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Periprosthetic Infection of Transfibular Ankle Arthroplasties Managed with Implant Retention: Anatomical Limitations of Surgical Debridement.

Background: Prosthetic ankle infection is an infrequent and rarely explored prosthetic joint infection (PJI). In early infection, the debridement of implants inserted using the transfibular approach has certain peculiarities that pose a diagnostic and therapeutic challenge, the impact of which on infection prognosis is still unknown. Methods: This study prospectively collected all cases of transfibular prosthetic ankle infection at a tertiary hospital between 2014 and 2022, describing their demographic, clinical, microbiological, and management characteristics, along with the outcome over a lo…

Модель " Коопман " , ориентированная на прогнозируемый контроль функциональной электрической стимуляции лодыжки дорсифлексиона и помощи в планировании.

Функциональная электрическая стимуляция (ФЭУ) может быть эффективным средством усиления паретической функции мышц и восстановления нормальной функции лодыжки. Наш подход предусматривает использование в реальном масштабе времени модели предсказательного контроля (МПК), основанной на концепции Koopman Operation (KOT). Эти рамки точно отражают сложную нелинейную динамику движения лодыжки в линейной форме, что позволяет применять линейные подходы к контролю для крайне нелинейной динамики FES. Наш метод точно предсказывает движения лодыжки, вызванные FES, с учетом нелинейной динамики приведения в д

Совпадение в аннотации оригинала
Functional Electrical Stimulation (FES) can be an effective tool to augment paretic muscle function and restore normal ankle function. Our approach incorporates a real-time, data-driven Model Predictive Control (MPC) scheme built upon a Koopman operator theory (KOT) framework. This framework adeptly captures the complex nonlinear dynamics of ankle motion in …

Evaluating ankle dorsiflexion in people with multiple sclerosis: Weight bearing vs. non-weight bearing methods.

BACKGROUND: Ankle joint contractures are common in Multiple Sclerosis (MS), significantly reducing dorsiflexion range of motion, hindering gait and increasing falls. Accurate, standardised ankle dorsiflexion measures for neurologically impaired populations are lacking. This study compared validity and reliability of the non-torque-controlled Weight-Bearing Lunge Test with the torque-controlled Modified Lidcombe Template in assessing ankle dorsiflexion among people with and without MS. METHODS: Sixty participants were included: 20 with MS, 20 healthy matched controls, and 20 young adults. Ankl…

Articulated ankle-foot-orthosis improves inter-limb propulsion symmetry during walking adaptability task post-stroke.

BACKGROUND: Community ambulation involves complex walking adaptability tasks such as stepping over obstacles or taking long steps, which require adequate propulsion generation by the trailing leg. Individuals post-stroke often have an increased reliance on their trailing nonparetic leg and favor leading with their paretic leg, which can limit mobility. Ankle-foot-orthoses are prescribed to address common deficits post-stroke such as foot drop and ankle instability. However, it is not clear if walking with an ankle-foot-orthosis improves inter-limb propulsion symmetry during adaptability tasks.…

Foot and Ankle Curricular Guidelines in Entry-Level Physical Therapist Education: How Are We Doing?

INTRODUCTION: The Foot and Ankle Curricular Guidelines for Physical Therapist Professional Degree Programs (FACG) provided recommendations regarding essential entry-level content and skills. Eight years later, the extent of its implementation is unknown. This study characterizes entry-level Doctor of Physical Therapy (DPT) programs' foot and ankle curriculum with reference to the FACG. REVIEW OF LITERATURE: Curricular guidelines offer recommendations to professional degree programs striving for excellence. Review and revisions of guidelines are important to keep pace with and reflect evolving…

AI-smartphone markerless motion capturing of hip, knee, and ankle joint kinematics during countermovement jumps.

Recently, AI-driven skeleton reconstruction tools that use multistage computer vision pipelines were designed to estimate 3D kinematics from 2D video sequences. In the present study, we validated a novel markerless, smartphone video-based artificial intelligence (AI) motion capture system for hip, knee, and ankle angles during countermovement jumps (CMJs). Eleven participants performed six CMJs. We used 2D videos created by a smartphone (Apple iPhone X, 4K, 60 fps) to create 24 different keypoints, which together built a full skeleton including joints and their connections. Body parts and skel…

Human in vivo talocrural contributions to ankle joint complex kinematics during walking, running, and hopping.

