Foot and Ankle Specialist

Christopher Reb

Randy Clements

Sudheer Reddy

Foot & Ankle Specialist

Foot Ankle Spec

2023 Best Articles of FAS

2023年FAS最佳文章

Background The purpose of this study was to evaluate opioid usage and prescribing trends among workers’ compensation (WC) patients who underwent foot or ankle operative procedures compared with a control group. Methods A retrospective review was conducted for WC and non-WC patients who underwent foot or ankle procedures in a single academic orthopaedic surgery practice. Outcome measures were total morphine milligram equivalents (MME) and number of opioid prescriptions. Results A total of 118 patients were identified, including 51 patients in the WC group and 67 in the non-WC group. After index surgery, 67% (34 of 51) of WC patients had 2 or more additional opioid prescriptions compared to 39% (26 of 67) of non-WC patients (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.4-6.7; P = .003). Collectively, there were greater prescriptions of oxycodone MME (P = .002) and hydrocodone MME (P = .07) in the WC cohort. Conclusions Workers’ compensation patients seem to be prescribed and consume opioids at a higher rate postoperatively. It is important for treating physicians to be aware of these trends, and discussions with patients regarding expected opioid use when planning surgical intervention may be beneficial. Physicians may need to set expectations preoperatively and suggest there are limits on the amount of opioids that can safely be prescribed. Level of Evidence: Level III, Retrospective cohort study, Prognostic

Tyler M. Goodwin

Daniel T. Miles

Richard D. Murray

Andrew W. Wilson

Jesse F. Doty

Opioid Prescribing Trends Among Workers’ Compensation Patients Undergoing Foot and Ankle Surgery

足踝手术工薪补偿患者中阿片类药物处方趋势

Background With its rising popularity of pickleball, particularly in the aging population, comes concern for potential injuries that previously rarely affected this patient cohort. The purpose of this study was to investigate the trends of pickleball-related Achilles tendon injuries. Methods A retrospective case series was performed to determine the trends associated with pickleball-related Achilles tendon injuries over the last 10 years. A database search of all Achilles tendon ruptures (ICD-10 S86.0) presenting to a large, multistate, subspecialty referral orthopaedic clinic between January 2013 and June 2023 were identified and included in the study. Pickleball-related injuries were identified via query and confirmed with manual chart review. The incidence of pickleball-related injuries, as well as patient demographics and rate of surgery was determined and compared with the total population during that time period. Results A total of 2684 patients who suffered an Achilles tendon injury between January 2013 and June 2023 were identified, with 43 patients meeting the inclusion criteria for pickleball-related Achilles tendon ruptures. The number and overall incidence of pickleball-related Achilles tendon injuries has been increasing since 2016, excluding 2020 where there was a large decrease likely due to the COVID-19 epidemic. Pickleball was associated with older age at time of injury (64.5 vs 48.6, P &lt; .001) as well as a lower BMI (26.6 vs 29.4, P &lt; .001). In addition, patients who sustained a pickleball-related Achilles tendon injury were more likely to undergo surgery (67.4% vs 45.4%, P = .008). Conclusion The rising popularity of pickleball and its associated injuries poses a significant risk to the aging population, with Achilles tendon injuries occurring in older individuals and resulting in a higher likelihood of undergoing surgery. Level of Evidence: IV; retrospective case-series

Joseph A. S. McCahon

Mark Miller

Samantha Riebesell

David I. Pedowitz

Selene G. Parekh

Joseph N. Daniel

Pickleball and the Rising Incidence of Achilles Tendon Injuries in the Elderly

匹克球与老年人跟腱损伤发病率上升

Background This study investigates the biomechanical efficacy of new 4-leg Sustained Dynamic Compression (SDC) NiTiNOL staples, hypothesized to offer superior stability and resilience to loading before fusion completion, compared with conventional hardware. Methods Twenty sawbones left full foot models were divided into 4 treatment groups: (1) 4-leg Inline Staple, (2) 4-leg Inline Staple + 2-leg Staple, (3) 4-leg Inline Staple + Screw, and (4) Plate + Screw. An osteotomy was performed to simulate a Lapidus procedure, and the respective fixation methods were applied. Mechanical testing was conducted using a servo-hydraulic testing machine to evaluate constructs’ load, contact force, contact area, and plantar gap. Results The 4-leg Inline Staple + Screw group demonstrated significantly increased joint contact force, joint contact area, and decreased plantar gap compared with the Plate + Screw group, both before and after cyclic testing. All SDC-containing constructs exhibited post-cyclic joint contact areas that were 2.36×, 3.87×, and 5.49× greater than the post-cyclic plate + screw group. Most notably, the 4-leg Inline Staple + Screw group maintained a plantar gap of less than 3 mm throughout the testing, unlike other groups. Conclusions The 4-leg Inline SDC Staple, particularly when combined with a static screw, demonstrated biomechanical superiority over traditional plate and screw constructs in Lapidus procedures. These findings suggest a promising avenue for enhanced post-operative stability, which could translate into quicker patient recovery, improved fusion rates, and potentially lower non-union rates. Further clinical trials are warranted to validate these biomechanical advantages in patient outcomes. Level of Evidence: Therapeutic, Level V: Bench Testing

Tian Wang

Matthew Pelletier

James Johnson

Courtney Kline

William Walsh

Craig Lareau

David Safranski

Biomechanical Performance of 4-Leg Sustained Dynamic Compression Staples in First Tarsometatarsal Arthrodesis

