgery has serious negative effects on patient health and quality of life. While previous studies have looked at predisposing factors for SSI, to our knowledge, no study has proposed a risk severity score.

Questions/purposes: Can a risk severity score, based on patient demographic characteristics and surgical variables, be developed for preoperative use in patients undergoing foot and ankle surgery that will calculate the risk of an irrigation and debridement (I&D) procedure within 90 days of surgery utilizing data from previous surgeries?

Methods: A retrospective chart study was performed on patients undergoing foot and ankle surgery.

TENDINopathy Severity assessment-Achilles (TENDINS-A): evaluation of reliability and validity in accordance with COSMIN recommendations.

Objective: To evaluate the construct validity (structural validity and hypothesis testing), reliability (test-retest reliability, measurement error and internal consistency) and minimal important change (MIC) of the 13-item TENDINopathy Severity assessment-Achilles (TENDINS-A).

Methods: Participants with Achilles pain completed an online survey including: demographics, TENDINS-A, Foot and Ankle Outcome Score (FAOS) and Victorian Institute of Sport Assessment-Achilles (VISA-A). Exploratory factor analysis (EFA) assessed dimensionality.

Revision Surgery and Wound Complications with Minimally Invasive Compared to Open Achilles Tendon Repair: A Retrospective Comparative Study of 116 Patients.

The current study analyzed revision surgery rate and wound complications of patients with Achilles tendon ruptures that received either minimally invasive repair or open standard repair. A retrospective chart review of patients that had Achilles tendon repair performed using either an open or minimally invasive technique was conducted. Primary outcomes were revision surgery rate and wound complication rate.

Diagnostic Imaging for Achilles Tendinopathy: Unnecessary Scans? Valuable Insights? Multidisciplinary Clinician-Scientists Present a Nuanced View.

Clinical practice guidelines for Achilles tendinopathy do not recommend imaging to inform diagnosis. However, there is considerable variation in how imaging is used, particularly in research and sports. Early imaging risks that people who see the images presume that what they "see" as pathology is the primary cause of pain; patients might end up receiving invasive treatments on the basis of the image when rehabilitation may suffice.

TENDINopathy Severity Assessment - Achilles (TENDINS-A): Development and Content Validity Assessment of a New Patient-Reported Outcome Measure for Achilles Tendinopathy.

To develop a new patient-reported outcome measure (PROM) assessing TENDINopathy Severity of the Achilles (TENDINS-Achilles) and evaluate its content validity. Mixed-methods, modified Delphi. We performed 1 round of semistructured one-on-one interview responses with professionals and patients, for initial item generation.

Republication of "Evidence Versus Practice: Operative Treatment Preferences in Hallux Valgus".

Background: There is substantial variability in the operative treatment of hallux valgus despite the existence of high quality evidence to guide treatment decisions. The purpose of this study was to determine the current trends in the treatment of mild, moderate, and severe hallux valgus and if greater degrees of consensus correlate with the presence of higher-level evidence.

Methods: Members of the American Orthopaedic Foot & Ankle Society completed a 14-item survey.

Combining radiographic and CT measurements to rival MRI for the diagnosis of acute isolated syndesmotic injury.

Background: Acute isolated syndesmotic injuries (AISIs) have a high potential to be misdiagnosed or underdiagnosed at initial presentation to the hospital. Although magnetic resonance imaging (MRI) is the gold standard in noninvasive diagnostics, it is not always available immediately and is much more expensive than other imaging modalities. This study identifies improvements in conventional radiography and computed tomography (CT) to diagnose AISI and aims to reduce the number of MRI scans needed to verify the diagnosis.

First MTP joint injuries: MR imaging findings in surgically managed patients.

Objectives: Determine whether MR imaging findings or demographics predict surgical management in patients with first MTP joint injuries.

Materials And Methods: Retrospective study of 161 forefoot MRs for traumatic first MTP injury (M:F 92:69, mean age 33 ± 13 yrs.).

Surgical Treatment of the Flexible, Progressive Collapsing Foot: Deformities, Definitions, and Decisions.

The complex adult acquired flatfoot deformity involves progressive collapse of the foot with attenuation of medial soft tissues such as the posterior tibialis tendon and spring ligament complex. Multiple deformities at different levels can coexist in the collapsed foot, including hindfoot valgus, midfoot abduction, forefoot varus, and valgus ankle instability. Definitions of flatfoot have evolved to encapsulate the peritalar basis of the deformity, with instability around the talus as the fulcrum.

