bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomechanics and Injury Prevention for Barefoot/Minimalist Running
Authors: Connors Gregory , Mathew Justin , Freeland Erik
Published: December 2023

Category:

Sports; Midfoot/Forefoot

Introduction/Purpose:

Running-related injuries are common despite technological advances in running shoes. Recently, there has been a movement towards barefoot/minimalist running. Proponents of barefoot running state that this style of running provides beneficial modifications to the gait cycle and prevents running-related injuries. The purpose of this review is to analyze the biomechanical consequences of barefoot/minimalist running and determine if barefoot/minimal style running prevents running- related injuries.

Methods:

A literature search was done on PUBMED using the keywords: Barefoot running, minimalist running, injury prevention, injury rate, foot-strike pattern, vertical loading rate, biomechanics, and clinical outcomes. Studies were then grouped into biomechanical studies and clinical outcome studies. Biomechanical studies were included if they analyzed outcomes such as: foot strike index/pattern, vertical loading rates, vertical ground reaction forces, joint angles, cadence, step length, or joint energy absorption. Clinical outcome studies were included if they analyzed injury rates and pain.

Results:

Biomechanical studies indicated that barefoot/minimalist running coincided with a transition to an anterior foot strike, lower vertical loading rates, higher cadences, less energy absorption at the knee joint, and higher energy absorption at the ankle joint. The clinical outcome studies indicated improvement of prior injuries and equivocal injury rates in the barefoot/minimal style running groups.

Conclusion:

Foot strike pattern is more important than footwear in regard to injury prevention and vertical loading rate. Switching to minimalist footwear improves running biomechanics with a more anterior foot strike, higher cadence, lower vertical loading rate, less knee energy absorption, and a shorter stride length. However, minimalist footwear places higher degrees of stress on the ankle joints and an increased injury rate when abruptly transitioning to barefoot running. Runners must weigh the risks and benefits and take caution to properly strengthen their feet and safely transition to minimalist running.
Clinical and Radiographic Outcomes of Supramalleolar Osteotomy for the Old Age Patients with Medial Compartment Ankle Osteoarthritis
Authors: Lim Jung-Won , Jung Hong-Geun , Im Je-Min
Published: December 2023

Category:

Ankle Arthritis

Introduction/Purpose:

Supramalleolar osteotomy (SMO) has recently been accepted as the major surgical option for treating painful asymmetric ankle arthritis. However, in many literatures, old age is regarded as relative contraindication for SMO. This study aimed to evaluate clinical and radiographic outcomes of medial compartment ankle osteoarthritis (OA) treated with SMO for the patients of relatively old age. Also, the study is aimed to compare the outcomes between old age group (≥ 65 years) and the group younger than 65 years.

Methods:

The study is based on consecutive 60 ankles of medial compartment ankle arthritis (60 patients) with moderate to severe medial ankle pain (at least 1-year follow-up). SMO and fibular valgization oblique osteotomy were performed. As for the functional evaluation, visual analogue scale (VAS) pain scores, American Orthopaedic Foot and Ankle Society (AOFAS) ankle- hindfoot scores and ankle range of motion (ROM) were evaluated. On radiographs, tibial anterior surface angles (TAS), tibial lateral surface angles (TLS), and talar tilt angles (TT) were measured and the severity of ankle OA was classified by the Takakura stage. To evaluate how the age affects the outcomes of SMO procedures, the subjects were classified as two groups (Group 1: ≥ 65 years, 14 ankles, Group 2: < 65 years, 46 ankles) and the comparison between the groups were made. Using second look arthroscopy, regeneration of articular cartilage was evaluated and compared between the groups.

Results:

The postoperative VAS pain score and ROM in group 1 were not inferior to those in group 2 (2.0 ± 2.0 vs 1.0 ± 1.4, p=0.949 / 50.7 ± 12.8 vs 52.0 ± 13.5, p=0.764). Also, the postoperative TLS angle and TT angle showed no significant difference between two groups. However, the postoperative AOFAS score was significantly higher in group 2 (79.0 ± 12.6 vs 88.0 ± 9.4, p< 0.05). In terms of delayed union, there was no significant difference between two groups (3/14, 21.4% vs 9/46, 19.6%, p=0.818). As to complication rate, there was also no significant difference between two groups (1/14, 7.1% vs 6/46, 13.0%, p=0.899). There were no significant difference according to articular cartilage regeneration after SMO between two groups.

