Background: Although numerous studies have investigated the influence of preoperative deformity and postoperative implant alignment on clinical outcomes after total ankle arthroplasty (TAA), the relationship between dynamic tibiotalar motion and patient-reported outcomes remains unclear. This pilot study investigated whether preoperative, postoperative, and longitudinal changes in computed tomography (CT)-based tibiotalar kinematics are associated with clinical outcomes after combined TAA. Methods: Thirteen ankles that underwent combined TAA for end-stage varus ankle osteoarthritis were retrospectively evaluated. CT was performed preoperatively and 3 months postoperatively with the ankle in active dorsiflexion and plantarflexion under nonweightbearing. Preoperative and postoperative tibial models were registered using a globally optimal iterative closest point algorithm, enabling direct comparison of tibiotalar kinematics within a common tibial coordinate system. Spearman rank correlation was used to assess associations among preoperative kinematics, postoperative kinematics, longitudinal changes, and 2-year postoperative Self-Administered Foot Evaluation Questionnaire (SAFE-Q) scores. Results: All SAFE-Q subscale scores improved significantly ( P < .05 for all) after surgery. Postoperatively, inversion decreased and the rotational pattern between the 2 end positions shifted from external to internal rotation. Postoperative inversion correction, preservation of a physiological internal rotational relationship between the talus and tibia, and plantarflexion-related kinematic parameters showed associations with postoperative SAFE-Q scores. Greater longitudinal correction of plantarflexion inversion and dorsiflexion internal rotation was associated with superior postoperative pain-related outcomes. Conclusion: CT-based tibiotalar kinematics at maximum active dorsiflexion and plantarflexion showed exploratory associations with postoperative patient-reported outcomes after combined TAA. Restoration of postoperative inversion alignment, physiological internal rotational motion, and plantarflexion-related dynamic motion were associated with superior clinical outcomes. Given the small sample size, these findings should be interpreted as hypothesis-generating and require confirmation in larger cohorts. CT-based tibiotalar kinematics assessment using a common tibial coordinate system may provide a basis for further investigation of the relationship between postoperative tibiotalar kinematics and patient-reported outcomes after combined TAA. Level of Evidence: Level III, retrospective cohort study.
Background: Scientific meetings are a primary venue for disseminating orthopaedic research, but not all presented work reaches full-text publication. The publication rate of American Orthopaedic Foot & Ankle Society (AOFAS) annual meeting abstracts has been examined only once, for the 2008 through 2012 meetings. We determined the publication rate, time to publication, and journals of publication for podium and poster presentations from 2013 through 2024. Methods: We retrospectively reviewed all podium (oral) and poster presentations from the 12 AOFAS annual meetings held between 2013 and 2024, and all podium presentations from the 3 AOFAS Winter Meetings (2022 through 2024). Two reviewers searched PubMed/MEDLINE, supplemented by manual searching, for a concordant full-text publication of each abstract through June 2026. Publication rates with 95% CIs, time to publication, the proportions published within 2 and 3 years, and the most frequent journals were determined. Trends across meeting years were assessed by the Cochran-Armitage test and linear regression. Results: Of 954 podium abstracts, 440 (46.1%; 95% CI, 43.0-49.3) reached full-text publication, compared with 1426 of 4264 poster abstracts (33.4%; 95% CI, 32.0-34.9; P < .001). Median time to publication was 10 months for podium and 9.4 months for poster presentations. Foot & Ankle International was the most frequent journal for both formats (43.9% and 26.5%), and Foot & Ankle Orthopaedics accounted for 4.5% and 7.2%; restricted to the 2016 meeting onward, the 2 society journals together accounted for 45. 5% of podium and 33.5% of poster publications. The number of podium presentations did not change significantly over the study period ( P = .06) whereas poster presentations ( P = .009) and total presentations ( P = .027) increased. Among meetings with mature follow-up (2013 through 2022), no significant trend in the podium publication rate was detected ( P = .06). Across the 3 Winter Meetings, at which all accepted abstracts were presented from the podium, 50 of 102 (49.0%) were published. Conclusion: Nearly half of AOFAS podium presentations and approximately one-third of poster presentations reached full-text publication, most within 3 years and most often in Foot & Ankle International . The gap in publication rates between podium and poster presentations, described a decade earlier, has persisted, although it is somewhat smaller. The number of podium presentations remained stable while poster and total presentations have increased, indicating that the growth of the meeting has occurred through poster formats. Level of Evidence: Level IV, retrospective review.
Background: When conservative management of Morton neuroma fails, surgical excision is the conventional next step. Neurectomy carries recognized morbidity, including permanent sensory deficit and painful stump-neuroma formation, leaving a gap for a minimally invasive, nerve-sparing alternative. Ultrasonography-guided cryoablation is one such option, but mid-term outcome data, particularly for CO 2 -based systems, are limited. We evaluated its technical success, safety, and clinical effectiveness at 24 and 52 weeks. Methods: In this retrospective, single-center study, 26 consecutively treated patients with neuromas refractory to conservative treatment underwent outpatient ultrasonography-guided cryoablation under local anesthesia; 19 (16 women, 3 men; aged 37-75 years, 25 neuromas) completed follow-up and were analyzed. A 2.3 mm CO 2 cryoprobe was positioned adjacent to the neuroma-bursal complex, with freeze-thaw cycles tailored to lesion length. Pain (0-10 visual analog scale [VAS]) and satisfaction were recorded at 24 weeks; at 52 weeks, patients were re-contacted to confirm whether symptoms had changed. Results: Technical success was 25 of 25 (100%; 95% CI 86.7-100). Mean VAS decreased from 5.82 ± 1.92 to 0.92 ± 1.59, an 84% reduction ( P < .001). Thirteen of 19 patients (95% CI 46.0-84.6) were pain-free at 24 weeks, and 12 of 14 single-lesion patients (95% CI 60.1-96.0) reported complete resolution. At 52 weeks, all 19 confirmed that their symptoms remained unchanged (VAS not readministered). Overall satisfaction was 16 of 19 (95% CI 62.4-94.5), with no dissatisfied patients. No complication was reported after either repeat cryoablation. Conclusion: Ultrasonography-guided CO 2 cryoablation achieved high technical success, marked pain reduction with patient-reported maintenance of benefit at 52 weeks, and high satisfaction, with no patient-reported complications or sensory deficit. It represents a promising nerve-sparing option for refractory Morton neuroma; prospective, comparative studies with longer follow-up are needed to confirm durability. Level of Evidence: Level IV, case series.
