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J Orthop Surg (Hong Kong) 2019 Jan-Apr;27(1):2309499019826492

Department of Orthopaedics and Traumatology, Duchess of Kent Children's Hospital, Hong Kong.

Objective:: The aim of the study is to investigate the long-term outcome of patients who received Lambrinudi arthrodesis for severe equinovarus deformities.

Methods:: This is a single-center, retrospective study of patients who received Lambrinudi triple arthrodesis of the foot. Both clinical and radiological information were analyzed. Read More

J Orthop Surg Res 2019 Feb 21;14(1):62. Epub 2019 Feb 21.

Department of Orthopedic Surgery, Southwest Hospital, Army Medical University, Chongqing, 400038, China.

Background: Adult acquired flatfoot deformity (AAFD) represents a spectrum of deformities affecting the foot and the ankle. The optimal management of AAFD remains controversial. We evaluated the efficacy of surgical treatments of AAFD using both direct and indirect evidences. Read More

J Foot Ankle Surg 2019 Feb 8. Epub 2019 Feb 8.

Attending Physician, Kaiser Permanente San Leandro, San Leandro, CA.

Few options exist for the treatment of revision and severe cases of end-stage flatfoot deformity. Triple arthrodesis or medial-approach double arthrodesis have been the standard but often do not provide enough correction of the deformity. Lateral column lengthening is a powerful procedure performed either with an Evans calcaneal osteotomy or calcaneocuboid distraction arthrodesis that can be used as an adjunct in realigning the flatfoot. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Oct;32(10):1249-1254

Department of Orthopaedics, Rehabilitation Hospital of the National Research Center for Rehabilitation Technical Aids, Beijing, 100176, P.R.China.

Objective: To summarize the effectiveness of limited orthopedic surgery combined with external fixation for the treatment of lower extremity sequelae of middle and old aged post-poliomyelitis, and then to explore the strategy of surgical correction and functional reconstruction method.

Methods: From the database of 23 310 cases of poliomyelitis sequelae treated by QIN Sihe Orthopaedic Surgical team between September 1982 and December 2017, 629 patients over 41 years old were retrieved and the epidemiological characteristics of the patients were analyzed. Between March 2011 and June 2015, 57 patients with poliomyelitis sequelae treated with limited operation and external fixation were followed up 2-6 years, and the history of poliomyelitis sequelae was 41-67 years (mean, 47. Read More

J Foot Ankle Surg 2019 Jan;58(1):165-170

Faculty, Division of Foot & Ankle Surgery, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA. Electronic address:

Posterior tibial tendon dysfunction (PTTD) is a progressive disorder secondary to advanced degeneration of the posterior tibial tendon, leading to the abduction of the forefoot, valgus rotation of the hindfoot, and collapse of the medial longitudinal arch. Eventually, the disease becomes so advanced that it begins to affect the deltoid ligament over time. This attenuation and eventual tear of the deltoid ligament leads to valgus deformity of the ankle. Read More

Foot Ankle Surg 2018 Nov 15. Epub 2018 Nov 15.

Foot and Ankle Unit, Ysbyty Ystrad Fawr, Ystrad Fawr Way, Ystrad Mynach, Hengoed CF82 7EP, United Kingdom.

Background: Delayed union and nonunion following foot and ankle arthrodesis is a disabling complication for patients. There are no clinical studies looking at whether there is a role for use of low-intensity pulsed ultrasound (LIPUS) following this. The aim of this study is to investigate the efficacy of LIPUS in this cohort of patients in our centre. Read More

J Foot Ankle Surg 2019 Jan 15;58(1):109-113. Epub 2018 Nov 15.

Surgeon, Department of Orthopedic Surgery, Albert Einstein Medical Center, Philadelphia, PA.

Rigid flatfoot deformity is a debilitating condition that can be managed by triple arthrodesis surgery. Triple arthrodesis has the potential to restore health-related quality of life, but it is also associated with several complications. Few studies have examined the 30-day readmission rates after triple arthrodesis. Read More

J Foot Ankle Surg 2019 Jan 10;58(1):2-5. Epub 2018 Oct 10.