Conclusion:

SMO for the relatively older patients with painful medial compartment ankle OA achieved favorable clinical and radiological outcomes. In terms of osteotomy site union and complications, older age group (≥ 65 years) showed the results not inferior to those of younger age group ( < 65 years). Even in the older age group, SMO could be one of the surgical options for the medial ankle OA.
Clinical Outcomes Following Tibiotalocalcaneal Arthrodesis with Intramedullary Nailing Combined with Partial Fibulectomy and Onlay Bone Graft
Authors: Kyung Min Gyu , Yoon Youngsik , Kang Ho Won , Kim Dae-Yoo , Choi Yoon Hyo , Lee Kyoung Min , Lee Doo Jae , Lee Dong Yeon
Published: December 2023

Category:

Hindfoot; Ankle Arthritis

Introduction/Purpose:

Although intramedullary nailing is a popular method for tibiotalocalcaneal (TTC) arthrodesis, nonunion is one of the most commonly reported complications. The purpose of this study was to evaluate the fusion rate, improvement in functional outcomes, and occurrence of complications in TTC arthrodesis using retrograde intramedullary nailing with partial fibulectomy and onlay bone graft technique.

Methods:

We retrospectively reviewed 26 consecutive patients who underwent TTC arthrodesis using the proposed technique. For radiographic outcomes, the union rate, alignment, and any related complications were assessed. Functional outcomes were evaluated using the American Orthopedic Foot and Ankle Society hindfoot scale, Foot and Ankle Outcome Score, and visual analog scale, preoperatively and at the final follow-up.

Results:

The mean follow-up period was 38.2 months. For the tibiotalar joint, the union rate was 80.8% six months postoperatively, while all the cases achieved complete bony union at twelve months postoperatively and at the final follow-up. However, for the subtalar joint, the union rate was 26.9% at six months postoperatively, which gradually increased to 73.1% at 12 months postoperatively, and 80.8% at the final follow-up without revision surgery. A subgroup analysis showed there was a trend of higher subtalar fusion rate when an additional screw for the subtalar joint fixation was placed (86.7% vs. 54.5%). The functional outcomes significantly improved at the final follow-up. A few minor complications occurred, including surgical site infection, irritational symptoms, and metal failure; however, these eventually resolved.

Conclusion:

Our technique of TTC arthrodesis with partial fibulectomy and onlay bone grafting demonstrated reliable radiographic and satisfactory functional outcomes including patients with previous failed hindfoot surgery. In addition, it is considered safe, as minimal complications occur postoperatively. We believe that our method of TTC arthrodesis provides a good option where both the tibiotalar and subtalar joints need to be fused.
Combined Deltoid and Spring Ligament Reconstruction Using Quadrangular Construct
Authors: Moonot Pradeep , Dakhode Shubham , Karwande Nikhil , Pawar Prashant
Published: December 2023

Category:

Trauma; Hindfoot

Introduction/Purpose:

Combined reconstruction of chronic deltoid and spring ligament insufficiency is pretty uncommon and literature surrounding that is rare. The purpose of our study was discuss our experience in treating post-traumatic, chronic deltoid and spring ligament insufficiency utilising a technique called the “Quadrangular Construct” (combined deltoid and spring ligament reconstruction), which uses fibertape together with suture anchor fixation which anatomically resembles the ligament complex.

Methods:

A total of five patients were included in the study who had post traumatic combined deltoid and spring ligament insufficiency. All patients had a “giving away sensation”. Preoperatively, every patient had underwent weight-bearing radiographs of ankle and foot. Talo 1st Metatarsal angle & hind-foot alignment angle using Saltzman view were noted. Ankle arthroscopy was performed for diagnosis and removal of intra-articular fibrous tissue. Superficial deltoid ligament was repaired using suture anchor. This was augmented with Internal Brace TM (Arthrex, Naples, USA) fibertape forming a quadrangular construct which anatomically mimics tibio-navicular, anterior tibio-talar, tibio-calcaneal and spring ligament components of the deltoid-spring complex. Due to associated excessive heel valgus, three patients also underwent medial displacement calcaneum osteotomy. Additionally, one patient required lateral ligament repair and one patient required syndesmotic stabilisation. American Orthopaedic Foot & Ankle Society (AOFAS) hind foot score was used to evaluate pre and post operative ankle function.

Results:

All five patients were followed up for a mean of 20 months (12–24 months). The mean angle between the long axes of the talus and first metatarsal bone on preoperative weight-bearing radiographs improved from 8.46° to 4.84°. Preoperative mean angle of hind-foot alignment in the Saltzman view was reduced from 10.9° to 5.76° post operatively. Pain was relieved postoperatively in all patients. One patient has irritation due to metal anchor which needed removal after one year. Postoperatively, none of the patients had re-experienced “feeling of giving way” sensation. AOFAS scores showed, two patients being considered excellent, two good, and one fair. All the patients could perform their ADL & recreational activities independently, and returned to their pre injury work.

