Outcomes of plantar fasciotomy to treat plantar fasciitis

Objective: This study sought to evaluate the effectiveness of a surgery (plantar fasciotomy) to treat plantar fasciitis using the American Orthopedic Foot and Ankle Society (AOFAS) questionnaire. Methods: Patients were retrospectively identified using their postoperative orthopedic (medical) records after receiving medial plantar fasciotomy for plantar fasciitis between 1997 and 2009. Results: A significant difference was observed between the pre- and postoperative AOFAS score; this result indicates that patient health improved after the fasciotomy to treat plantar fasciitis. Conclusions: A strength of this study was its long follow-up time of patients undergoing plantar fasciotomy to treat plantar fasciitis. This surgery is indicated for patients with chronic plantar fasciitis after 6 months without response to conservative treatment. Level of Evidence IV; Therapeutic Studies; Case Series.

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Clinical Outcomes of Percutaneous Plantar Fasciotomy Using Microdebrider Coblation Wand

Foot & Ankle International ◽

10.1177/1071100719883266 ◽

2019 ◽

Vol 41 (2) ◽

pp. 187-192

Author(s):

Ricardo E. Colberg ◽

Monte Ketchum ◽

Avani Javer ◽

Monika Drogosz ◽

Melissa Gomez ◽

...

Keyword(s):

Conservative Treatment ◽

Plantar Fasciitis ◽

Case Series ◽

Successful Outcome ◽

Oral Steroid ◽

Tarsal Tunnel ◽

Retrospective Case ◽

Level Of Evidence ◽

Plantar Fasciotomy

Background: Plantar fasciitis is the most common cause of heel pain in adults. Multiple conservative treatment plans exist; however, some cases do not obtain significant clinical improvement with conservative treatment and require further intervention. This retrospective case study evaluated the success rate of percutaneous plantar fasciotomy and confounding comorbidities that negatively affect outcomes. Methods: A series of 41 patients treated with percutaneous plantar fasciotomy using the Topaz EZ microdebrider coblation wand were invited to participate in this retrospective follow-up study, and 88% ( N = 36) participated. A limited chart review was completed and the patients answered a survey with the visual analog scale (VAS) for pain and the Foot and Ankle Ability Measure (FAAM) questionnaire. Average outcomes were calculated and 45 variables were analyzed to determine if they were statistically significant confounders. Patients had symptoms for an average of 3 years before the procedure and were contacted for follow-up at an average of 14 months after the procedure. Results: The average VAS for pain score was 1.3 ± 1.8 and the average FAAM score was 92 ± 15. Eighty-nine percent of patients had a successful outcome, defined as FAAM greater than 75. In addition, patients at 18 months postprocedure reported complete or near-complete resolution of symptoms with an FAAM score greater than 97. Concurrent foot pathologies (eg, tarsal tunnel syndrome), oral steroid treatment prior to the procedure, and immobilization with a boot prior to the procedure were statistically significant negative confounders ( P < .05). Being an athlete was a positive confounder ( P = .02). Conclusion: Percutaneous plantar fasciotomy using a microdebrider coblation was an effective treatment for plantar fasciitis, particularly without concurrent foot pathology, with a low risk of complications. Level of Evidence: Level IV, retrospective case series.

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Three-Stage Masquelet Technique and One-Stage Reconstruction to Treat Foot and Ankle Tuberculosis

Foot & Ankle International ◽

10.1177/1071100719890854 ◽

2019 ◽

Vol 41 (3) ◽

pp. 331-341 ◽

Cited By ~ 1

Author(s):

Wenqiang Qu ◽

Chi Wei ◽

Li Yu ◽

Yu Deng ◽

Panfeng Fu ◽

...

Keyword(s):

