Overuse injuries and trauma in tendon often involve acute or chronic pain eventual matrix destruction. Anti-inflammatory drugs have been used as a treatment, however, the cellular molecular mechanisms of destructive processes are not clearly understood. It is thought that an inflammatory event may be involved initiating factor. Mediators response include cytokines released from macrophages monocytes. Interleukin-1 beta (IL-1 beta) candidate proinflammatory cytokine active connective tissues...

Hypotheses/Purpose: The medial displacement calcaneal osteotomy has recently become a popular addition to flexor digitorum longus transfer for stage II posterior tibial tendon dysfunction. We reviewed the results of 26 patients who had undergone procedure at an average 32 months prior follow-up (range 12 70 months) with particular attention objective functional parameters. Conclusions/Significance: FDL and provides good symptomatic in middle-term. operation preserves majority subtalar motion...

The AOFAS foot scores are four related outcome instruments based on the use of quantitative interval data and have seen increasing in literature. mathematical construction scales is particularly notable for a very small number intervals available to answer each component item quantitatively unequal some items. Monte Carlo computer modeling techniques were used simulate responses variety idealized patient populations with several different means, standard deviations, levels interaction...

Background: There currently is no widely used, validated, self-administered instrument for measuring musculoskeletal functional status in individuals with nonsystemic foot disorders. The purpose of this paper was to report on the assessment reliability one these instruments. We wanted determine if Foot Function Index (FFI), which has been validated rheumatoid patients without fixed deformity or prior surgery, would be reliable a population complaints systemic disease. Methods: Patients were...

Many physicians continue to fear iatrogenic complications of the total contact cast, and use this modality has remained restricted a segment orthopaedic podiatric communities. I examined actual rate factors associated with them in large consecutive series casts drawn from practice single surgeon determine whether is safe for multiple conditions neuropathic foot ankle.A 398 spanning 28-month period physician were analyzed. All placed by same team orthotists. This study comprised 70 patients...

Lengthening of the lateral column is commonly used for reconstruction adult and pediatric flatfoot, but can result in supination foot symptomatic overload. The addition a medial cuneiform osteotomy has been to redistribute forces column. combined use lengthening reproducible cadaver flatfoot model was evaluated.Twelve specimens were physiologically loaded each evaluated radiographically pedobarographically following conditions: 1) intact, 2) severe 3) with simulated flexor digitorum longus...

Background: Little has been reported about the biologic effect of shock waves on human normal or pathologic tendon tissue. We hypothesized that inflammatory cytokine and MMP production would be down-regulated by wave stimulation. Materials Methods: Diseased Achilles tissue healthy flexor hallucis longus were used. Shock treatment was applied to cultured cells at 0.17 mJ/mm 2 energy 250, 500, 1000, 2000 times. Results: A dose-dependent decrease in cell viability noted receiving 1000 shocks...

Background: In patients with Achilles tendinosis, tendon debridement can be supplemented flexor hallucis longus transfer. Outcomes have not been studied prospectively in older, sedentary, and overweight patients. Methods: Fifty-eight consecutive limbs fifty-six sedentary insertional or midsubstance tendinosis were enrolled underwent the procedure. Ten lost to follow-up, leaving forty-eight forty-six available for evaluation after twenty-four months. Results: The who included study had an...

Background: We aimed to define reference lines on standard lateral ankle radiographs that could be used intraoperatively minimize iatrogenic nerve injury risk in medial displacement calcaneal osteotomy. Methods: Forty cadaveric specimens were used. In 20 specimens, the sural, plantar (MP), and (LP) nerves sutured radiopaque wire, a radiograph was obtained. On radiograph, line drawn from posterior superior apex of tuberosity origin fascia labeled as “landmark line.” A parallel 2 mm most...

Elongation of ligaments during early mobilization after reconstruction may be associated with decreased stability. We evaluated elongation the anterior talofibular ligament (ATFL) before and lateral within a physiologic range motion protected unprotected, isolated dorsiflexion/plantarflexion motion.Six fresh frozen cadaver legs were used ATFL meticulously dissected. A differential variable reluctance transducer (DVRT) was spaced to span course using consistent placement points based on...

Chondral lesions, peroneal tendon tears, and other disorders in patients with chronic ankle instability may not be detected by preoperative MRI. Also, MRI often is obtained interpreted at the referring institution, leading to variability reading.We assessed accuracy of radiologists' orthopaedic surgeon's reading for diagnosing lesions warranting surgery.We retrospectively reviewed 133 who underwent 135 surgeries lateral ligament reconstruction concomitant arthroscopy had MRI.We found 72...