Conclusion:

It is uncommon and challenging to treat post-traumatic chronic deltoid and spring ligament insufficiency. Our technique of combined deltoid and spring ligament reconstruction using a quadrangular construct aids in anatomical restoration of stability, is safe, cost effective, and easily reproducible, and has a positive short-term follow-up.
Comparative Study between Semitendinous Autograft Tendon Length Harvested in Ventral vs Dorsal Decubitus
Authors: Nery Caio , de Britto Costa Lucas Plens , Mann Tania Szejnfeld , Lima Ricardo Luiz Gave , Raduan Fernando , Mansur Nacime Salomao Barbachan , Maffulli Nicola
Published: December 2023

Category:

Sports; Ankle

Introduction/Purpose:

Chronic Achilles tendon ruptures is challenging because the tendon ends are usually retracted, and if the gap between the proximal and distal stumps are of more than 6 cms with the ankle in plantarflexion the currently literature shows that semitendinous tendon (ST) autograft reconstruction has satisfactory funcional outcome. The usual anteromedial approach for ST harvest might be more demanding with the patient in ventral decubitus, requiring knee flexion and a change of perspective. The posterior approach offers direct access to the ST but some questions might be raised about the tendon length obtained, once the incision is made 5 to 8 cm proximal to its insertion. The objetive of this study is to compare the ST length obtained from posterior and anteromedial approach.

Methods:

Prospective comparative study, level III of evidence, authorized by Ethics Committee of our institution, assessed the ST length obtained by anteromedial and posterior approach (image 1) in patients submitted to anterior cruzade ligament (ACL) reconstruction and achilles tendon reconstruction, respectively, between March 2021 and June 2022. The patients with chronic achilles tendon rupture were diagnosed by 2 orthopaedic foot and ankle surgeons board certificated and were subjected to the following inclusion criteria: age between 18-60 years, agreeing to participate, with chronic achilles tendon rupture (> 12 weeks) and gap between proximal and distal stump larger than 6cm confirmed by ultrasound with the ankle in plantarflexion position. Demographic data was obtained, including gender, BMI and height and the full tendon length intraoperatively and Visual Analog Scale (VAS) 6 weeks was applied postoperatively.

Results:

In the Achilles group 20 patients were included, with medium age of 45 years old and medium gap of 6.3 cm. In ACL group 20 patients were included, with medium age of 30.9 years old. The medium BMI was 27.9 and 26.2 in posterior and anterior approach, respectively. The medium lenght of the ST from the posterior approach was 26.3 cm and the from the anteromedial approach was 26.9 cm, with no statistic difference between groups. The VAS for pain after six weeks had no statistic difference between approachs but the anteromedial approach had 15% of numbness on the correspondent area of the safenous nerve. There were no complications reported in the posterior approach.

Conclusion:

There was no difference in the ST length between posterior and anteromedial approach, with more complications in the anteromedial approach. During achilles tendon reconstruction, the use of the posterior approach is a safe, more direct and easy approach and non inferior in terms of tendon length extraction, and should be consider the first option for tendon harvest in this procedure.
Correlation between Level of Evidence and Citations in Top 100 Cited Hallux Valgus Articles
Authors: Panchbhavi Vishank V.
Published: December 2023

Category:

Bunion; Midfoot/Forefoot

Introduction/Purpose:

An article's scientific impact has often been measured by the number of citations it receives. A citation analysis can help determine impactful works in medical specialties. The objective of this study is to describe the metrics and levels of evidence of articles on Hallux valgus.

Methods:

This study reviewed the top 100 most cited articles available when searching for articles in an electronic database using the keywords “hallux valgus”, and “bunion”. Each article was examined for the number of citations, publication type, journal specialty, authorship, country of origin, year of publication, level of evidence, and total sample size.

Results:

The number of citations ranged from 68 to 424. The 100 most cited articles were published in 24 journals, spanning from general to more specific subspecialty journals. 45% of articles were published by Foot and Ankle International. The most common level of evidence was V (34 out of 100 articles), and most articles were case series (n = 28) and expert opinion (n = 19). The median sample size in experimental studies was 44. Out of 100 articles, only 3 were randomized controlled trials.