Pain Score ◽

Early Stage ◽

Distal Tibia ◽

Case Series ◽

Cement Spacer ◽

Foot And Ankle ◽

Aofas Score ◽

Level Of Evidence ◽

Masquelet Technique

Background: The purpose of this article was to report the feasibility and effectiveness of 3-stage Masquelet technique and 1-stage operation for different stages of foot and ankle tuberculosis (TB). Methods: Ten consecutive patients with foot and ankle TB were retrospectively analyzed between January 2014 and December 2018. Five patients were treated with the 3-stage Masquelet technique, including thorough debridement with vacuum sealing drainage, implantation of antibiotic cement spacer, and subsequent reconstruction. Five patients were treated with a 1-stage reconstruction. The American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog scale (VAS) pain scores were recorded at the last follow-up. The follow-up was 30.3 ± 17.8 months. Results: No reactivation of TB was observed in any patients. For the 3-stage operation group, 1 patient developed a distal tibia fracture. The duration of anti-TB therapy was 12.0 ± 0.8 months. The AOFAS score increased from 39.5 ± 9.9 preoperatively to 75.3 ± 7.0 postoperatively ( P < .05). The VAS pain score decreased from 6.3 ± 1.9 to 1.5 ± 1.3 ( P < .05). For the 1-stage operation, 1 patient had wound necrosis. The duration of anti-TB therapy was 13.8 ± 1.1 months. The AOFAS score increased from 51.8 ± 15.0 to 81.8 ± 6.3 ( P < .05). The VAS pain score decreased from 5.4 ± 1.1 to 1.0 ± 0.7 ( P < .05). Conclusion: Three-stage operation was effective for foot and ankle TB with stage IV, sinus tracts or other infections, and 1-stage reconstruction was effective for early-stage TBs. Level of Evidence: Level IV, case series.

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Minimally invasive bunionette treatment

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2020.v14.1160 ◽

2020 ◽

Vol 14 (2) ◽

pp. 148-152

Author(s):

Alexander Felipe de Vete Lima ◽

Tiago Soares Baumfeld ◽

Bruno Maciel Maciel ◽

Daniel Soares Baumfeld ◽

Guillaume Cordier ◽

...

Keyword(s):

Patient Satisfaction ◽

Minimally Invasive ◽

Callus Formation ◽

Case Series ◽

Invasive Technique ◽

Aofas Score ◽

Level Of Evidence ◽

Radiographic Measurements ◽

Significant Difference

Objective: To report the clinical and radiographic results of surgical treatment of bunionette deformity with a minimally invasive technique without the use of hardware. Methods: This is a case series of 13 patients (14 feet) with a diagnosis of bunionette surgically treated with a minimally invasive osteotomy of the fifth metatarsal. All patients completed the American Orthopedic Foot and Ankle Society (AOFAS) score and a visual analog scale (VAS) for pain preoperatively and in the last follow-up visit. Radiographic measurements included the fourth-fifth intermetatarsal angle (4-5 IMA) and the fifth metatarsophalangeal (MTP-5) angle. Complications and level of patient satisfaction were also documented. Results: Mean follow-up was 12.3 months. The mean AOFAS score increased from 51.3 to 94.0, and the VAS score decrease from 7.5 to 1.1. The MTP-5 angle decreased from 11.5º to 2.3º, and the 4-5 IMA decreased from 9.8º to 3.6º. These outcomes showed a statistically significant difference (p<0.001). The only complication was hypertrophic callus formation observed in 3 feet (21.4%). There were no cases of infection, neurapraxia, wound dehiscence, nonunion, or deformity recurrence. Ten patients rated their outcome as excellent and 3 as good. Conclusion: Treatment of bunionette with percutaneous osteotomy of the fifth metatarsal without the use of hardware showed good clinical and radiographic results, with a low complication rate and a high level of patient satisfaction. Level of Evidence IV; Therapeutic Studies; Case Series.

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Reverdin-Isham technique with and without fixation

Scientific Journal of the Foot & Ankle ◽

10.30795/scijfootankle.2018.v12.813 ◽

2018 ◽

Vol 12 (3) ◽

Author(s):

Aleksei Dickow Sato ◽

Ronaldo Muramoto Nakato ◽

Bruno Cerutti Bolsi ◽

Thiago Pavani Zigovski ◽

João Luiz Vieira da Silva

Keyword(s):

Hallux Valgus ◽

Case Series ◽

Foot And Ankle ◽

Aofas Score ◽

Intermetatarsal Angle ◽

Significant Difference ◽

Proposed Modification ◽

American Orthopaedic ◽

Additional Fixation

Objective: This study evaluated the radiographic results of the traditional minimally invasive percutaneous Reverdin-Isham surgical technique for hallux valgus treatment using the American Orthopaedic Foot and Ankle Society (AOFAS) score and compared this result with a proposed modification involving additional osteosynthesis with a cannulated screw. Methods: We retrospectively assessed 22 feet across 15 patients with mild to moderate hallux valgus. All patients underwent surgical treatment using the Reverdin-Isham technique. Eleven feet were fixed with 2.4- or 2.7-mm cannulated screws. A single orthopaedic surgeon performed these procedures between January 2014 and June 2016. The metatarsophalangeal (MTP) angle and intermetatarsal angle (IMA) were evaluated using radiographs, and the AOFAS score was applied before surgery and 90 days after. Results: An improvement was found in the parameters evaluated in both groups, with significant differences shown between the pre- and post-procedure follow-up assessment. No significant difference was found between the groups with regard to fixation; however, the scores were slightly higher for the group where osteosynthesis was used. Conclusions: The Reverdin-Isham procedure is effective and safe for correcting mild to moderate hallux valgus and additional fixation presented with promising results, although without significant difference. Additional studies with larger samples and longer follow-up times are needed to define the role that additional screw fixation plays in the overall scope of treatment.Level of Evidence IV; Therapeutic Studies; Case Series.