Attending Physician, Kaiser Permanente San Leandro, San Leandro, CA.

Foot and ankle surgeons continue to explore bone graft alternatives that will be comparable to the reference standard of autologous bone. The purpose of the present study was to consider the outcomes of hindfoot arthrodesis supplemented with bioactive glass in patients at risk of delayed union and nonunion. We performed a retrospective radiographic review of 29 consecutive patients (48 joints) who had undergone arthrodesis of ≥1 joint of the hindfoot (ankle, subtalar, talonavicular, calcaneocuboid). Read More

Foot Ankle Spec 2018 Oct 4:1938640018803699. Epub 2018 Oct 4.

University of Alabama School of Medicine, Birmingham, Alabama (AS Moon, AS McGee, HAP, RC, SN, AS).

Background: Hindfoot fusion procedures are increasingly being performed in the outpatient setting. However, the cost savings of these procedures compared with the risks and benefits has not been clearly investigated. The objective of this study was to compare patient characteristics, costs, and short-term complications between inpatient and outpatient procedures. Read More

J Foot Ankle Surg 2018 Nov - Dec;57(6):1154-1156. Epub 2018 Sep 22.

Biostatistician, Division of Research, Kaiser Permanente Northern California, Oakland, CA.

The contemporary literature is unclear regarding the joint that is most "at risk" to yield a nonunion in the performance of triple arthrodesis of the foot. There is also a debate regarding the best methods of joint preparation. A retrospective radiographic review was conducted of all primary triple arthrodeses performed within in a Northern California health maintenance organization between January 2007 and June 2013. Read More

Foot Ankle Clin 2018 Sep;23(3):451-460

Trauma and Orthopaedic Department, Aintree University Hospital, Liverpool University, Liverpool, UK. Electronic address:

Surgical access to the subtalar joint is required in a plethora of pathologic conditions of the hindfoot. The conventional lateral approach can give excellent access to subtalar joint; however, in hindfoot valgus deformities, there can be unacceptable risks of wound problems and incomplete deformity corrections. The medial approach offers good access to the subtalar joint with an increasing evidence base for its use, especially with double fusions in pes planus deformities. Read More

Arch Orthop Trauma Surg 2018 Aug 9;138(8):1037-1043. Epub 2018 Apr 9.

Olgahospital Stuttgart, Kriegsbergstrasse 62, 70174, Stuttgart, Germany.

Introduction: Flatfoot is a severe complication of extensive clubfoot surgery. In this retrospective study, we evaluated our results following flatfoot surgery in overcorrected clubfeet. The aim was to analyze the success of different surgical techniques, including tarsal osteotomies and arthrodesis, in correcting different types of flatfeet. Read More

Int Orthop 2018 06 17;42(6):1297-1306. Epub 2018 Feb 17.

Mittal Ortho Centre, 97, New Lal Bagh Colony, Patiala, Punjab, 147001, India.

Aim/purpose: Extreme congenital club foot deformities are common in developing countries, presenting at birth, persisting in children, adolescents and adults; as untreated/under-corrected by conservative and/or surgical means. Scores of confusing names exist in literature for such deformities with no good treatment available; mostly advocating unacceptable arthrodesis. The author researched this grey area for more than 40 years and successfully innovated improved surgical corrections, more acceptable to patients. Read More

Foot Ankle Surg 2018 Oct 23;24(5):417-422. Epub 2017 Apr 23.

Royal Cornwall Hospitals NHS Trust, Treliske, Cornwall, UK.

Background: Subtalar arthrodesis through an open approach carries significant risk of complications. An arthroscopic approach aims to minimise damage to the soft tissue envelope to improve recovery, union and complication rates. A two portal approach through the sinus tarsi was used. Read More

Foot Ankle Surg 2017 Nov 29. Epub 2017 Nov 29.

Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands. Electronic address:

Background: Pain, deformity and instability are the main reasons for fusion of the tarsal joints, a triple arthrodesis. The short and midterm results show that mobility, function and satisfaction increase postoperatively. However, osteoarthritis (OA) of the adjacent ankle joint is described as a long-term complication. Read More

Physiother Theory Pract 2018 May 8;34(5):403-410. Epub 2018 Jan 8.

b Department of Physical Therapy , Western Michigan University , Kalamazoo , MI.

Background And Purpose: Qualitative analysis has its limitations as the speed of human movement often occurs more quickly than can be comprehended. Digital video allows for frame-by-frame analysis, and therefore likely more effective interventions for gait dysfunction. Although the use of digital video outside laboratory settings, just a decade ago, was challenging due to cost and time constraints, rapid use of smartphones and software applications has made this technology much more practical for clinical usage. Read More

Vestn Ross Akad Med Nauk 2017 ;72(1):53-8

This paper presents a comprehensive review on the current concept of the diagnosis and treatment of central metatarsalgia on the basis of medical literature analyses. Metatarsalgia is the term for pain in the forefoot. This is a set of symptoms corresponding to a wide range of diseases. Read More

J Foot Ankle Surg 2018 Mar - Apr;57(2):364-369. Epub 2017 Dec 15.

Fellowship Co-Director, Fellowship-Trained Foot and Ankle Surgeon, Foot and Ankle Center, Westerville, OH. Electronic address:

The triple arthrodesis procedure remains the historical standard to treat complex hindfoot pathology. However, in recent data, the medial double arthrodesis has been documented to provide similar benefit with decreased complication rates compared with the triple arthrodesis. Therefore, increased interest in this procedure for the treatment of complex hindfoot pathologies has ensued. Read More

J Craniofac Surg 2018 Jan;29(1):e80-e83

Department of Orthopaedic Surgery & Biomedical Engineering, University of Tennessee-Campbell Clinic.

Orthopedic complications of intravenous (IV) infiltration are rare, with only a handful of cases reported in the literature. Because of the relatively high rate of IV infiltration in neonates, however, such complications do occur and can include growth arrest, limb length discrepancy, and joint deformities that require surgical intervention. The risk of these complications is highest in preterm neonates. Read More

Oper Orthop Traumatol 2017 Dec 25;29(6):473-482. Epub 2017 Oct 25.

Zentrum für Fuß- und Sprunggelenkchirurgie, Schön Klinik München Harlaching, Harlachinger Straße 51, 81547, München, Deutschland.

Cavovarus deformities in children and adolescents require sound considerations concerning the timing for corrective surgery. Progression can be recognized best by repeated pedographic examination with evaluation of the typical features of cavovarus deformity. Surgical correction consists of a combination of soft tissue release, bony realignment, and restoration of muscle balance. Read More

Oper Orthop Traumatol 2017 Dec 20;29(6):461-472. Epub 2017 Oct 20.

Klinik für Orthopädie und Traumatologie des Bewegungsapparates, Kantonsspital Baselland, Liestal, Schweiz.

Objective: The aim is to correct the underlying cavovarus deformity and to achieve a pain-free and stable hindfoot.

Indications: Rigid neurologic, posttraumatic, congenital, and idiopathic cavovarus deformities.

Contraindications: General surgical or anesthesiological risks, infections, critical soft tissue conditions, neurovascular impairment of the lower extremity, noncompliance, patients with severely reduced bone quality, insulin-dependent diabetes mellitus, smoking. Read More

Foot Ankle Clin 2017 Sep 3;22(3):625-636. Epub 2017 Jun 3.

Twin Cities Orthopedics, 4010 West 65th Street, Edina, MN 55435, USA. Electronic address:

Malunion remains a common complication after triple arthrodesis, with rates as high as 6% in the reported literature. Careful patient evaluation is critical to determine the location and degree of bony deformity. A stepwise systematic approach to correct hindfoot and midfoot deformity is presented in this article. Read More

Foot Ankle Clin 2017 Sep 3;22(3):613-624. Epub 2017 Jun 3.