Conclusion:

The median year of most cited publications, 2003, suggests a need for newer studies reviewing Hallux valgus. The paucity of articles with an evidence level of 1 or 2 and a small median sample size suggests a lack of scientifically rigorous studies reviewing Hallux valgus. There is a weak positive correlation between strength of evidence and number of citations in the top 100 articles cited on Hallux valgus (r= 0.149).
Decreased Reoperation Rate with ABMP in Foot and Ankle Fusions
Authors: Bennfors Grace , Cutrone Joseph , Nadeau Elizabeth K. , Morningstar Joshua L. , Scott Daniel , Gross Christopher E.
Published: December 2023

Category:

Ankle; Hindfoot

Introduction/Purpose:

A nonunion is a challenging clinic problem following foot and ankle arthrodeses. There is great interest in orthobiologics as surgical adjuvants. The purpose of this study is to compare three orthobiologics (PDGF-B agonist [PDGF-B], allograft bone morphogenetic protein [ABMP], crushed cancellous allograft [CC]) to determine if there is a difference in union rates following foot and ankle arthrodeses.

Methods:

A retrospective review was conducted of 258 feet (255 patients) with minimum 3-month follow-up, undergoing arthrodesis by a single fellowship-trained foot and ankle orthopaedic surgeon from 2016-2022. Patients underwent ankle, pantalar, triple, subtalar (ST), midfoot, or talonavicular fusion. Data collected included demographics, medical history, orthobiologics used, postoperative complications, readmission and reoperation rates. 83 (34.0%) cases used PDGF-B with CC, 32 (13.1%) used solely ABMP, 66 (27.0%) used ABMP with CC, and 63 (25.8%) used solely CC. Union was defined as bridging bone on three joint quadrants on AP and lateral radiographs, or greater than 50% bridging bone of the joint space on computed tomography (CT).

Results:

Of the 258 cases, the ST joint was most commonly fused (53.7%). Cases using ABMP had statistically significantly shorter mean time to fusion (ABMP=120.81 days, no ABMP=162.04 days). Patients treated with ABMP were also significantly less likely to undergo reoperation or removal of hardware. Between PDGF-B+CC and ABMP+CC groups, only reoperation rates differed significantly (PDGF-B+CC=26.5%, ABMP+CC=7.6%,). Multivariate regression modeling for time to fusion found ABMP usage to be the only statistically significant predictor of time to fusion, predicting patients will achieve fusion nearly 40.7 days quicker with the use of ABMP.

Conclusion:

Joints treated with PDGF-B and ABMP demonstrated equivalent fusion rates. Treatments using ABMP and CC achieved quicker time to fusion and lower rates of reoperation when compared to treatments using PDGF-B and CC.
Distance Mapping of the Ankle Joint Before and After Corrective Anterolateral Arthroscopic Subtalar Arthrodesis (ALAPSTA)
Authors: Bernasconi Alessio , Fernando Céline , Izzo Antonio , Lintz François
Published: December 2023

Category:

Hindfoot; Arthroscopy

Introduction/Purpose:

Supramalleolar osteotomies have been proposed as surgical option to realign the ankle joint in case of altered intra-articular loading. Little is known about the changes occurring at the tibiotalar joint after inframalleolar procedures, such as the corrective arthroscopic anterolateral subtalar arthrodesis (ALAPSTA). We set out to investigate changes in terms of joint interaction between the articular surfaces at the tibiotalar joint after corrective anterolateral arthroscopic subtalar arthrodesis (ALAPSTA) to treat Progressive Collapsing Foot Deformity (PCFD) with sinus tarsi impingement and subtalar joint degeneration. We hypothesized that ALAPSTA would improve hindfoot malalignment and that the distances between articular surfaces at the ankle would change significantly.

Methods:

In this retrospective study, we evaluated a consecutive series of 33 feet from 33 patients (mean age 60 years, SD 16.2; 16 right and 17 left) diagnosed with PCFD undergone ALAPSTA and reassessed at a mean follow-up of 7 months (range, 2 to 50). Weightbearing computed-tomography (WBCT) images were retrieved and the Foot and Ankle Offset (FAO) was calculated to assess the hindfoot alignment. Distance Mapping (DM) at the ankle joint (divided in 9 regions) allowed to assess changes in terms of joint interaction at this level between pre and postoperative images.

Results:

Hindfoot alignment significantly improved with a pre-operative FAO at 10.7 points (SD 4.7) and a post-operative FAO at 4.8 (SD 4.9) (p < 0.001). The mean improvement was 5.6 points. We found a significant increase in mean distances occurring posterolaterally at the ankle (from 4.5 mm (SD 1.2) to 5.4 mm (SD 1.5), p< 0.001) along with a significant decrease occurring anteromedially (from 9.1 mm (SD 1.2) to 8.3 mm (SD 1.4), p< 0.001).

