What’s New in Foot and Ankle Surgery: Level I and II Studies

Every month, JBJS publishes a Specialty Update—a review of the most pertinent and impactful studies published in the orthopaedic literature during the previous year in 13 subspecialties. Here is a summary of selected findings from Level I and II studies cited in the May 20, 2015 Specialty Update on foot and ankle surgery:

Talar and Calcaneal Fractures

Ankle Instability

  • A prospective randomized study of treatments for severe lateral ankle sprains compared a walking boot with restricted joint mobilization for three weeks with immediate application of a functional brace. No between-group differences in pain scores or development of mechanical instability were found, but the immediate functional-brace group had better function scores and shorter recoveries.
  • A randomized trial comparing neuromuscular training, bracing, and a combination of the two for managing lateral ankle sprains concluded that bracing is the dominant secondary preventive intervention.

Total Ankle Arthroplasty

Ankle and Hindfoot Arthrodesis

  • A pilot RCT comparing B2A-coated ceramic granules with autograft in foot and ankle arthrodesis found that the B2A approach produced a 100% fusion rate, compared with a 92% rate in the autograft group.

Achilles Tendon

  • A Level II study found that weight-bearing cast immobilization provided outcomes that were similar to those of non-weight-bearing cast immobilization in non-operative management of acute Achilles tendon ruptures.

Peripheral Neuropathy

  • In an RCT comparing standard-of-care orthoses with experimental pressure-based orthoses to prevent plantar foot ulcers, the experimental orthoses outperformed the standard ones.
  • A Level I study investigating surgical-site infections after foot and/or ankle surgery found an increased risk of infection associated with concomitant peripheral neuropathy, even in patients without diabetes.

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One response to “What’s New in Foot and Ankle Surgery: Level I and II Studies”

  1. chrishowell532 says :

    These are great studies, especially since I’m getting a foot surgery soon. My foot has been killing me as of late and I went to the doctor and they said I have a tendon out of place that needs to be surgically fixed. I hope it goes smoothly as I really love running and I need my foot.

    Like

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