Rehabilitation following operative treatment of acute Achilles tendon ruptures: a systematic review and meta-analysis.

Purpose: The aim of this systematic review and meta-analysis was to compare re-rupture rates, complication rates, functional outcomes, as well as return to work (RTW)/sport (RTS) among different rehabilitation protocols following operative treatment of acute Achilles tendon ruptures.

Methods: Systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five databases were searched for randomized controlled trials (RCTs) comparing at least two rehabilitation protocols following surgical repair of acute Achilles tendon ruptures.

Rotational abnormalities in dysplastic hips and how to predict acetabular torsion.

Objectives: The aim of this study was to investigate the degree to which conventional radiography can represent the acetabular and femoral rotational alignment profile between dysplastic and borderline-dysplastic hips.

Methods: A retrospective trial was conducted including 56 borderline-dysplastic and dysplastic hips at a mean age of 28.9 years (range from 18 to 46).

Economic Impact of Unused Surgical Instruments in an Orthopaedic Surgery Department at an Academic Medical Center: A Prospective Cross-sectional Study.

Orthopaedic surgical trays contain unused instruments, but we do not know which specific instruments go unused nor do we know the savings from eliminating them from a given tray. This was a single-site, observational study conducted at an academic medical center. The primary outcome was type of unused instruments and percentage of instruments used in two commonly used surgical trays.

The Fragility of Statistical Findings in Achilles Tendon Injury Research: A Systematic Review.

Introduction: Probability analysis with the reporting of P values is often used to determine the statistical significance of study findings in the Achilles literature. The purpose of this study was to determine the utility of applying a fragility analysis to comparative trials evaluating Achilles tendon injuries.

Methods: We identified all dichotomous outcome data for comparative studies of Achilles tendon injuries published in 11 orthopaedic journals from 2000 to 2020.

Revision Lateral Ankle Reconstruction 40 Years After Chrisman-Snook Procedure: A Case Report.

Case: A 70-year-old active woman presented with lateral ankle instability 40 years after a lateral ankle reconstruction procedure. Examination demonstrated gross instability, and advanced imaging revealed attenuation of her previous graft. She underwent anatomic reconstruction through a modified Brostrom-Gould technique and was able to return to hiking without pain.

Functional Outcomes of Insertional Achilles Tendinopathy Treatment: A Systematic Review.

Background: Achilles tendinopathy is a common clinical problem that can be either insertional or noninsertional, and effective treatment of each type can vary. We sought to investigate the current evidence on different treatment methods for insertional Achilles tendinopathy with a focus on functional outcomes.

Methods: We performed a systematic review of the available literature using the PubMed/MEDLINE and Cochrane Central Register of Controlled Trials databases.

Intramedullary fixation of fibula fractures: A systematic review.

Introduction: Distal fibula fractures are common injuries that often require open reduction internal fixation. Intramedullary fixation of the fibula has been used historically, and interest has been renewed somewhat recently, although there is limited data assessing outcomes after intramedullary fibular fixation. The purpose of this study was to systematically evaluate the literature as it relates to the clinical and functional outcome after fibular fracture fixation using an intramedullary device.

Risk Factors for Anterior Tibial Tendon Pathology.

Background: Though the tibialis anterior (TA) serves a vital role in ankle dorsiflexion, there is little information regarding risk factors and demographic information that might predispose one to tendinopathy or rupture. This study investigates the features of patients in a single institution who presented with either TA tendinopathy or rupture. The circumstances surrounding rupture were also noted.

COVID-19 and Orthopaedic International Humanitarianism.

As the world continues to adjust to life with COVID-19, one topic that requires further thought and discussion is whether elective international medical volunteerism can continue, and, if so, what challenges will need to be addressed. During a pandemic, the medical community is attentive to controlling the disease outbreak, and most of the literature regarding physician involvement during a pandemic focuses primarily on physicians traveling to areas of need to help treat the disease. As a result, little has been written about medical volunteerism that focuses on medical treatment unrelated to the disease outbreak.

Propensity Score-Matched Analysis of Arthroscopically Assisted Ankle Facture Treatment Versus Conventional Treatment.

Background: The aim of this study was to assess the prospective, longitudinal outcome after arthroscopically assisted open reduction and internal fixation (AORIF) and to compare the results with open reduction and internal fixation (ORIF) in complex ankle fractures.

Methods: Acute, closed, bimalleolar equivalent, bimalleolar, or trimalleolar ankle fractures were included. The AORIF cohort was enrolled prospectively.