Conclusion:

In this series, ALAPSTA was effective at correcting hindfoot malalignment in PCFD. After the procedure, the interaction at the ankle joint significantly changed with a reduction of anteromedial distance and an increase of posterolateral distance. Inframalleolar procedures seem to alter significantly the interaction between the tibia and the talus at the ankle. Further studies are warranted to ascertain whether changes in distances between surfaces correspond to changes in intra-articular pressures.
Does Different Anatomical Foot/ Ankle Arthritis Affect Functional Disability Differently?
Authors: Hakeem Samir , Nicolas Andrea Pujol , Porter Anna , Qasim Sultan , Chambers Simon , Ramaskandhan Jayasree R. , Torres Paulo , Siddique Malik
Published: December 2023

Category:

Ankle Arthritis; Ankle

Introduction/ Purpose:

There is paucity of literature comparing foot and general health status including quality of life between patients presenting with Ankle/ Hindfoot, Midfoot and 1st MTPJ arthritis. The aim of this study is to compare foot specific patient reported disability and quality of life satisfaction scores between patients presenting with arthritis of either the ankle/hindfoot, midfoot or 1st MTPJ.

Methods:

Patients who presented between 2020 and 2021 with a diagnosis of primary Osteoarthritis (OA) in either the ankle/hindfoot (AHA), midfoot (MA) or first MTPJ (MTPJA) were included in this study. Patients with associated foot problems, bilateral presentations, previous reconstructive surgery, or underlying neurological conditions were excluded. Differences in preoperative Patient Reported Outcome Measures (PROMs) including, MOX-FQ (Domains: Pain, Walking/Standing, Social activities), EQ-5D (UK) and Foot and Ankle outcomes scores (FAOS) (Domains: Pain, symptoms, ADL, sport, Recreation, Quality of Life) were analysed.

Results:

94 patients (2020-2021) were included in this study (mean age 58.50). There were 45 patients with AHA, 21 with MA and 28 with MTPJA. The AHA group reported worse pain compared to the MTPJA group (p=0.03), and the MA group (p=0.004). AHA patients had more difficulty with Sports & Recreational Activities (p=0.029). Quality of Life scores was not significantly different between the groups. MTPJA patients had more difficulty with engaging in social activities compared the AHA patients (p=0.049).

Conclusion:

AHA patients suffer more pain that patients with arthritis in other areas of the foot. They appear to struggle with walking and standing and have difficulty participating in sports and recreational activities. Interestingly, MTPJA patients experience the most difficulty taking part in social activities. Patients with any type of foot or ankle arthritis experience similar difficulties with their mental health and their ability to carry out activities of daily living.
Does Perioperative use of Bisphosphonate Affect Implant Revision Rate of Total Ankle Arthroplasty?
Authors: Lee Dong-Oh , Kang Ho Won , Kim Dae-Yoo , Yoon Youngsik , Lee Doo Jae , Choi Yoon Hyo , Lee Kyoung Min , Kyung Min Gyu , Lee Dong Yeon
Published: December 2023

Category:

Ankle Arthritis; Other

Introduction/Purpose:

It is unknown whether perioperative bisphosphonate (BP) use reduces revision rates in total ankle replacement arthroplasty (TAR) although its effect has been demonstrated to be effective in reducing revision rates in total knee or hip replacement arthroplasty. Therefore, the purpose of this study was 1) to investigate whether there is a relationship between the use of BP and the revision rate of TAR, and (2) to determine the effect of BP medication period on the revision rate of TAR. Our hypothesis was that the use of BP would lower the revision rate of TAR.

Methods:

We reviewed National Health Insurance Service data based on national health insurance service claim data and health care utilization, health screening, socio-demographic variables, medication history, operation codes, and mortality data for 50 million Koreans. From 2002 to 2014, 6391 of 7300 patients who underwent TAR were BP non-users, while 909 patients were BP users. The revision rate according to BP medication and co-morbidities was investigated. The Kaplan-Meier estimate and extended Cox proportional hazard model were also used.

Results:

The revision rate of TAR was 7.9% for BP users and 9.5% for BP non-users, which showed no significant difference (p=0.251). Implant survival over time decreased constantly. Adjusted hazard ratio for hypertension was 1.242 (p=0.017), while other co-morbidities such as diabetes had no effect on revision rate of TAR.

Conclusion:

We found that the perioperative BP use do not reduce the revision rate of TAR. Co-morbidities except hypertension did not affect the revision rate of TAR. More research regarding various factor affecting revision of TAR could be warranted.
Does use of Allograft Affect Union Rates in Minimally Invasive Hallux Valgus Surgery?
Authors: Gil Jorge , Lopez Kyra E. , Guevara Christian , Callan Claire , Latta Steven , Chapman Cary
Published: December 2023

Category:

Bunion; Basic Sciences/Biologics

Introduction/Purpose:

Hallux valgus is a common foot deformity that can cause significant discomfort. Surgical correction of hallux valgus can be achieved through various techniques with minimally invasive surgery (MIS) gaining popularity amongst surgeons. The use of allograft in traditional open approaches has been proposed to improve the outcomes of hallux valgus repair by expediting time to union. We performed a retrospective analysis of patients undergoing MIS hallux valgus correction with and without the allograft at time of surgery. The primary aim of our study was to determine if use of allograft in hallux valgus MIS correction led to different time to union as well as rate of unions.