Background: Arthroscopic criteria for identifying syndesmotic disruption have been variable and subjective. We aimed to quantify arthroscopically using a standardized measurement device. Methods: Ten cadaveric lower extremity specimens were tested in intact state after serial sectioning of the structures (anterior inferior tibiofibular ligament [AiTFL], interosseous [IOL], posterior [PiTFL], deltoid). Diagnostic ankle arthroscopy was performed each sectioning. Manual external rotational...

Background: Excessive varus alignment of the forefoot after lateral column lengthening has been reported to lead overloading foot. The purpose this study was investigate whether there is a difference between Evans opening wedge calcaneal osteotomy (Evans) and calcaneocuboid distraction arthrodesis (CCDA) with respect loading. Methods: In each 12 matched pairs cadaver feet, plantar pressure measurements intact specimens were obtained during simulated foot-flat early heel-rise phases gait...

Background: Little has been reported about the biologic effect of shock waves on human normal or pathologic tendon tissue. We hypothesized that inflammatory cytokine and MMP production would be down-regulated by wave stimulation. Materials Methods: Diseased Achilles tissue healthy flexor hallucis longus were used. Shock treatment was applied to cultured cells at 0.17 mJ/mm 2 energy 250, 500, 1000, 2000 times. Results: A dose-dependent decrease in cell viability noted receiving 1000 shocks...

Background: There is a paucity of research on posttraumatic ankle arthritis (PTAA). We aimed to identify synovial fluid PTAA biomarkers using cytokine analysis and metabolic profiling. Methods: Ankle joint was obtained from 20 patients with no pain radiographic evidence (control group). Synovial samples were analyzed for IFN-γ, TNF-α, MIP-1β, MCP-1, IL-1β, IL-1Ra, IL-4, IL-6, IL-8, IL-10, IL-13, IL-15 ELISA more than 3000 metabolites liquid gas chromatography mass spectroscopy. To compare...

Proliferation of cultured human fibroblasts and other types cells has been shown to be hindered by exposure local anesthetics, which are widely used in musculoskeletal medicine for their use regional anesthesia, selective nerve blocks, bursography, brisement. We hypothesized that bupivacaine would decrease cell proliferation production extracellular matrix components collagen proteoglycan healthy tenocytes culture. Primary tenocyte cultures were prepared from samples normal tendons obtained...

The addition of unconstrained internal rotation to the physical examination could allow for detection more subtle degrees ankle instability. We hypothesized that a simulated anterolateral drawer test allowing would provoke greater displacement lateral talus in mortise versus anterior test.Ten cadaveric lower extremities were tested custom apparatus designed reproduce and test, which was allowed internally rotate about intact deep deltoid ligament while being subluxed anteriorly. Specimens...

Few studies have reported the outcomes following minimally invasive medial displacement calcaneal osteotomy (MDCO) for correction of pes planovalgus deformities.Charts were retrospectively reviewed consecutive patients who underwent MDCO procedures by a single surgeon from 2013 to 2019 with more than 3 months follow-up. A total 160 189 included in study. Median follow-up was 12 (interquartile range, 7-25 months).Osteotomy healing complications present 7% cases during 6-year study period....

Background: Talar neck fracture fixation has been studied in noncomminuted models, but no large clinical series of comminuted patterns have published and biomechanical studies compared plate with screw talar fractures. Methods: Nine matched pairs fresh frozen specimens were stripped soft tissue mounted a cylindrical jig. The was fractured using dorsally directed shear force at rate 200 mm/min, dorsal comminution simulated by removing 2-mm section bone from the distal fragment. One specimen...

Background: We hypothesized that a locking plate would be stronger than blade for tibiotalocalcaneal arthrodesis under dorsiflexion and torsional loading. Materials Methods: Nine pairs of matched cadaveric lower extremities were used. BMD was obtained each specimen. Each received retrograde augmentation screw stainless steel LC-angled (Synthes, Paoli, PA) or LCP proximal humerus PA). Specimens cyclically loaded in to simulate 6 weeks partial weightbearing then monotonically failure. removed...

Background: Digital media is an effective tool to enhance brand recognition and currently referenced by more than 40% of orthopedic patients when selecting a physician. The purpose this study was evaluate the use social among foot ankle (F&A) surgeons, impact that presence on scores physician-rated website (PRW). Methods: Randomly selected F&A surgeons from all major geographical locations across United States were identified using AAOS.org website. Internet searches then performed...

New indications for arthroscopy are being considered because limits incision size and potentially decreases operative morbidity. This cadaver study investigated the utility of performing an all-endoscopic flexor hallucis longus (FHL) decompression.Eight fresh-frozen legs were used. In simulated prone position with large joint arthroscopic equipment, posterolateral posteromedial portals used to perform talar process bony excision FHL sheath debridement release. We noted integrity sural nerve,...