Automated Cuff Occlusion Pressure Effect on Quality of Operative Fields in Foot and Ankle Surgery: A Randomized Prospective Study

2011 ◽  
Vol 32 (3) ◽  
pp. 239-243 ◽  
Author(s):  
Alastair SE Younger ◽  
Mojieb Manzary ◽  
Kevin J. Wing ◽  
Keith Stothers
Keyword(s):  
Prospective Study ◽  
Pressure Effect ◽  
Foot And Ankle ◽  
Occlusion Pressure ◽  
Ankle Surgery ◽  
Cuff Occlusion

scholarly journals Trends of Foot and Ankle Publishing in JBJS[A] over a 15 Year Period From 2004-2018

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0010
Author(s):  
Bradley Alexander ◽  
James Hicks ◽  
Abhinav Agarwal ◽  
Aaradhana J. Jha ◽  
Spaulding F. Solar ◽  
...  
Keyword(s):  
Geographic Origin ◽  
Median Number ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Quality Research ◽  
Level Ii ◽  
Ankle Surgery ◽  
Ankle Research ◽  
Quality Of Research

Category: Other Introduction/Purpose: As the field of foot and ankle surgery grows and new innovations continue to be made it is important that the quality of research improves. This will help to lay a strong foundation for current and future surgeons in the field. Leading journals need to set the tone for all orthopedic journals by publishing quality literature. This current study will look at all foot and ankle articles published by JBJS[A] over a 15-year period and analyze authorship, article type, geographic origin of articles, and level of evidence trends. This study will give a representative view of where foot and ankle research is currently and where it can go as we enter the new decade. Methods: A foot and ankle research fellow reviewed all of the articles published in JBJS[A] from January 2004 to December of 2018. Articles that related to foot and ankle topics were then selected to analyzed. Editorials, letters to the editor, announcements, technical notes, retraction notes, events, errata, retracted manuscripts, historical papers and pediatric foot and ankle articles were excluded. After exclusions were applied 321 and information pertaining to each article was analyzed. Additionally, a Google Scholar search was conducted for each article to determine the number of times an article had been cited. For calculations relating to median number of citations for each article we excluded articles that were published less than three years ago (2017 and 2018). For level of evidence a kappa value (0.82) was calculated to measure interobserver reliability between two reviewers. Results: We found the following results to be significant. Clinical therapeutic studies were the predominant study design over 15 years. The amount of literature over ankle arthroplasty has increased more than any other article topic. The amount of level IV and V evidence has decreased and the amount of level II and III evidence has increased. The median number of authors has been increasing. This includes female authorship. There has been in an increase in MD, PhDs as last authors. There is more foot and ankle research being produced by Asian countries. A majority of high level of evidence articles (level I and II) comes from North America and Europe. Level of evidence doesn’t correlate with the amount of times an article is cited. Conclusion: As the field of foot and ankle surgery continues to grow it is important that there is a high quality of research being conducted and published to guide surgical and clinical decisions. Our study shows that research is being produced more globally and the number of individuals involved in the research process is increasing and diversifying. This has led to higher quality research being produced (more level II and III) and a decrease in lower quality research (IV and V). Overall, the standard of research has increased in JBJS[A] which benefits the foot and ankle surgery community. [Table: see text]

Quality of Research and Level of Evidence in Foot and Ankle Publications

2012 ◽  
Vol 33 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Heather L. Barske ◽  
Judith Baumhauer
Keyword(s):  
Clinical Research ◽  
Medical Profession ◽  
Research Articles ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Ankle Surgery ◽  
Ankle Research ◽  
Level I ◽  
Quality Of Research

Background: The quality of research and evidence to support medical treatments is under scrutiny from the medical profession and the public. This study examined the current quality of research and level of evidence (LOE) of foot and ankle surgery papers published in orthopedic and podiatric medical journals. Methods: Two independent evaluators performed a blinded assessment of all foot and ankle clinical research articles (January 2010 to June 2010) from seven North American orthopedic and podiatric journals. JBJS-A grading system was used for LOE. Articles were assessed for indicators of study quality. The data was stratified by journal and medical credentials. Results: A total of 245 articles were published, 128 were excluded based on study design, leaving 117 clinical research articles. Seven (6%) were Level I, 14 (12%) Level II, 18 (15%) Level III, and 78 (67%) Level IV. The orthopedic journals published 78 studies on foot and ankle topics. Of the podiatric journals, the Journal of the American Podiatric Medical Association (JAPMA) published 12 clinical studies and the Journal of Foot and Ankle Surgery (JFAS) published 27, 21 (78%) of which were Level IV studies. When the quality of research was examined, few therapeutic studies used validated outcome measures and only 38 of 96 (40%) gathered data prospectively. Thirty (31%) studies used a comparison group. Eighty-seven articles (74%) were authored by a MD and 22 (19%) by a DPM. Conclusion: Foot & Ankle International (FAI) published higher quality studies with a higher LOE as compared to podiatry journals. Regardless of the journal, MDs produced the majority of published clinical foot and ankle research. Although improvements have been made in the quality of some clinical research, this study highlights the need for continued improvement in methodology within foot and ankle literature.

