Operative Treatment of Medial Impingement Syndrome of the Ankle Concomitant With Osteochondral Lesion of the Medial Talar Dome: When and How?

Background: Coexisting medial impingement syndrome of the ankle (MIA) is often observed when planning surgical treatment for medial osteochondral lesion of the talus (OLT). To date, there is no clear consensus on the surgical indications for MIA in relation to medial OLT or on whether overtreatment or undertreatment is preferable.

Purpose: To investigate when and how MIAs should be treated in patients with concomitant medial OLT.

Comparative Analysis of Minimally Invasive and Open Proximal Chevron-Akin Osteotomies in Moderate-to-Severe Hallux Valgus Deformity.

Background: Studies comparing the minimally invasive proximal chevron and Akin osteotomies (MIPCA) technique with conventional techniques, such as the open proximal chevron metatarsal osteotomy with the Akin procedure (open PCMO-Akin procedure), are limited. This study aimed to compare and evaluate operative MIPCA and open PCMO-Akin procedure outcomes in the surgical correction of moderate-to-severe hallux valgus deformities.

Methods: We conducted a retrospective comparison of clinical and radiographic outcomes between the MIPCA and open PCMO-Akin procedure in patients with a hallux valgus deformity, defined as a preoperative hallux valgus angle (HVA) of ≥ 30° and/or a first to second intermetatarsal angle of ≥ 13°.

Surgical Correction of Large Talar Tilt in Varus Ankle Osteoarthritis: Lessons from Clinical Experience and a Review of the Literature.

Numerous studies exist on medial opening wedge supramalleolar osteotomy (SMO), ever since its introduction by Takakura et al., as a joint-preserving surgical option for treating varus ankle osteoarthritis (OA). Although SMO can induce lateral translation of the talus-which is medially translated in varus ankle OA-it has only minimal effects on the correction of the varus tilt of the talus.

Approach to Osteochondral Lesions of the Posteromedial Talar Dome: A Review of Arthroscopic Videos.

Background: Osteochondral lesions of the talus (OLTs) most commonly occur in the posteromedial talar dome; however, there are no consensus guidelines on the appropriate approach to performing microfracture; that is, whether adequate visualization can be achieved solely through anterior ankle arthroscopy as well as the circumstances under which posterior ankle arthroscopy is required.

Purpose: To ascertain whether (1) arthroscopic microfracture of posteromedial OLT can be accomplished solely through anterior ankle arthroscopy and (2) if there are specific conditions that may require posterior ankle arthroscopy.

Study Design: Cross-sectional study; Level of evidence, 3.

Critical factors in enhancing the correction efficacy for varus talar tilt in patients with varus ankle osteoarthritis: relative fibular shortening to the tibia and syndesmotic widening.

Introduction: Relative fibular shortening compared to the tibia and syndesmotic widening are recognized contributors to the valgus tilt of the talus. This study aimed to assess: (1) the impact of fibular shortening relative to the tibia; and (2) the influence of syndesmotic widening, in correcting a large varus talar tilt (TT) associated with advanced ankle osteoarthritis through medial opening wedge valgization supramalleolar osteotomy (SMO).

Materials And Methods: We retrospectively reviewed the clinico-radiographic findings of 41 patients with a preoperative TT of 8 degrees or more who underwent SMO for varus ankle osteoarthritis, with a minimum follow-up of more than two years.

Imaging evaluation of extraarticular posterior loose bodies in varus ankle osteoarthritis.

Multiple loose bodies (LBs) are often found in patients with varus ankle osteoarthritis (OA). This study aimed to investigate the characteristics of extra-articular posterior ankle LBs in patients with varus ankle OA. We also sought to determine whether there were variations in the characteristics of LBs according to the degree of ankle OA.

Joint preserving procedures for Takakura stage IIIB varus ankle osteoarthritis.