The human ankle joint complex, consisting of calcaneus, talus, and tibia, is often simplified as a single functional ankle joint, neglecting the motion of the talus. Understanding the individual contributions of the talus and calcaneus is crucial for comprehending ankle joint complex function in healthy populations, and alterations in function that may exist in clinical conditions. To achieve accurate bone kinematics, high-resolution biplanar videoradiography was used with participants engaged in walking and running (n = 9) and hopping (n = 9) with no overlap in participants. The rotation axes…

3D-printed custom ankle braces for people with Charcot-Marie-Tooth disease: A pilot study.

INTRODUCTION: Charcot-Marie-Tooth disease (CMT) is a neurodegenerative condition resulting in footdrop, ankle instability and impaired balance and gait. This study aimed to determine (1) whether 3D-printed custom ankle braces improve function and balance in people with CMT and (2) whether this is an acceptable device for use in this population. METHODS: A within-subject comparison pragmatic/pilot study was undertaken. Ten people with CMT (mean [SD] age 48 [14] years, 60% male) were fitted with 3D-printed ankle braces. Following a 4-week wear-in period, walking and balance tests and patient-re…

Efficacy of post-operative X-rays after operatively treated ankle fractures: What is their role?

OBJECTIVE: The utility of routine post-operative imaging in clinically asymptomatic patients is unclear. We sought to determine how frequently X-rays following operatively treated ankle fractures result in a change in management. DESIGN: Retrospective cohort study conducted with hospital electronic health record SETTING: Single level 1 trauma center in major urban city. PATIENTS/PARTICIPANTS: 193 patients with operatively treated ankle fractures at our institution between January 2020 and December 2021. MAIN OUTCOME MEASURES: Patient radiographs were categorized as surveillance X-rays and c…

[Multivariate analysis of influencing functional recovery after ankle fracture of typeⅡand above supination-external rotation].

OBJECTIVE: To explore influencing factors of functional recovery after ankle fracture of typeⅡdegree and above supination-external rotation. METHODS: Clinical data of 120 patients with ankle fractures of typeⅡdegree and above supination-external rotation admitted from February 2019 to April 2021 were retrospectively analyzed. According to American Orthopaedic Foot and Ankle Society (AOFAS), patients were divided into excellent group with 73 patients (90 to 100 points), good group with 35 patients (75 to 89 points), and fair group with 12 patients(<50 points). The differences of ankle active r…

Clinical, functional and radiological outcome after osteosynthesis of ankle fractures using a specific provocation test.

BACKGROUND: Ankle fractures are frequent, and despite numerous publications on their treatment and outcome, there is a lack of precise data on the functional results in young, healthy and physically active patients. We hypothesized that patients who underwent open reduction and internal fixation (ORIF) for simple ankle fractures would have similar function compared to a healthy control group, whereas patients with complex fractures will have significant functional deficits. Furthermore, we postulate that there is a discrepancy between the radiological and the functional outcomes. METHODS: A s…

Neurophysiologic inhibitory factors influencing subsequent ankle sprain in collegiate male athletes: a prospective cohort study.

Many athletes with recurrent ankle sprains complain of neurophysiological deficits related to chronic ankle instability (CAI). However, it remains unclear how changes in the corticospinal pathway affect the potential risk of subsequent ankle sprains. The purpose of this study was to investigate whether the corticospinal excitability (input-output properties) and silent period (SP) could be related to the risk of subsequent ankle sprains among athletes. Forty-three male collegiate basketball athletes were enrolled, and 82 ankles were finally sorted into four ankle groups based on symptoms (CAI,…

Subchondral Bone Degeneration and Pathology 3-15 Years Following Ankle Sprain Injury in Adolescent Sport.

BACKGROUND: Sport-related ankle sprains (SASs) are prevalent in adolescents (ages 10-19), increasing the risk of developing posttraumatic osteoarthritis (PTOA). Although early ankle osteoarthritis (OA) is not well defined, OA eventually includes alterations in bone mineral density (BMD), structural changes, and soft tissue pathology. This study examined the impact of SAS sustained in adolescent sport on bone and soft tissue structural outcomes 3-15 years postinjury. METHODS: Participants (n = 10) with prior unilateral SAS in adolescent sport (HxAI) were compared to age- and sex-matched contro…

Perceptions and biomechanical effects of varying prosthetic ankle stiffness during uphill walking: A case series.