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Lateral open wedge calcaneus osteotomy with bony allograft augmentation in adult acquired flatfoot deformity. Clinical and radiological results

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-021-02888-3 ◽

2021 ◽

Author(s):

Gabriele Colo’ ◽

Mattia Alessio Mazzola ◽

Giulio Pilone ◽

Giacomo Dagnino ◽

Lamberto Felli

Keyword(s):

Range Of Motion ◽

Case Series ◽

Deformity Correction ◽

Tibialis Posterior ◽

Open Wedge ◽

Foot And Ankle ◽

Retrospective Case ◽

Level Of Evidence ◽

Adult Acquired Flatfoot Deformity

Abstract The aim of this study is to evaluate the results of patients underwent lateral open wedge calcaneus osteotomy with bony allograft augmentation combined with tibialis posterior and tibialis anterior tenodesis. Twenty-two patients underwent adult-acquired flatfoot deformity were retrospectively evaluated with a minimum 2-year follow-up. Radiographic preoperative and final comparison of tibio-calcaneal angle, talo–first metatarsal and calcaneal pitch angles have been performed. The Visual Analog Scale, American Orthopedic Foot and Ankle Score, the Foot and Ankle Disability Index and the Foot and Ankle Ability Measure were used for subjective and functional assessment. The instrumental range of motion has been also assessed at latest follow-up evaluation and compared with preoperative value. There was a significant improvement of final mean values of clinical scores (p < 0.001). Nineteen out of 22 (86.4%) patients resulted very satisfied or satisfied for the clinical result. There was a significant improvement of the radiographic parameters (p < 0.001). There were no differences between preoperative and final values of range of motion. One failure occurred 7 years after surgery. Adult-acquired flatfoot deformity correction demonstrated good mid-term results and low recurrence and complications rate. Level of evidence Level 4, retrospective case series.

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Functional assessment of foot and ankle tendinopathies treated with tendoscopy

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2021.v15.1531 ◽

2021 ◽

Vol 15 (2) ◽

pp. 128-132

Author(s):

Rodrigo Guimarães Huyer ◽

Mário Sérgio Paulillo Cillo ◽

Carlos Daniel Cândido Castro Filho ◽

Hallan Douglas Bertelli ◽

Renato Morelli Berg

Keyword(s):

Functional Assessment ◽

Descriptive Analysis ◽

Case Series ◽

P Value ◽

Peroneal Tendon ◽

Foot And Ankle ◽

Treatment Results ◽

Duration Of Treatment ◽

Aofas Score ◽

Level Of Evidence

Objective: To assess postoperative clinical functional outcomes, based on the American Orthopaedic Foot & Ankle Society (AOFAS) score, of tendoscopies performed in the treatment of foot and ankle pathologies. Methods: Our comparative assessment used AOFAS scores obtained preoperatively and at early and late postoperative stages - 1 month and 6 to 12 months after surgery - of 14 patients with foot and ankle tendinopathies. These included peroneal tendon dislocation, peroneal tendonitis, and tearing of the peroneus longus or brevis, all treated with tendoscopy for peroneal reconstruction and tenorrhaphy. The AOFAS score was obtained by functional assessment during outpatient physical examination. We presented a descriptive analysis of cases, comparing scores over time through the Friedman test followed by Dunn’s test. The relationship between score variations and sex was assessed using the Mann-Whitney test; their comparison with age used Spearman’s linear correlation coefficient. Significance levels were 5%.Results: The AOFAS score showed important improvements such as preoperative scores of 56 and 67 followed by postoperative scores of 100 both in the early and late stages, supporting the efficacy and persistence of this treatment strategy. The p-value obtained after statistical analysis was <0.0001. Conclusion: We concluded that the treatment of foot and ankle comorbidities with tendoscopy, in addition to being less invasive, shows consistency and efficacy as demonstrated by the AOFAS score and functional assessment via postoperative physical examinations. AOFAS scores were increased and maintained at high levels in the postoperative period, demonstrating the efficacy of this procedure and the duration of treatment results. Level of Evidence IV; Case Series; Therapeutic Studies - Investigation of Treatment Results.