Methods:

A retrospective analysis was conducted to compare outcomes of patients who underwent hallux valgus correction with or without allograft. Patients included in the analysis underwent primary hallux valgus correction using third generation minimally invasive techniques and had postoperative weightbearing x-rays. Exclusion criteria included revision surgery, open surgeries, and loss-to-follow up. All surgeries were performed by three fellowship trained Foot and Ankle Orthopaedic surgeons at a single center from September 2019 to December 2022. All patients had similar post operative protocols. The allograft group received 2- 5 cc’s of a demineralized bone matrix (DBM) gel. Radiographs were evaluated by two independent orthopedic surgeons who were blinded to the patient's group allocation. The primary outcome of this study was time to radiographic union and rate of union. The data was analyzed using the independent t- test for continuous variables and the Fisher Exact test for categorical variables.

Results:

Seventy-two patients (77 feet) met inclusion criteria: allograft group (n=25) and a control group (n=52). Demographics between both groups were similar; the overall demographics can be found in Table 1. In our study, all 77 feet obtained complete union and no malunions or non-unions were observed in either group. The average time to complete union for the allograft group was 3.52 months (± 1.58) and the control group was 4.36 months (± 2.20); union times between groups did not reach statistical significance (p = 0.09) but did demonstrate a trend towards significance (Figure 1.) Maintenance of surgical correction was observed in all patients.

Conclusion:

While there was no statistically significant difference in union time and/or rates between the allograft group and control group, the allograft recipients had a reduction in the average time to union post MIS hallux valgus correction. No differences were observed with regards to radiographic recurrence nor complications between the two groups. This study suggests that demineralized bone matrix allograft may potentially decrease time to union but further studies are needed to confirm this.
Early Outcomes after Minimally Invasive Percutaneous Zadek Osteotomy for the Treatment of Insertional Achilles Tendinitis and Haglund’s Deformity
Authors: Phillips Tammy , Encinas Rodrigo , Edelman David , Jackson J. Benjamin , Gonzalez Tyler
Published: December 2023

Category:

Hindfoot; Other

Introduction/Purpose:

Zadek dorsal closing wedge calcaneal osteotomy (DCWCO) has been increasingly investigated as an effective technique for the treatment of Insertional Achilles Tendinopathy and Haglund’s deformity. More recently, this strategy has been modified using minimally invasive techniques. A percutaneous approach, in comparison to the standard open DCWCO, allows for reduced postoperative complication, improved clinical function, and decreased pain. This retrospective chart review aims to evaluate the postoperative outcomes of patients undergoing Zadek osteotomy via a minimally invasive percutaneous approach to assess early functional outcomes, complication rates, and revision rates.

Methods:

Two fellowship-trained foot and ankle orthopaedic surgeons at one academic institution performed minimally invasive percutaneous Zadek osteotomies on 21 patients. All cases were completed between March 2021 and February 2023. Patient charts were reviewed for outcome data including complication rate, union rate, revision rate, and Patient-Reported Outcomes Measurement Information System (PROMIS) scores.

Results:

Average age of patients was 54 years. Average BMI was 39.4. Average follow up was 111.6 days. Complications included 1/21 (4.7%) superficial infection that resolved with oral antibiotics, 1/21 (4.7%) tibial neuritis that resolved 3 months after surgery, and 1/21 (4.7%) postoperative plantar fasciitis that resolved with home stretching by 6 months. There were no revisions to open procedures or hardware removal. All participants achieved union. 20/21 (95%) were very satisfied with their surgery. Average preoperative PROMIS scores regarding physical function, pain interference, and mobility were 38.3 (27-51), 65.1 (55-75), and 35.0 (25-46), respectively. Average postoperative PROMIS scores in these same domains were 38.5 (19-54), 58.8 (39-72), and 36.8 (22- 51). There was an average improvement in PROMIS scores in all domains (0.23, -6.35, and 1.76).

Conclusion:

Minimally invasive percutaneous Zadek osteotomy appears to be an efficacious and safe treatment option for insertional Achilles tendinitis and Haglund’s deformity with low complication profile, high union rate of the osteotomy and high patient satisfaction. Early functional outcome data shows trends in improvements in PROMIS scores. However, longer term data will be needed to assess long term functional outcomes and revision rates.
Accuracy of 3D facial scans: a comparison of three different scanning system in an in vivo study
Authors: Pellitteri Federica , Scisciola Fabrizio , Cremonini Francesca , Baciliero Matilde , Lombardo Luca
Published: December 2023

Background

The aim of the study was to compare the accuracy and reproducibility of three different 3D facial scanning systems, relying, respectively, on stereophotogrammetry, structured light and a smartphone app and camera.

