Foot & Ankle International

Psychological distress has been associated with inferior outcomes after major joint arthroplasty, but its impact on outcomes after total ankle arthroplasty (TAA) remains unclear. The main aim of this study was to investigate whether patients reporting anxiety or depression before TAA surgery had inferior outcomes 1 year after surgery. In conclusion, Preoperative self-reported anxiety or depression was common among patients undergoing TAA and was associated with worse symptoms before surgery. However, the reporting of such symptoms did not appear to limit postoperative improvement in patient-reported outcomes at 12 months. Among patients reporting anxiety/depression preoperatively, approximately two-thirds no longer reported anxiety/depression at 12 months. Click here to read the article

First metatarsophalangeal joint arthrodesis is a reliable treatment for painful end-stage degenerative, inflammatory, and post-traumatic conditions and severe deformities of the first ray. Although long-term functional outcomes are well documented, the incidence and relevance of degenerative changes in adjacent joints of the medial column after first metatarsophalangeal joint (MTP1) fusion remain uncertain. In conclusion, MTP1 arthrodesis provides excellent long-term satisfaction and functional outcomes with low revision rates. Although radiographic adjacent-joint degeneration, particularly involving the interphalangeal joint, may occur over time, these changes do not appear to influence clinical outcomes.

Supramalleolar osteotomy (SMO) enables deformity correction of the distal tibia, but the procedure remains technically demanding. Patient-specific instruments (PSIs) have the potential to mitigate the technical drawbacks associated with SMO that are performed free-hand, but their accuracy has not been investigated. Therefore, we aimed to perform a pre- vs post-operative comparison to assess the accuracy of PSI in the setting of SMO correction. In conclusion,This study demonstrated an accurate correction of distal tibia deformities by SMO using PSIs. The achieved post-operative correction differed within the range of 1° from the pre-operatively simulated correction. This indicates that PSIs provide a precise execution of the pre-operative planning. Future studies should assess the added value of performing an SMO with PSI compared with former free-hand techniques towards clinical and radiographical outcomes. Click here to read the article

Conflicting evidence exists regarding the ability of surgical helmet systems (SHSs) to reduce rates of infection after joint replacement. The purpose of this study was to investigate the use of SHS in total ankle arthroplasty (TAA) and their effect on postoperative infection rates. In conclusion, Although SHS may provide additional protection for the surgeon from being contaminated during the surgery, the use of surgical hoods was not associated with a protective effect against surgical site infection. Considering the disadvantages and added costs of SHS, the decision to wear hoods during TAA is therefore left to the individual surgeon's discretion and personal preference. Click here to read the article