四腿持续动态压缩钉在第一跖跗关节融合中的生物力学性能

Background Venous thromboembolism (VTE) is a rare but potentially serious complication following elective foot and ankle (F&amp;A) procedures. The absence of guidelines for thromboprophylaxis in elective procedures underscores the importance of identifying patients at risk. This study aimed to identify key risk factors of VTE in patients who underwent elective foot and ankle (F&amp;A) operations. Methods Data was collected from the IBM MarketScan Database (2009-2019) for patients &gt;18 years old without prior VTE who underwent elective F&amp;A procedures. Patients were divided into 3 groups based on region of operation (forefoot, mid/hindfoot, lower leg/ankle). VTE incidence (including deep vein thrombosis and/or pulmonary embolism) was recorded 30 and 90 days postprocedure. Risk factors for VTE were identified through multivariate logistic regression. Results Among the 301 256 patients who underwent elective F&amp;A procedures, the overall 90-day incidence of VTE was 0.95%. The findings revealed that 31.9% of VTE incidents occurred within the first 2 weeks after operation, and 29.2% still occurred after 6 weeks. Analysis of the anatomical region of operation demonstrated that the lowest rate of 90-day VTE was amongst patients undergoing forefoot procedures (0.70%). There was a higher risk for VTE in patients undergoing midfoot/hindfoot procedures (1.22%, OR = 1.81) and lower leg/ankle procedures (1.76%, OR = 2.31). Additional risk factors for VTE included thrombophilia (4.02%, OR = 3.37), male sex (1.30%, OR = 1.47), increasing age (1.02% age 65+, OR = 1.41), and a high Charlson Comorbidity Index (1.12%, OR &lt; 0.82 for scores &lt;5). Conclusion This study identifies the incidence and timing for VTE after elective F&amp;A procedures. Furthermore, this study defines the risk factors associated with increased odds of VTE after elective F&amp;A procedures. These findings are helpful in educating patients about a continued risk for VTE throughout the 90-day postoperative period and beyond. These results can also be utilized to stratify patients who need thromboprophylaxis based on the individual risk level. Level of Evidence: Level III: Retrospective cohort study

Kevin Y. Heo

Anthony Karzon

Wesley Manz

Rishin J. Kadakia

Jason T. Bariteau

Michelle M. Coleman

Venous Thromboembolism in Outpatient Elective Foot and Ankle Procedure Patients Who Is at Risk?

门诊择期足踝手术患者中的静脉血栓栓塞症：谁有风险？

Background Masses in the forefoot and midfoot are common reasons for medical presentation and can be caused by various pathological conditions. The challenge in clinical practice is to distinguish the multitude of trivialities from the few malignant entities and to arrive at a reliable clinical diagnosis in a reasonable amount of time with a moderate use of diagnostic tools. Material and Methods In a retrospective analysis, tumors, tumor-like lesions, and pseudotumors distal to the Chopart joint presented to our multidisciplinary university tumor board between January 2010 und June 2023 were analyzed concerning entity, location, age, and sex. Results Of the 167 cases included, 18 were osseous and 149 were soft tissue lesions. Overall, the metatarsal region was most frequently affected, accounting for 42.5% of all cases. Osseous lesions showed a preference for the phalanges and soft-tissue lesions occurring more frequently in the metatarsal region. In total, 88.0% of all cases were benign. All 20 malignant cases derived from soft tissue, occurred in all sections of the forefoot and midfoot and comprised 13 entities. Most lesions affected middle-aged patients, but cases occurred in almost every age group. Conclusion In the examined patient population of a German university hospital, most cases were benign soft tissue lesions with a substantial share of pseudotumors and tumor-like lesions. However, the malignancy rate of 12.0% highlights the importance of differential diagnostic considerations. In cases of uncertain results, it is crucial to refer individuals with unclear masses to a specialized center for musculoskeletal tumor care early on in their treatment process. Levels of Evidence: III

Christian Scheele

Norbert Harrasser

Simone Beischl

Dietmar Dammerer

Ulrich Lenze

Carolin Knebel

Florian Lenze

Distribution Patterns of Tumors and Tumor-Like Lesions of the Forefoot and Midfoot A 12.5-Year Study at a University Hospital

前足和中足肿瘤及肿瘤样病变的分布模式：某大学医院12.5年研究

短名
Journal Impact	1.89
国际分区	ORTHOPEDICS(Q2)

ISSN	1938-6400, 1938-7636
h-index	37

涉及主题	医学外科生物病理解剖脚踝放射科内科学物理心理学口腔正畸科遗传学地质学古生物学物理疗法精神科数学化学哲学
出版信息	出版商: SAGE Publications Ltd，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2008，原创研究文献占比: 0.00%，自引率:N.A.， Gold OA占比: 0.00%

Foot and Ankle Specialist

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2023 Best Articles of FAS

Opioid Prescribing Trends Among Workers’ Compensation Patients Undergoing Foot and Ankle Surgery

Pickleball and the Rising Incidence of Achilles Tendon Injuries in the Elderly

Biomechanical Performance of 4-Leg Sustained Dynamic Compression Staples in First Tarsometatarsal Arthrodesis

Venous Thromboembolism in Outpatient Elective Foot and Ankle Procedure Patients Who Is at Risk?

2023 Best Articles of FAS

Distribution Patterns of Tumors and Tumor-Like Lesions of the Forefoot and Midfoot A 12.5-Year Study at a University Hospital

Biomechanical Performance of 4-Leg Sustained Dynamic Compression Staples in First Tarsometatarsal Arthrodesis

Venous Thromboembolism in Outpatient Elective Foot and Ankle Procedure Patients Who Is at Risk?

Opioid Prescribing Trends Among Workers’ Compensation Patients Undergoing Foot and Ankle Surgery