Factors associated with patient satisfaction with foot and ankle surgery in a large prospective study

The Foot ◽  
2012 ◽  
Vol 22 (3) ◽  
pp. 211-218 ◽  
Author(s):  
Jill Dawson ◽  
Irene Boller ◽  
Helen Doll ◽  
Grahame Lavis ◽  
Robert J. Sharp ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Prospective Study ◽  
Foot And Ankle ◽  
Large Prospective Study ◽  
Factors Associated ◽  
Ankle Surgery

Survey of Tourniquet Use in Orthopaedic Foot and Ankle Surgery

2005 ◽  
Vol 26 (3) ◽  
pp. 208-217 ◽  
Author(s):  
Alastair S.E. Younger ◽  
Timothy P. Kalla ◽  
James A. McEwen ◽  
Kevin Inkpen
Keyword(s):  
Cuff Pressure ◽  
Standard Of Care ◽  
Foot And Ankle ◽  
Occlusion Pressure ◽  
Current Standard ◽  
Breakthrough Bleeding ◽  
Pressure Setting ◽  
Ankle Surgery ◽  
American Orthopaedic ◽  
Limb Occlusion Pressure

Background: Tourniquet technique varies among foot and ankle surgeons, and to establish a standard practice guideline the current standard of care should be examined. Methods: One hundred and forty responses were received after 253 surveys were mailed to American Orthopaedic Foot and Ankle Society (AOFAS) members, concerning type of tourniquets, location, and pressures used. Results: Cuff pressures most commonly used were 301 to 350 mmHg for thigh cuffs (49% of thigh cuff users) and 201 to 250 mmHG for calf and ankle cuffs (52% of calf cuff users, 66% of ankle cuff users). A substantial number of foot and ankle surgeons who use calf and ankle cuffs frequently use pressures above 250 mmHg (41% of calf cuff users, 19% of ankle cuff users). Only 9% use limb occlusion pressure when determining cuff pressure. Conclusion: Based on the existing evidence-based literature these pressures may be higher than necessary for many patients, and increased adoption of optimal pressure setting techniques as reported in the literature may help reduce tourniquet pressures used and risk of tourniquet injury. Respondents reported experiencing or hearing reports of breakthrough bleeding, nerve injury, and skin injuries under the cuff.

scholarly journals Cost-Utility Analyses in Foot & Ankle Surgery

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0028
Author(s):  
Aditya Karhade ◽  
John Kwon
Keyword(s):  
Health Economic ◽  
Cost Effective ◽  
Cost Utility ◽  
Ankle Sprains ◽  
Foot And Ankle ◽  
Percentile Score ◽  
Ankle Surgery ◽  
Value Based Care ◽  
Economic Studies

Category: Other Introduction/Purpose: Orthopedic surgery lies at the forefront of the initiative to deliver value-based care. As a result, cost utility analyses have gained increased importance in the orthopedic literature. While other authors have previously reviewed the quality of US-based cost-utility analyses in orthopedic trauma, spine, sports, and arthroplasty, a similar analysis specific to foot and ankle surgery has not been performed. As such, the practicing foot and ankle surgeon does not yet have a comprehensive analysis of the available cost-utility analyses or the quality of the available evidence. The purpose of this study was to perform a systematic review of cost-utility analyses in foot and ankle surgery. Methods: A systematic review of foot and ankle studies was conducted to identify cost-utility based analyses published between 2000 and 2017. Of 687 studies screened by abstract, eight cost-utility foot and ankle studies were identified that met inclusion criteria and were scored by the Quality of Health Economic Studies instrument for overall quality. Results: Of the eight studies that met inclusion criteria, four were published in the U.S. Regarding topic, three examined end-stage arthritis, two examined diabetic foot ulcers, two examined ankle fractures and one examined ankle sprains. Cost-effective interventions identified by these studies included total ankle arthroplasty over ankle fusion or nonoperative treatment, adjunctive hyperbaric oxygen therapy for diabetic foot ulcers, suture button fixation over syndesmotic screws for unstable supination-external rotation type IV ankle fractures, and below knee cast and fracture boot immobilization over tubular bandages for acute severe ankle sprains respectively. The mean Quality of Health Economic Studies scores for these studies was 81.9 with interquartile range, 25th percentile score of 74.8 to 75th percentile score of 86. Conclusion: Despite the increasing focus on value-based care delivery, there are few foot and ankle cost-utility analyses in the current literature. Nonetheless, the quality of existing analyses is high as rated by the Quality of Health Economic Studies and certain interventions have been identified as cost-effective as highlighted above. The findings of this review can be used to help design future analyses in order to best demonstrate the cost-effectiveness of foot and ankle interventions.