Department of Orthopaedic Surgery, University of Colorado School of Medicine, 12631 East 17th Avenue, Room 4508, Aurora, CO 80045, USA.

In symptomatic patients, undercorrection of a flatfoot deformity can lead to the need for revision surgery to restore functional mechanics and prevent progression of deformity. The underlying cause of undercorrection is failure to fully recognize or understand the extent of the deformity. This article discusses the typical deformities in adult flatfoot and indications for surgical intervention. Read More

Foot Ankle Clin 2017 Sep 2;22(3):503-514. Epub 2017 Jun 2.

Institute of Foot and Ankle Reconstruction, 301 St. Paul Place, Baltimore, MD 21202, USA.

Deltoid ligament reconstruction allows for joint preservation of the ankle in the setting of patients a triple arthrodesis due to a flat foot deformity. Although the increased forces that may occur in the ankle joint after a triple arthrodesis cannot be eliminated, reconstruction of the ligament will delay and may prevent the onset arthritis, allowing the patient to maintain mobility of the ankle joint. The anatomy, surgery, and risks and benefits are discussed. Read More

Bone Joint J 2017 Aug;99-B(8):1080-1087

Royal Hospital for Sick Children, Sciennes Road, Edinburgh EH9 1LF, UK.

Aims: We present the results of correcting a double or triple curve adolescent idiopathic scoliosis using a convex segmental pedicle screw technique.

Patients And Methods: We reviewed 191 patients with a mean age at surgery of 15 years (11 to 23.3). Read More

Arthrosc Tech 2017 Jun 26;6(3):e871-e877. Epub 2017 Jun 26.

Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, NT, Hong Kong SAR, China.

Triple arthrodesis has a significant role in the management of hindfoot osteoarthritis and deformity. Traditionally, it is an open procedure with extensive soft tissue dissection. Arthroscopic triple arthrodesis would appear to provide good visualization and preparation of the fusion surfaces while preserving the soft tissue envelope. Read More

J Foot Ankle Surg 2017 Jul - Aug;56(4):805-812

Professor and Chair, Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation, Boonshoft School of Medicine, Wright State University, Dayton, OH.

Delayed identification of patients requiring admission to extended care facilities (ECFs) can lead to greater healthcare costs through an increased length of hospital stay (LOHS). Previous studies of hip and knee arthroplasty identified factors associated with a likely discharge to an ECF. These issues have not been extensively studied for major hindfoot procedures. Read More

Clin Podiatr Med Surg 2017 Jul 8;34(3):339-346. Epub 2017 Apr 8.

Division of Podiatric Medicine and Surgery, Department of Orthopaedics, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, MSC 7776, San Antonio, TX 78229, USA.

Triple (talonavicular, subtalar, and calcaneocuboid) joint arthrodesis and most recently double (talonavicular and subtalar) joint arthrodesis have been well proposed in the literature for surgical repair of the elective, posttraumatic, and/or neuropathic hindfoot deformities. The articulation of the hindfoot with the ankle and midfoot is multiaxial, and arthrodesis of these joints can significantly alter the lower extremity biomechanical manifestations by providing anatomic correction and alignment. This article reviews the indications and preoperative planning for some of the most common procedures to address the hindfoot deformity. Read More

J Foot Ankle Surg 2017 Mar - Apr;56(2):255-257

Consultant, Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, New Territories, Hong Kong Special Administrative Region, China. Electronic address:

Lateral heel pain after triple arthrodesis can have numerous causes, including nonunion of the fusion site, hindfoot malalignment, degenerative arthritis in adjacent joints, and deep infection. We present a case of lateral heel pain after triple arthrodesis due to synovitis of the tarsal canal that was successfully treated with anterior subtalar arthroscopy. Read More

Foot Ankle Int 2017 May 31;38(5):519-525. Epub 2017 Jan 31.

3 Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, New York, USA.