Background: When conservative management of Morton neuroma fails, surgical excision is the conventional next step. Neurectomy carries recognized morbidity, including permanent sensory deficit and painful stump-neuroma formation, leaving a gap for a minimally invasive, nerve-sparing alternative. Ultrasonography-guided cryoablation is one such option, but mid-term outcome data, particularly for CO 2 -based systems, are limited. We evaluated its technical success, safety, and clinical effectiveness at 24 and 52 weeks. Methods: In this retrospective, single-center study, 26 consecutively treated patients with neuromas refractory to conservative treatment underwent outpatient ultrasonography-guided cryoablation under local anesthesia; 19 (16 women, 3 men; aged 37-75 years, 25 neuromas) completed follow-up and were analyzed. A 2.3 mm CO 2 cryoprobe was positioned adjacent to the neuroma-bursal complex, with freeze-thaw cycles tailored to lesion length. Pain (0-10 visual analog scale [VAS]) and satisfaction were recorded at 24 weeks; at 52 weeks, patients were re-contacted to confirm whether symptoms had changed. Results: Technical success was 25 of 25 (100%; 95% CI 86.7-100). Mean VAS decreased from 5.82 ± 1.92 to 0.92 ± 1.59, an 84% reduction ( P < .001). Thirteen of 19 patients (95% CI 46.0-84.6) were pain-free at 24 weeks, and 12 of 14 single-lesion patients (95% CI 60.1-96.0) reported complete resolution. At 52 weeks, all 19 confirmed that their symptoms remained unchanged (VAS not readministered). Overall satisfaction was 16 of 19 (95% CI 62.4-94.5), with no dissatisfied patients. No complication was reported after either repeat cryoablation. Conclusion: Ultrasonography-guided CO 2 cryoablation achieved high technical success, marked pain reduction with patient-reported maintenance of benefit at 52 weeks, and high satisfaction, with no patient-reported complications or sensory deficit. It represents a promising nerve-sparing option for refractory Morton neuroma; prospective, comparative studies with longer follow-up are needed to confirm durability. Level of Evidence: Level IV, case series.
Background Adequate nutrition is essential for wound healing and postoperative recovery. Preoperative screening may identify high-risk patients and improve outcomes. This study aimed to determine whether abnormal preoperative nutritional laboratory values are associated with 90-day and 1-year complications including pseudarthrosis following midfoot fusion. Methods: We conducted a retrospective propensity score–matched cohort study using the TriNetX research network of more than 147 million patients, evaluating patients undergoing midfoot fusion with available preoperative nutritional laboratory values. Rates of preoperative laboratory testing were assessed, followed by propensity score–matched analyses comparing patients with abnormal and normal values. Ninety-day and 1-year postoperative complications were evaluated. Results: A total of 5667 patients underwent midfoot fusion. Preoperative nutritional laboratory markers were infrequently obtained (albumin 58.9%, leukocytes 36.0%, transferrin 3.2%, and prealbumin 1.9%) and often within normal limits (albumin 89.9%, leukocytes 99.5%, transferrin 79.7%, and prealbumin 91.0%). With the numbers available, no association could be detected between preoperative hypoalbuminemia and 90-day wound disruption (risk ratio [RR] 1.10, 95% CI 0.61-1.98), SSI (SSI; RR 0.96, 95% CI 0.54-1.68), hardware infection (RR 1.33, 95% CI 0.70-2.56), return to emergency department (ED; RR 1.05, 95% CI 0.70-1.59), or readmission (RR 1.13, 95% CI 0.88-1.45). With the numbers available, no association could be detected at 1 year postoperatively for pseudarthrosis (RR 1.06, 95% CI 0.55-2.07), wound disruption (RR 1.03, 95% CI 0.64-1.68), SSI (RR 1.03, 95% CI 0.64-1.67), hardware infection (RR 1.14, 95% CI 0.71-1.83), return to ED (RR 1.07, 95% CI 0.83-1.39), readmission (RR 1.18, 95% CI 0.95-1.46), hardware removal (RR 1.07, 95% CI 0.66-1.71), pneumonia (RR 0.79, 95% CI 0.36-1.71), and venous thromboembolism (RR 1.23, 95% CI 0.60-2.52). Conclusions: Preoperative nutritional laboratory markers are infrequently obtained and are rarely abnormal when measured. With the numbers available, no association could be detected between preoperative hypoalbuminemia and increased 90-day or 1-year complications including pseudarthrosis following midfoot fusion. Level of Evidence: Level III, retrospective cohort study.