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Effect of Postoperative Ketorolac Administration on Bone Healing in Ankle Fracture Surgery

Foot & Ankle International ◽

10.1177/1071100718782489 ◽

2018 ◽

Vol 39 (10) ◽

pp. 1135-1140 ◽

Cited By ~ 9

Author(s):

Elizabeth McDonald ◽

Brian Winters ◽

Kristen Nicholson ◽

Rachel Shakked ◽

Steven Raikin ◽

...

Keyword(s):

Bone Healing ◽

Case Series ◽

Ankle Fractures ◽

High Rate ◽

Foot And Ankle ◽

Level Of Evidence ◽

Radiographic Outcomes ◽

Significant Difference ◽

Clinical Healing ◽

Mean Time

Background: In an effort to minimize narcotic analgesia and its potential side effects, anti-inflammatory agents offer great potential provided they do not interfere with bone healing. The safety of ketorolac administration after foot and ankle surgery has not been well defined in the current literature. The purpose of this study was to report clinical healing and radiographic outcomes for patients treated with a perioperative ketorolac regimen after open reduction and internal fixation (ORIF) of ankle fractures. Methods: A retrospective review was performed on all patients that received perioperative ketorolac at the time of lateral malleolar, bimalleolar, and trimalleolar ankle ORIF by a single surgeon between 2010 and 2016 with minimum 4 months follow-up. Patients received 20 tablets of 10 mg ketorolac Q6 hours. Radiographs were evaluated independently by 2 blinded fellowship-trained orthopedic foot and ankle surgeons to assess for radiographic healing. A total of 281 patients were included, with a median age of 51 years and 138 males (47%). Statistical analysis consisted of a linear mixed-effects regression. Results: In all, 265/281 (94%) were clinically healed within 12 weeks and 261/281 (92%) were radiographically healed within 12 weeks. Within the group of patients that did not heal within 12 weeks, mean time to clinical healing was 16.9 weeks (range = 14-25 weeks), and mean time to radiographic healing was 17.1 weeks (range = 14-25 weeks). In patients taking ketorolac, there were no cases of nonunion in our series (n = 281) and no significant difference found between fracture patterns and healing or complications ( P = .500). Conclusions: Perioperative ketorolac use was associated with a high rate of fracture union by 12 weeks. This is the first study to examine the effect of ketorolac on radiographic time to union of ankle fractures. Additional studies are necessary to determine whether ketorolac helps reduce opioid consumption and improve pain following ORIF of ankle fractures. Level of Evidence: Level IV, case series.

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Comparative study of the FAOS and FAAM questionnaires as functional assessment instruments for patients with hallux valgus

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2020.v14.1149 ◽

2020 ◽

Vol 14 (2) ◽

pp. 144-147

Author(s):

Alesson Filipi Bernini ◽

Silvia Iovine Kobata ◽

Alexandre Cassini de Oliveira ◽

Rubens Trabbold Aguiar ◽

Antônio César Mezêncio da Silveira

Keyword(s):

Hallux Valgus ◽

Functional Assessment ◽

Case Series ◽

Assessment Instruments ◽

Foot And Ankle ◽

Level Of Evidence ◽

Significant Difference ◽

Functional Scores ◽

The Right ◽

Relationship Of

Objective: To compare the Portuguese translations of the Foot and Ankle Activity Measure (FAAM) and the Foot and Ankle Outcome Score (FAOS) questionnaires as functional assessment instruments for patients with hallux valgus and assess correlations between scores and severity of deformity. Methods: A total of 28 patients were assessed and the functional scores provided by the FAAM and FAOS questionnaires were compared and their correlations with clinical and radiological severity were analyzed. Results: Mean age was 46.88 years (range: 18 to 64). Laterality was distributed as follows: 57.1% had the deformity on the right foot (16 cases) and 42.9% on the left (12 cases). The deformities identified were graded as follows: 26.1% of patients had mild deformity (6 cases), 45.3% had moderate deformity (14 cases), and 28.6% had severe deformity (8 cases). It was observed that the distribution of scores for the different grades of deformity was the same for both questionnaires. Conclusion: There was no significant difference between the results obtained using the FAAM or the FAOS questionnaire or in the relationship of proportionality between radiological deformity grade and the functional scores obtained using the two tests. Level of Evidence IV; Therapeutic Studies; Case Series.

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Arthroscopic-assisted arthrodesis in the foot and ankle. Subtalar, tibiotalar, tibiocalcaneal, and metatarsophalangeal: 25 years of experience

Journal of Arthroscopic Surgery and Sports Medicine ◽

10.25259/jassm_16_2021 ◽

2021 ◽

Vol 0 ◽

pp. 1-7

Author(s):

Luis Perez-Carro ◽

Carlos Rodrigo-Arriaza ◽

Lorena Trueba-Sanchez ◽

Gustavo Gutierrez-Castanedo ◽

Guillermo Menendez-Solana ◽

...