Background: The development of valgus tibiotalar tilt following hindfoot arthrodesis is rarely discussed in the literature. The purpose of this study was to determine the incidence of valgus tibiotalar tilt and to evaluate if there were any radiographic predictors for the development of valgus tibiotalar tilt.

Methods: Patients who underwent hindfoot fusion between January 1, 2004 and December 31, 2013 were identified. Read More

J Orthop Surg Res 2017 Jan 19;12(1):13. Epub 2017 Jan 19.

Department of Mathematics, University of Waterloo, Waterloo, N2L 3G1, Canada.

Background: Mueller-Weiss disease is a rarely diagnosed deformity where the navicular bone undergoes spontaneous osteonecrosis in adults. Until now, there is no widely accepted operative treatment for this unusual disease. We aimed to compare clinical and radiological outcomes between the open triple fusion and talonavicular-cuneiform arthrodesis for Mueller-Weiss disease of stage 4. Read More

Foot Ankle Spec 2017 Aug 4;10(4):372-376. Epub 2016 Dec 4.

Grant Medical Center, Columbus, Ohio (ES, LMH).

Neurogenic contracture often results in spastic, nonreducible equinovarus deformity. Rigid contracture leads to pain, instability, and bracing difficulties. This case report details the utilization of the modified Lambrinudi triple arthrodesis intended to create a plantigrade, functional limb that is amenable to an extremity brace in a case of an acquired neurologic clubfoot. Read More

Eklem Hastalik Cerrahisi 2016 Dec;27(3):171-4

Department of Orthopedics and Traumatology, Medical Faculty of Ege University, 35100 Bornova, İzmir, Turkey.

Escobar (multiple pterygium) syndrome is progressive and a very rare syndrome. It is generally characterized by multiple pterygia that are found in the cervical, antecubital and popliteal regions. In this report, we present the treatment management of a 14-year-old case with late stage Escobar syndrome who was admitted due to multiple pterygia and bilateral knee contractures. Read More

Foot Ankle Surg 2016 Dec 7;22(4):265-269. Epub 2015 Dec 7.

Department of Orthopaedics, Sint Maartenskliniek, Nijmegen, the Netherlands.

Background: Debate exists regarding the effect of triple fusion on the development of osteoarthritis (OA) of the ankle joint. The midterm outcome after triple arthrodesis and the prevalence of OA following triple arthrodesis are reported in this study. The role of alignment in the development of OA was investigated. Read More

J Foot Ankle Surg 2016 Nov - Dec;55(6):1169-1174. Epub 2016 Sep 7.

Assistant Professor, Division Head, Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA.

For rigid pes planovalgus deformities, modified double and triple arthrodeses have had high union rates and subjective outcomes reported. Increased rates of talonavicular nonunions after modified double arthrodesis have led to concern regarding this procedure. A retrospective medical record review was performed of patients who had undergone either a modified double (n = 9) or triple (n = 7) arthrodesis for stage 3 pes planovalgus deformity. Read More

Sci Rep 2016 10 18;6:35493. Epub 2016 Oct 18.

Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Shanghai 200120, China.

Single, double, and triple hindfoot arthrodeses are used to correct hindfoot deformities and relieve chronic pain. However, joint fusion may lead to dysfunction in adjacent articular surfaces. We compared range of motion in adjacent joints before and after arthrodesis to determine the effects of each procedure on joint motion. Read More

Foot (Edinb) 2016 Aug 20;28:20-25. Epub 2016 Sep 20.

Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi, 110076, India. Electronic address:

Osteoarticular TB around the tarsal navicular is a chronic, uncommon condition affecting the midfoot, which causes significant morbidity to the patient. Tuberculosis around the tarsal navicular is rarely described in the literature. A series of three cases - two involving the talo-navicular joint and one involving the naviculo-cuneiform joint is described. Read More

J Bone Joint Surg Am 2016 Sep;98(17):1453-8

University of California Los Angeles, Los Angeles, California.

