Quantifying anterior tibial translation and rotation in chronic ACL-deficient knees: a prospective, observational study using weight-bearing CT.

Objective: To evaluate the ability of weight-bearing computed tomography (WBCT) to detect and quantify differences in anterior tibial translation (ATT) and tibiofemoral rotation (TFR) between anterior cruciate ligament (ACL)-injured and uninjured knees in patients with chronic ACL tears.

Materials And Methods: This prospective, observational study included 20 patients (40 knees) with chronic unilateral ACL injuries confirmed by clinical exam and MRI. Knee WBCT was performed in four standardized positions: full extension and 30° flexion (bipodal), and internal and external rotation (unipodal).

[Current Concepts in Intra-articular Calcaneus Fractures].

Intra-articular calcaneal fractures are significant injuries to the locomotor system, often leading to lifelong impairments in foot mechanics with substantial occupational, social, and financial repercussions. The initial imaging diagnosis relies on radiography; however, computed tomography is crucial for understanding the three-dimensional anatomy of the fracture and facilitating surgical planning.The treatment of intra-articular calcaneal fractures remains a subject of debate, with literature supporting diverse approaches for similar fracture types.

Current Concepts in Intra-articular Calcaneus Fractures.

Intra-articular calcaneal fractures are significant injuries to the locomotor system, often leading to lifelong impairments in foot mechanics with substantial occupational, social, and financial repercussions. The initial imaging diagnosis relies on radiography; however, computed tomography is crucial for understanding the three-dimensional anatomy of the fracture and facilitating surgical planning. The treatment of intra-articular calcaneal fractures remains a subject of debate, with literature supporting diverse approaches for similar fracture types.

Endoscopic flexor hallucis longus transfer for acute Achilles tendon ruptures is associated with a high re-rupture rate: A prospective case series.

Introduction: Achilles tendon rupture (ATR) is one of the most common injuries to the musculoskeletal system. Recently, endoscopic FHL transfer has been successfully used to treat acute injuries in soccer players, with good return to play rates and good functional outcomes. The aim of this study is to analyze patient-reported questionnaires, functional capacity assessment (FCA), and re-rupture rates following endoscopic FHL transfer for acute ATR.

The Lateral Calcaneal Lengthening Osteotomy (LCLOT)-A Contemporary Review.

Calcaneal osteotomies are a common procedure in foot and ankle surgery for the treatment of the painful flexible Progressive Collapsing Foot Deformity (PCFD). The lateral calcaneal lengthening osteotomy (LCLOT) allows a three-dimensional foot and ankle flatfoot correction with a single osteotomy. The purpose of this article is to review the types of calcaneal lengthening osteotomies.

Metatarsal Malunion.

Metatarsal fractures account for almost 50% of all foot fractures; the most frequent trauma mechanism for central metatarsal fractures is direct trauma. Care should be taken when evaluating patients with higher energy accidents, as they are often associated with serious soft-tissue damage and adjacent joint injuries, such as Lisfranc injuries. Malunions on the axial plane (varus/valgus) are usually better tolerated than the ones on the coronal plane, especially plantar flexion deformity.

Inframalleolar harvest of the peroneus longus tendon graft: Surgical technique.

Peroneus longus tendon (PLT) graft has recently gained visibility in the literature as a promising option for knee ligament reconstructions. The most used harvesting technique is performed with a single incision posterior to the lateral malleolus, with large series reporting tendon lengths enough to prepare a double or triple anterior cruciate ligament (ACL) graft, resulting in mean diameters greater than 8.0 mm.

Anatomical and Micro-CT Assessment of the First Metatarsal Head Vascularization and Soft Tissue Envelope Following Minimally Invasive Chevron Osteotomy for Hallux Valgus Deformity.

Background: Minimally invasive surgical (MIS) chevron-type osteotomy for hallux valgus (HV) treatment offers a surgical alternative to open surgery with minimal surgical dissection and a hypothetical decreased risk for soft tissue complications. The objectives of this study were to assess the incidence of injuries to the soft tissue envelope and to the blood supply of the first metatarsal head through gross dissection and, using micro-computed tomography (micro-CT), to identify the safe position to perform the MIS chevron-type osteotomy of the first metatarsal head based on the anatomical data.

Methods: Twenty cadaveric specimens with HV were used for the study.

Biomechanical Problems Related to Lesser Toes Dysfunction and Amputation.

Should we care about the biomechanics of the foot or the full locomotor system? Anatomic changes are the main concerns of an orthopedic surgeon; however, the main objectives of treatment for lesser toe dysfunctions are to relieve the patient's symptoms to preserve or improve function. It is imperative to understand that the foot is part a three-dimensional biokinetic system that needs to function combined so that loads are harmoniously distributed throughout the body without harmful effects, especially for one of the most frequent voluntary neuromotor tasks in humans: walking.