Keyword(s):

Case Series ◽

Invasive Procedure ◽

Foot And Ankle ◽

Retrospective Case ◽

Aofas Score ◽

Level Of Evidence ◽

Non Union ◽

End Stage ◽

Mean Time ◽

Radiographic Union

Objectives: Arthritis of the foot and ankle joints provoke pain and restricts function. The arthroscopic assisted arthrodesis (AAA) is a minimally invasive procedure for end stage arthritis to eliminate pain and achieve painless mobilization, with numerous benefits like faster time to union, less blood loss, less morbidity, less infection rate, and less soft tissue complications compared with open surgery. The objective of this paper is to retrospectively evaluate our case series (136 patients) of arthroscopic assisted foot and ankle fusion that includes the subtalar, tibiocalcaneal, tibiotalar and metatarsophalangeal joint in our last 25 years of practice. Level of Evidence: Level IV, retrospective case series. Materials and Methods: Patients who underwent arthroscopic assisted arthrodesis in the foot and ankle were identified by review of a registry. Minimum follow-up was 24 months. Patient demographics characteristics, time to radiographic union, and preoperative and postoperative American Orthopaedic Foot and Ankle Society score (AOFAS) were obtained. Results: Subtalar fusion: 43 patients. Radiographic union was seen in 40 patients at a mean time of 10 weeks (8-14) and non union was seen in three patients, of which 1 required open revision surgery. AOFAS score improved from 43 preoperatively (27-57) to 83 (67-93) postoperatively. Tibiotalar fusion: 55 patients. Radiographic union in a mean time of 12 weeks (7-15) in all 55 cases. AOFAS score improved from 50.5 preoperatively (25-60) to 82 (62-94) postoperatively. Tibiotalocalcaneal fusion: 3 patients. 2 patients with radiographic union at 14 and 16 weeks and 1 showed a fibrotic union of the subtalar joint without pain. AOFAS score improved from 43 preoperatively (34-58) to 78 (67-81) postoperatively. Metatarsophalangeal fusion: 35 patients. Radiographic union in 33 patients at a mean time of 8 weeks (6-11). Two patients presented asymptomatic non union. AOFAS score improved from 38 preoperatively (30-60) to 86 (75-93) postoperatively. Conclusion: Arthroscopic assisted arthrodesis in the foot and ankle is an excellent procedure for end stage degenerated joint.

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Arthroscopic-Guided Balloon Tibioplasty in Schatzker III Tibial Plateau Fracture

Joints ◽

10.1055/s-0039-1697607 ◽

2018 ◽

Vol 06 (04) ◽

pp. 220-227 ◽

Cited By ~ 1

Author(s):

Fabrizio Cuzzocrea ◽

Eugenio Jannelli ◽

Alessandro Ivone ◽

Simone Perelli ◽

Alberto Fioruzzi ◽

...

Keyword(s):

Ct Scan ◽

Tibial Plateau ◽

Case Series ◽

Clinical Score ◽

Joint Surface ◽

X Rays ◽

Level Of Evidence ◽

Significant Difference ◽

The Mean

Abstract Purpose The study aims to present the results at a mean 28-months follow-up of arthroscopic-guided balloon tibioplasty and to spot some technical tricks and some practice using tools and materials. Methods The study relates to six patients with tibial plateau fractures type Schatzker III with tibial plateau depression more than 4 mm at preoperative computed tomography scan (CT-scan). The follow-up period ranged from 22 to 33 months, with a mean of 28 months. No patients were lost to follow-up. The patients were evaluated clinically using the Rasmussen score system and Lysholm score systems at 6 to 12 and 24 months, postoperatively. Radiographic evaluations (standard X-rays) were done preoperatively at 1, 3, and 12 months postoperatively while a CT-scan with 3D reconstruction was performed preoperatively, at the first day and 6 months, postoperatively. Results The mean Rasmussen clinical score at 6 months postoperatively was 26.3 while at 1-year postoperatively the mean Rasmussen clinical score was 28.33. At 2-year postoperatively the mean Rasmussen clinical score was 28.83. Statistically significant difference was found in 6-months and 2-years results (p < 0.05). CT-scan achieved the first postoperative day showed the recovery of approximately 70% of the area of the interested tibial plateau, restoring of the joint surface without articular bone free fragments. Conclusion The described surgical procedure, if correctly performed with proper indications (Schatzker III), respect the principles mentioned above and the clinical and radiological results confirm our purpose. Level of Evidence This is a therapeutic case series, level IV study.

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