Background: This study provides an updated comparison of the reoperation rates following primary ankle arthrodesis and total ankle replacement on the basis of observational, population-based data from California. We previously reported data from 1995 to 2004, and our current study includes new data from 2005 to 2010. Our hypothesis was that total ankle replacement would demonstrate increasing utilization and lower complication rates given advances in implant design and growth in surgeon experience. Read More

Foot Ankle Clin 2016 Sep;21(3):681-93

Department of Trauma and Orthopaedics, Sports and Orthopaedic Clinic, Bristol Spire Hospital, Redland Road, Bristol BS6 6UT, UK. Electronic address:

Arthroscopic approaches to subtalar, double, and triple arthrodesis allow relative preservation of the soft tissue envelope compared with traditional open approaches. The surgical technique involving the use of a 4.5-mm 30° arthroscope via sinus tarsi portals is described. Read More

Foot Ankle Clin 2016 Sep;21(3):629-40

Department of Orthopedic Surgery, Ambroise Paré Hospital, West Paris University, 9 Avenue Charles de Gaulle, Boulogne 92100, France. Electronic address:

Hindfoot and midfoot fusions can be performed with percutaneous techniques. Preliminary results of these procedures are encouraging because they provide similar results than those obtained with open techniques with less morbidity and quick recovery. The best indications are probably fusions for mild-to-moderate reducible hindfoot and midfoot deformities in fragile patients with general or local bad conditions. Read More

JBJS Essent Surg Tech 2016 Sep 10;6(3):e29. Epub 2016 Aug 10.

Twin Cities Orthopedics, Edina, Minnesota.

Introduction: Primary triple arthrodesis is a powerful and reliable procedure for stabilizing and correcting painful rigid flatfoot deformities with a low rate of complications.

Indications & Contraindications:

Step 1 Preoperative Planning: Pay careful attention to the history, physical examination, and weight-bearing radiographic studies as they are critical for selecting patients who will benefit from a triple arthrodesis.

Step 2 Room Setup And Patient Positioning: Position the patient supine on the operating table with the toes pointing straight up to the ceiling. Read More

Comput Methods Biomech Biomed Engin 2017 Feb 11;20(2):130-141. Epub 2016 Jul 11.

b Department of Mechanical and Manufacturing Engineering , Aalborg University , Aalborg , Denmark.

This paper presents a finite element model of the ankle, taking into account the effects of muscle forces, determined by a musculoskeletal analysis, to investigate the contact stress distribution in the tibio-talar joint in patients with triple arthrodesis and in normal subjects. Forces of major ankle muscles were simulated and corresponded well with the trend of their EMG signals. These forces were applied to the finite element model to obtain stress distributions for patients with triple arthrodesis and normal subjects in three stages of the gait cycle, i. Read More

Foot Ankle Surg 2016 Jun 26;22(2):131-8. Epub 2015 Jun 26.

Department for Foot and Ankle Surgery Rummelsberg and Nuremberg, Hospital Rummelsberg, Schwarzenbruck, Germany.

Background: The aim of the study was to analyze the clinical aspects including 2-year follow-up of tibiotalocalcaneal arthrodesis (TTCA) with a triple-bend retrograde intramedullary nail (A3, Stryker, Airview Boulevard, MN, USA).

Methods: All patients with TTCA with A3 between October 18, 2011 and April 29, 2013 were included. Visual Analogue Scale Foot and Anklenkle (VAS FA), indications for surgery, details of surgery, radiographic measurements, and complications were analyzed. Read More

Foot Ankle Surg 2016 Jun 9;22(2):114-9. Epub 2015 Jun 9.

Department of Orthopaedic Surgery, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK. Electronic address:

Background: Triple arthrodesis may be performed using various surgical approaches, most typically through two incisions and without structural bone graft. We have found that a single lateral incision allows adequate surgical exposure and structural bone graft facilitates lateral column reconstruction.

Methods: A consecutive series of 30 triple arthrodeses with additive bone graft using a single lateral incision. Read More

J Foot Ankle Surg 2017 Jan - Feb;56(1):167-170. Epub 2016 Apr 9.