Cone-Beam Weight-Bearing Computed Tomography of Ankle Arthritis and Total Ankle Arthroplasty.

Weight-bearing computed tomography has multiple advantages in evaluating the hindfoot and ankle. It can assess hindfoot and ankle alignment, pathology in ankle arthritis, and complications related to total ankle replacements. It is an essential tool in ankle osteoarthritis diagnostic, preoperative planning, and total ankle replacement outcomes.

PATHOPHYSIOLOGY OF POSTTRAUMATIC ANKLE OSTEOARTHRITIS: A MULTICENTER PERSPECTIVE.

Unlabelled: Besides the acute injury and trauma-induced macroscopic alterations, the evolution to posttraumatic ankle osteoarthritis (PTOA) is a complex process progressing at the tissue and molecular level. Furthermore, changes in the molecular pathways affect chondrocyte viability. Treatment modalities for PTOA focal or confined disease include innovative techniques.

Imaging Features of Plantar Vein Thrombosis: An Easily Overlooked Condition in the Differential Diagnosis of Foot Pain.

Plantar vein thrombosis is a venous disorder affecting deep plantar veins that can manifest with non-specific localized pain, plantar foot pain, swelling, and sensation of fullness. Plantar veins are not routinely assessed during sonographic scans for deep venous thrombosis, which makes plantar venous thrombosis a commonly missed diagnosis. This paper provides a comprehensive review of the venous anatomy of the foot and imaging findings of plantar venous thrombosis as well as discusses the current literature on the topic and its differential diagnoses.

Assessment of knee instability in ACL-injured knees using weight-bearing computed tomography (WBCT): a novel protocol and preliminary results.

Objective: To propose a protocol for assessing knee instability in ACL-injured knees using weight-bearing computed tomography (WBCT).

Materials And Methods: We enrolled five patients with unilateral chronic ACL tears referred for WBCT. Bilateral images were obtained in four positions: bilateral knee extension, bilateral knee flexion, single-leg stance with knee flexion and external rotation, and single-leg stance with knee flexion and internal rotation.

The Classic Three-Month Post-Operative Adaptation Phase in Foot and Ankle Surgery-An Expert Perspective.

Foot and ankle disorders are a common reason for orthopedic surgical intervention. After surgery, specific precautions such as partial weight bearing or complete unloading, and the use of walking aids, coupled with a period of rest, are usually implemented to ensure the surgical outcome. However, when these aids are discontinued and the patients resume load increase and normal daily activities, they may enter a transitional phase characterized by inflammation, swelling, and pain.

Effect of Peritalar Subluxation Correction for Progressive Collapsing Foot Deformity on Patient-Reported Outcomes.

Background: Peritalar subluxation (PTS) is part of progressive collapsing foot deformity (PCFD). This study aimed to evaluate initial deformity correction and PTS optimization in PCFD patients with flexible hindfoot deformity undergoing hindfoot joint-sparing surgical procedures and its relationship with improvements in patient-reported outcome measures (PROMs) at latest follow-up. We hypothesized that significant deformity/PTS correction would be observed postoperatively, positively correlating with improved PROMs.

Acute Deltoid Injury in Ankle Fractures: A Biomechanical Analysis of Different Repair Constructs.

Background: The importance of the deltoid ligament in the congruency and coupling of the tibiotalar joint is well known. The current trend is to repair it in cases of acute injuries in the context of ankle fractures; however, there is limited information on how it should be reconstructed. The objective of this study was to compare different deltoid ligament repair types in an ankle fracture cadaveric model.

ANALYSIS OF 45,507 SURGICAL TREATMENT OF DISTAL TIBIA AND MALLEOLAR FRACTURES OVER 14 YEARS.

Unlabelled: The distal leg joint fractures are among the most common fractures in humans across all age groups, and 50% of them require surgical treatment. Few studies discuss the epidemiology and costs of this fracture in the global and national literature.

Objective: To evaluate the annual incidence and reimbursement value of distal leg joint fractures requiring surgical treatment from 2008 to 2021.

High-Ankle Sprain and Syndesmotic Instability: How Far Have We Come with Diagnosis and Treatment?

Probably one of the most controversial subjects in the orthopedic field is the distal tibiofibular articulation. Even though its most primary knowledge can be a matter of enormous debate, it is in the diagnosis and treatment most of the disagreements reign. Distinguishing between injury and instability remains challenging as well as an optimal clinical decision regarding surgical intervention.