Methods

Thirty subjects have been scanned with three different facial scanning systems, stereophotogrammetry, structured light and a smartphone app and camera. Linear measurements were compared with direct anthropometries measured on the patient's face, while the study of areas (forehead, tip of the nose, chin, right and left cheek) was evaluated by overlapping scans using the Geomagic Control X program. Statistical analyses were conducted using IBM SPSS v28 software.

Results

The ANOVA test was used to compare linear distances and direct anthropometry measurements, revealing statically significant values for all distances investigated, especially for the Face Hunter scanner, except for the Prn–Pog′ distance (p = 0.092). The three facial scans were superimposed pairwise almost the 100 per cent of the overlapping areas fell within the tolerance limits for all three comparisons analysed. The chin was the most accurately reproduced, with no differences among scanners, while the forehead proved to be the least accurately reproduced by all scanners.

Conclusions

All three acquisition systems proved to be effective in capturing 3D images of the face, with the exception of the Face Hunter scanner, that produced statistically significant differences in linear measurements for the distances Tr–Na′ and Zyg–Zyg with respect to direct anthropometric measurements.
The Palladium Effect: Great Power Values in the Era of Artificial Intelligence
Authors: Fedorchenko Sergey
Published: December 2023

The purpose of the article is to identify the features of the development of modern great powers against the background of their digital contradictions and value specifics in order to determine scenarios for the development of the future political world order. The methodological lens was the principles of critical discourse analysis of academic literature, comparative analysis of value orientations, as well as the normative basis for the introduction of artificial intelligence technologies in modern great powers – Russia, the USA and China. As a hypothesis, the author suggests the Palladium effect, according to which a great power, being given the opportunity to change the world order based on its interests, will strive for this using modern technologies, appealing to justice and taking into account its own value orientations. The Palladium effect was studied by the author in the context of the analytical verification of the "Thucydides trap". L. Althusser's theory of ideology and a number of theses of modern realism were also taken into account as a conceptual framework. The conclusions indicate that the key to the emergence of an economically and politically profitable digital environment, comfortable for a great power, is its tax residents-digital corporations that develop and distribute digital standards in other countries. In this situation, Russia strategically needs to initiate protectionist measures for its digital corporations, a policy of supporting them abroad, create favorable conditions for public-private partnerships, financing, and attracting venture capital in the field of artificial intelligence technology development in order to preserve its value and digital sovereignty (as forms of state sovereignty). In addition, key trends in the field of AI competition and variants of the axiomachy (value confrontation) of the great powers are identified, and the main scenarios for the evolution of the political world order are proposed – Triplex Mundi, Duplex Mundi and Multiplex Mundi.
The image of the future Russian state in the political worldview of student youth: sociological analysis
Authors: Shmeleva O. , Sud'in S. , Golubin Roman , Shmelev A.
Published: December 2023

The article is devoted to the study of the image of the future Russian state as a structural element of the political worldview of student youth. The image is considered by the authors as a socio-psychological phenomenon associated with the reflection in the minds of young people of the essential properties and characteristics of the state of the future, represented by a system of cognitive ideas, social attitudes, demands and expectations of the audience being studied. The image is revealed in the system of concepts « worldview - social attitudes - ideas - perception», which make up the conceptual scheme of the article and are united by a single mechanism of perception. Within the framework of the scenario approach, the cognitive, value elements of the image of the future, the emotional and evaluative background of perception, which set the framework for the perception of the Russian state, are studied. The purpose of this article is to analyze the main content characteristics of the image of the future Russian state in the minds of university students in the Volga Federal District. The authors’ conclusions are based on materials from a sociological study conducted in October-November 2023 among student youth in five regions of the Volga Federal District (sample size was 1048 respondents, sample type – cluster). The image of the future state in the mirror of the survey is characterized by a positive perception; negative scenarios are considered by respondents as unlikely or unacceptable. Students associate the prospects for the development of the state with the new opportunities that are opening up and an adequate response to the challenges of the time. The image of the future Russian state appears in the minds of young people as a multidimensional, complex, antinomic phenomenon that combines the features of a social, democratic, strong, sovereign, technologically developed state. In young people’s ideas about the future of the state, individual and personal aspects prevail over socially significant goals.
Modelling Microbial Nitrification and Exploring Nonlinear Mechanism by Dynamical Complexity
Authors:   Research Center for Engineering Ecology and Nonlinear Science, North China Electric Power University, Beijing 102206, P.R. China, Zhang Xiumin , Zhang Huayong ,   Research Center for Engineering Ecology and Nonlinear Science, North China Electric Power University, Beijing 102206, P.R. China
Published: December 2023