Attending Physician, Department of Orthopaedic Surgery, The Permanente Medical Group, San Leandro, CA.

The single medial incision subtalar joint and talonavicular joint arthrodesis has been shown to be a useful alternative for the correction of hindfoot valgus deformity. We describe an arthroscopic method of joint preparation using this approach. The present case report included 6 consecutive patients aged 35 to 72 (mean ± standard deviation 55. Read More

J Child Orthop 2016 Apr 2;10(2):119-25. Epub 2016 Apr 2.

Northeast Ohio Medical University, Rootstown, OH, 44272, USA.

Purpose: Triple arthrodesis is a commonly performed salvage procedure to correct hindfoot deformity. Non-union is considered an undesirable radiographic outcome; however, the clinical ramifications of this are not as well defined. The purpose of this study was to determine the incidence of partial or complete radiographic non-union after triple arthrodesis in children and characterize the clinical consequences. Read More

Foot Ankle Int 2016 Jul 30;37(7):709-14. Epub 2016 Mar 30.

Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.

Background: While it is thought that stresses through the subtalar and talonavicular joints will be decreased after total ankle replacement (TAR) relative to ankle fusion, progressive arthritis or deformity of these joints may require a fusion after a successful TAR. However, after ankle replacement, it is unknown how hindfoot biomechanics and blood supply may be affected. Consequently, subsequent hindfoot joint fusion may be adversely affected. Read More

Int Orthop 2016 Apr 3;40(4):745-9. Epub 2016 Feb 3.

Department of Orthopaedics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Purpose: This study examines the responsiveness of the Foot Functional Index (FFI) and Leeds Foot Impact Scale for Rheumatoid Arthritis (LFIS-RA) in rheumatoid arthritis (RA) patients receiving a forefoot or hindfoot reconstruction.

Methods: This was a prospective cohort study including 30 rheumatoid arthritis patients with severe rheumatoid foot deformities in need for surgical correction. Responsiveness was measured using distribution-based methods (standardized effect size, standardized response mean and Guyatt responsiveness ratio) and anchor-based methods (receiver operating characteristics curves and correlation analyses) by making use of an anchor question. Read More

Clin Orthop Relat Res 2016 Apr 21;474(4):1008-16. Epub 2015 Dec 21.

Department of Foot and Ankle Surgery, Hospital for Special Surgery, 523 East 72nd Street, New York, NY, 10021, USA.

Background: While successful subtalar joint arthrodesis provides pain relief, resultant alterations in ankle biomechanics need to be considered, as this procedure may predispose the remaining hindfoot and tibiotalar joint to accelerated degenerative changes. However, the biomechanical consequences of isolated subtalar joint arthrodesis and additive fusions of the Chopart's joints on tibiotalar joint biomechanics remain poorly understood.

Questions/purposes: We asked: What is the effect of isolated subtalar fusion and sequential Chopart's joint fusions of the talonavicular and calcaneocuboid joints on tibiotalar joint (1) mechanics and (2) kinematics during loading for neutral, inverted, and everted orientations of the foot?

Methods: We evaluated the total force, contact area, and the magnitude and distribution of the contact stress on the articular surface of the talar dome, while simultaneously tracking the position of the talus relative to the tibia during loading in seven fresh-frozen cadaver feet. Read More

Foot Ankle Clin 2015 Dec 21;20(4):657-68. Epub 2015 Oct 21.

Department of Orthopaedic Surgery, Maimonides Medical Center, Maimonides Bone & Joint Center, 6010 Bay Parkway, 7th Floor, Brooklyn, NY 11204, USA.

Foot and ankle deformities in cerebral palsy can be effectively treated with surgery. Surgery should be considered in patients with significant deformity and those who have pain or difficulty with orthotic and shoe wear. Equinus contracture of both gastrocnemius and soleus can be treated with open tendoachilles lengthening; ankle valgus with medial epiphysiodesis. Read More