A man in his early 70s with right Takakura stage IIIB varus ankle osteoarthritis underwent medial opening wedge supramalleolar osteotomy with inframalleolar correction as joint preserving procedure. We also performed anteroinferior tibiofibular ligament (AITFL) resection with fibular shortening valgisation osteotomy to enhance the talar tilt correction. Postoperative decrease in talar tilt with dramatic symptom improvement was achieved.

Outcome comparison of minimally invasive proximal and distal chevron Akin osteotomies in patients with severe hallux valgus deformity: A randomized prospective study.

Purpose: To date, the surgical treatment of severe hallux valgus deformity remains challenging despite the various methods presented. This study aimed to compare the effectiveness of minimally invasive distal chevron Akin osteotomies (d-MICA) and minimally invasive proximal chevron Akin osteotomies (p-MICA) in correcting severe hallux valgus deformities.

Methods: This prospective follow-up study included patients randomly assigned to undergo p-MICA or d-MICA for hallux valgus deformities with a preoperative hallux valgus angle (HVA) ≥ 40° and/or a first to second intermetatarsal angle (IMA) ≥ 16°.

Corrigendum to "The Association of Body Mass Index and Waist Circumference with the Risk of Achilles Tendon Problems: A Nationwide Population-Based Longitudinal Cohort Study".

[This corrects the article on p. 488 in vol. 15, PMID: 37274500.

A Novel Technique of Medial Displacement Calcaneal Osteotomy Using the Intramedullary Fixation of a Conventional Low-Profile Locking Wedge Plate.

Background: Postoperative heel pain arising from prominent screw heads is a common complication following medial displacement calcaneal osteotomy (MDCO). This study aims to present the clinicoradiographic outcomes of a novel MDCO technique, wherein intramedullary fixation of a conventional low-profile locking wedge plate is employed.

Methods: A retrospective analysis, involving a comparison of clinical and radiographic parameters among consecutive patients who underwent MDCO was conducted.

The association between refractory plantar fasciitis and insertional Achilles tendinopathy and peripheral spondyloarthritis: a report of human leukocyte antigen B-27 investigation and treatment outcome.

Purpose: This study aimed to determine the presence of peripheral spondyloarthritis and investigate the clinical characteristics of patients with concurrent peripheral spondyloarthritis in those presenting with refractory plantar fasciitis and Achilles tendinopathy by conducting human leukocyte antigen B-27 (HLA-B27) testing.

Methods: This retrospective study aimed to investigate patients who complained of persistent pain and significant limitations in daily activities due to their respective foot pain, despite receiving conservative treatment for over one year under the diagnosis of plantar fasciitis or insertional Achilles tendinopathy. The study included 63 patients who underwent HLA-B27 testing.

A comparison of characteristics and outcomes of operative treatment for Achilles tendon sleeve avulsion in older versus younger patients.

Introduction: Achilles tendon sleeve avulsion (ATSA) is a rare injury that often results from pre-existing insertional Achilles tendinopathy and occurs when a tendon avulses from the insertion as a continuous sleeve. To date, outcomes of operative treatment for ATSA in older patients have not been reported. Therefore, this study aims to compare the characteristics and outcomes of Achilles tendon (AT) reattachment with or without tendon lengthening for ATSA between older and younger patients.

The Association of Body Mass Index and Waist Circumference with the Risk of Achilles Tendon Problems: A Nationwide Population-Based Longitudinal Cohort Study.

Background: The purpose of this study was to evaluate the association of body mass index (BMI) and waist circumference (WC) with the risk of Achilles tendinopathy (AT) or Achilles tendon rupture (ATR), using data from a nationwide population-based cohort. We hypothesized that higher BMI and WC would be independently associated with the increased risk of AT or ATR. In addition, a higher WC may potentiate the association between BMI and the risk of Achilles tendon problems.

Operative outcome of mucous cyst of lesser toes: A comparison between cyst excision with osteophytectomy and distal interphalangeal fusion.