scholarly journals The Combined Lambrinudi and Ankle Arthrodesis with Ring External Fixation in the Long-term Severe Neuromuscular Equinocavovarus Deformity with Ankle and Hindfoot Osteoarthritis: The Cases Presentation and Modified Guideline of Treatment

2019 ◽  
Vol 13 (1) ◽  
pp. 183-188
Author(s):  
Prasit Rajbhandari ◽  
Chayanin Angthong ◽  
Jiancheng Zang ◽  
Sihe Qin ◽  
Andrea Veljkovic
Keyword(s):  
Present Report ◽  
Treatment Algorithm ◽  
Deformity Correction ◽  
Ankle Arthrodesis ◽  
Foot And Ankle ◽  
Improved Outcomes ◽  
Ankle Surgery

Background: Severe equinocavovarus deformity develops from various causes and generally results in major disability that affects patient’s mobility and quality of life. It can be divided into neuromuscular and non-neuromuscular deformities, including two major subtypes: i.e., paralytic and spastic. In addition, ankle osteoarthritis could be caused by prolonged or progressive foot deformity. Objective: The present report proposes a modification of the accepted treatment algorithm and Lambrinudi’s surgical technique with ankle and hindfoot arthrodesis to correct theses challenging deformities with the long-term condition. Results: Two equinocavovarus cases were included, one in a 54-year old male and the second in a 63-year old female with paralaytic and spastic etiologies respectively. Patient’s deformity correction was acceptable. Each patient demonstrated improved outcomes due to a postoperative plantigrade foot and ankle position. No significant complications were encountered during the course of care and last follow-up. The mean follow-up time was 26 months. Conclusion: Severe long term neuromuscular equinocavovarus deformities are a challenging disability in the foot and ankle surgery. The present article proposes a modified guideline of treatment illustrated in two representative case studies of long-term paralytic and spastic equinocavovarus deformities. These conditions can be treated surgically using the stepwise approach as demonstrated in this article with acceptable outcomes.

The Problem with Measuring Patient Perceptions of Outcome with Existing Outcome Measures in Foot and Ankle Surgery

2003 ◽  
Vol 24 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Jan Parker ◽  
Christopher J. Nester ◽  
Andrew F. Long ◽  
Jim Barrie
Keyword(s):  
Quality Of Life ◽  
Outcome Measures ◽  
Patient Perceptions ◽  
Foot And Ankle ◽  
General Health Status ◽  
Foot Surgery ◽  
Ankle Surgery ◽  
Surgery Research ◽  
The Many

Quality outcome measures are the cornerstone of clinical research. A review of outcome measures used in foot and ankle surgery research reveals that the issues of validity, reliability and responsiveness of outcome measures have not been addressed. Most reports in the literature have attempted to evaluate patient perceptions of outcome following foot surgery. Underlying the many difficulties with these outcome measures is a lack of understanding of what patients perceive to be important in terms of outcome. Consequently none of the existing outcome measures can claim to be valid measures of patient perceptions of outcome, as there has been no research uncovering these perceptions. In addition, measures of general health status and quality of life in relation to outcome of foot and ankle surgery have been largely ignored to date.

scholarly journals A new path for the Journal of the Foot & Ankle - JFA

2020 ◽  
Vol 14 (1) ◽  
pp. 1
Author(s):  
Alexandre Leme Godoy-Santos ◽  
Cristian Ortiz ◽  
Daniel Baumfeld ◽  
Gabriel Khazen ◽  
Luis Hermida ◽  
...  
Keyword(s):  
Clinical Evidence ◽  
Research Community ◽  
Hard Work ◽  
Foot And Ankle ◽  
Common Goal ◽  
Treatment Results ◽  
High Quality ◽  
Phone Calls ◽  
Ankle Surgery

Hard work is the key to success. It may sound like a cliché, but the preparation and the release of this first edition of the new Journal of the Foot & Ankle (JFA) were based on this very concept, and we took it very seriously! For years many of us have dedicated time and efforts to bring this Journal to life. After countless meetings, discussions, phone calls, WhatsApp messages, and an infinite amount of writing, our collaborative hard work and friendship finally brought us here! Now we need to stay focused and ahead of the game, looking forward to the future and the innovations. We should aim to publish high-quality, unbiased research, with emphasis on strong clinical evidence. Our vision is to support researchers and research that can enable the Orthopaedic Foot and Ankle Surgery Community to understand better the complexity of the pathologies, guide treatment, and, most importantly, improve the treatment results and quality of life of our patients. Our thoughts are that keeping all these goals in mind will allow us to achieve the expected acceptance and respect of the research community, as well as the desired indexation. It is not an easy task! But we are confident we can get there with your help! We’re great believers in working as a team towards a common goal, and we are sure that with the help of our dedicated Foot and Ankle colleagues and researchers, we will soon make our vision become a reality! Let’s do it together!

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