BACKGROUND: Prosthetic foot stiffness, which is typically invariable for commercially available prosthetic feet, needs to be considered when … gnificant effects were only observed on the biomechanical parameters directly related to prosthetic ankle kinematics and kinetics (i.e., peak prosthetic ankle dorsiflexion, peak prosthetic ankle power, dynamic joint stiffness during controlled dorsiflexion). Participant perception during walking was affected by changes in stiffness. Individual analyses …

Impact of Subtalar Distraction Arthrodesis on Ankle Joint: Radiological Insights from Modified Grice-Green Procedure.

Subtalar distraction arthrodesis (SDA) is a surgical procedure designed to treat hindfoot deformities associated with isolated subtalar join … re included. The patient records were reviewed to extract demographic data. Weight-bearing foot and ankle radiographs were assessed to measure the talar tilt angle and the tibiotalar ratio on the same picture archiving and communication system by three independent observers. A total of 69 patients met the criteria for inclusion. The mean talar tilt show …

[Tibiotalocalcaneal arthrodesis for end-stage ankle and hindfoot arthropathy: Short- and mid-term clinical outcomes].

OBJECTIVE: To analyze the clinical data of patients with end-stage ankle and hindfoot arthropathy who underwent tibiotalocalcaneal (TTC) arthrodesis by the same surgeon, explore the short- and mid-term clinical results, complications and functional improvement, and discuss the clinical prognosis and precautions of TTC arthrodesis. METHODS: Retrospective analysis was made on the clinical data of 40 patients who underwent TTC arthrodesis by the same surgeon from March 2011 to December 2020. In this study, 23 males and 17 females were included, with an average age of (49.1±16.0) years. All the p…

Brachial-ankle pulse wave velocity is associated with intracranial artery calcification in acute stroke patients.

BACKGROUND: Intracranial artery calcification (IAC) is closely associated with cerebrovascular disease. Brachial-ankle pulse wave velocity (baPWV) is a noninvasive method for estimating arterial stiffness, which reflects the stiffness of peripheral arteries. This study aimed to examine the association of baPWV with the presence and degree of IAC in patients with acute ischemic stroke. METHODS: A total of 143 ischemic stroke subjects were recruited. A head computed tomography (CT) scan was used to assess the presence and severity of IAC. The oscillometric method was used to simultaneously meas…

Clinical implications of the cardio-ankle vascular index before and after transcatheter aortic valve implantation.

BACKGROUND: Arterial stiffness indices are used to assess the material properties of the arterial wall and are associated with cardiovascular events. Aortic stenosis (AS) is commonly caused by degenerative calcification and can be associated with increased arterial stiffness. However, the clinical implications of arterial stiffness indices in AS patients before and after treatment are unknown. METHODS: This single-center observational study enrolled 150 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) for severe AS. The cardio-ankle vascular index (CAVI) was m…

Recurrent diabetic foot ulcers: Results of a maximal multidisciplinary approach including reconstructive foot/ankle surgery.

The diabetic foot ulcer (DFU) and Charcot Neuroarthropathy (CN) are serious complications of diabetes mellitus in which wound closure is complex to achieve. Treating recurrent DFU in patients with a combination of infection, ischemia, and deformities is extremely challenging and this group of patients has a very poor outcome. This case series describes the outcomes of patients with a recurrent DFU and CN, with a mean SINBAD score of 4 and of which 40% had a TCS of D3, using a multidisciplinary protocol that includes reconstructive foot and ankle surgery. In 24/35 (69%) of patients, wound closu…

Regional anesthesia provides limited decreases in opioid use following distal tibia and ankle fracture surgery.

PURPOSE: Regional anesthesia (RA) is used for pain control, but its impacts on the orthopedic trauma population are not well known. This study evaluated the impact of peripheral nerve blocks after distal tibia and ankle fracture repair on opioid use and pain scores and quantified the magnitude and duration of any changes. METHODS: This retrospective cohort study included patients treated operatively for distal tibia and ankle fractures over a 5-year period, both with and without peripheral nerve blocks. Total inpatient 5 mg oxycodone equivalents (OEs) used in the post-operative period, from 0…