Background: To date, the optimal operative treatment for mucous cysts of the lesser toes (MCLT) has not been discussed in detail, although many previous studies have focused on treating finger lesions. Therefore, we evaluated the operative outcomes of two different procedures for MCLT: cyst excision with osteophytectomy and cyst excision with distal interphalangeal (DIP) fusion.

Methods: We retrospectively reviewed and compared the clinico-radiographic outcomes of patients who underwent cyst excision with osteophytectomy (group 1, 22 cases) or cyst excision with DIP fusion (group 2, 16 cases) for MCLT between January 2010 and August 2021.

Operative outcomes of a high-grade talar neck fracture - Lessons from 20 years' clinical experience in a single, tertiary hospital.

Background: The operative treatment of high-grade talar neck fractures remains challenging, despite numerous previous reports. Our goal was to determine long-term outcomes and to establish a plan for management of postoperative complications (especially, avascular necrosis [AVN] of talar body) after high-grade talar neck fractures. We hypothesized that not every case with AVN of talar body require secondary surgical interventions.

Does ankle arthrodesis induce satisfactory changes in the medial longitudinal arch height of the foot for severe varus ankle arthritis?

Purpose: We designed this study to determine how changes in coronal ankle alignment affect sagittal alignment of the foot. Specifically, we focused on the changes in medial longitudinal arch height, which could be reflected by the medial cuneiform height (MCH), Meary's angle, and calcaneal pitch angle (CPA).

Methods: We retrospectively analyzed the radiographic findings of 37 patients who underwent open ankle arthrodesis without inframalleolar correction (such as first metatarsal dorsal closing wedge osteotomy, calcaneal osteotomies, tendon transfers, or tarsal joint arthrodesis) of severe varus ankle arthritis.

Operative strategy for tri-malleolar ankle fractures with posteromedial plafond involvement: a review of sixty six cases.

Purpose: We aimed to summarize the radiographic and clinical outcomes in various conditions of tri-malleolar ankle fractures (TMFs) with posteromedial (PM) plafond involvement (TMF + PM) and determine the factors affecting their subjective clinical outcomes.

Methods: Radiographic and clinical findings of 66 patients who underwent operative treatment for TMF + PM were retrospectively reviewed. The patients were classified into three groups according to the PM fracture line location.

Effect of four combined procedures to achieve inframalleolar correction for advanced varus ankle arthritis.

A man in his early 60s with Takakura stage IIIB varus ankle arthritis underwent four combined procedures (Dwyer's osteotomy with lateral displacement, superficial/deep deltoid ligament release, anterior talofibular ligament/calcaneofibular ligament reconstruction with suture tape augmentation and posterior tibial tendon lengthening). Decreased talar tilt and talar centre lateral shifting and improved hindfoot varus were observed 2 years postoperatively. Also, excellent clinical outcome could be achieved.

Operative treatment options for Morton's neuroma other than neurectomy - a systematic review.

Background: The effectiveness of operative treatments other than neurectomy for Morton's neuroma remains debatable despite several reported studies. This review aimed to evaluate the effects of operative treatments for Morton's neuroma other than neurectomy using an algorithmic approach and a structured critical framework to assess the methodological quality of reported studies.

Methods: Several electronic databases were searched for articles published until August 2021 that evaluated the outcomes of operative treatments other than neurectomy in patients diagnosed with Morton's neuroma.

Dyslipidemia Is Associated With Increased Risk of Achilles Tendon Disorders in Underweight Individuals to a Greater Extent Than Obese Individuals: A Nationwide, Population-Based, Longitudinal Cohort Study.

Background: The association between dyslipidemia and Achilles tendinopathy (AT) or Achilles tendon rupture (ATR) remains controversial, although some studies have examined this topic.

Purpose: To evaluate the correlation of dyslipidemia and the risk of AT or ATR, and its association with body mass index (BMI), by assessing data from a nationwide population-based cohort.

Study Design: Cohort study; Level of evidence, 3.