Nitrification, a crucial step in nitrogen cycle of ecosystems, is an important issue that attracts many attentions. In this research, the nitrification process is investigated by developing a new dynamical model which couples the kinetics of ammonia oxidation process and nitrite oxidation process. With the application of literature-based parameter values, the dynamical characteristics of nitrification process in aquatic and soil environments are studied. Stable coexistent equilibrium, periodic oscillations, as well as more complex nitrification dynamics, such as quasiperiodic and chaotic oscillations, are predicted in both environments under seasonal variations. The projected levels of ammonia and nitrite ions are similarly aligned with previously reported observations in natural ecosystems. By uncovering the dynamical complexity of nitrification process, this research can advance our comprehension of the nonlinear mechanisms underlying microbial nitrification in ecosystems.
A Study on Tourism Carbon Emission Efficiency in Guangxi Region Through Spatiotemporal Evolution
Authors: Yang Chunling
Published: December 2023

Currently, there are high emissions and high pollution in the tourism industry around the world, particularly due to carbon emissions from transportation. At the same time, attention is being paid to improving tourism carbon emission efficiency as tourist accommodations and activities consume significant amounts of energy. This article used the slack-based model (SBM) to calculate the tourism carbon emission efficiency in different years and explored its spatiotemporal evolution in the Guangxi region. The factors that affected tourism carbon emission efficiency in Guangxi were selected and examined through Tobit model regression. The results showed that the correlation coefficient of the tourism scale was the largest, reaching 0.6572, making it the variable factor with the greatest impact. The second factor was the tourism industry structure coefficient, which had a correlation coefficient of 0.5688. The impact of tourism industry size and transportation facilities on tourism carbon emission efficiency in Guangxi Province was relatively small, with coefficients of 0.0451 and 0.0357, respectively, i.e., both significance levels were below 0.1, indicating that spatiotemporal evolution can be applied to analyze Guangxi’s tourism carbon emission efficiency.
The Effect of Macroprudential Policy on Credit Growth and Financing of MSMEs in Indonesia
Authors: Ade Surya Sukma  , Sunaryati
Published: December 2023

The global crisis in 2008 had weakened the Financial System Stability (FFS) of almost every country. This financial crisis proved that the country had not been really responsive to global change so the financial system risk management done by the central bank was not able to stabilize the crisis. The formulation of macroprudential policies aims to mitigate the bank behavior in distributing credits and financing to the MSMEs which are pro-cyclical. Macroprudential policy instruments used in this study are Loan to Value (LTV)/ Financing to Value (FTV) and Minimum Statutory Reserves based on Loan to Deposit Ratio (LDR)/ Financing to Deposit Ratio (FDR). In addition, there are also macroeconomic variables and bank liquidity variables. The purpose of this study is to see how the influence of macroprudential policies on credit growth and MSME financing distributed by banks. The research method used is the Vector Error Correction Model (VECM) analysis using time series data from January 2010 to July 2020. The results show that macroprudential policies have not been able to suppress financing and in general the macroeconomic variables and bank liquidity also have an influence on credit and financing.
Forest Complex of the Far Eastern Federal District: Development Trends in 2022–2023
Authors:   Economic Research Institute FEB RAS, Antonova Natalia
Published: December 2023

An assessment is made of the impact of ongoing sanctions shocks, as well as internal export restrictions on the national and Far Eastern forest complexes. It is shown that the crisis of 2022 only aggravated the situation previously formed by institutional innovations in the forest regions of the Far East. The crisis did not have a catastrophic impact on the state of timber industry enterprises, which managed to both partially maintain external demand and partially offset the ban on wood exports by supplying the domestic market. In 2023 compared to 2022, despite the increase in profitability from the supply of products to the foreign market as a result of the rising dollar exchange rate, improving conditions in the Chinese market due to the easing of covid restrictions, the negative effect of sanctions shocks (market closures, restrictions in logistics, reduction in imports of equipment and materials) have intensified. As a result, there was an increase in losses of enterprises due to delays in the transportation of timber cargo, an increase in transport costs, the cost and delivery time of imported spare parts, which led to a decrease in production activity in the main forest regions of the Far Eastern Federal District, which has negative social consequences, especially in remote settlements. In conditions of low population density, the development of domestic demand for timber products in the Far East, even with government support, is uncompetitive in comparison with external demand, which is increasingly oriented toward the monopsony Chinese market
Long-term results of treatment of patients with monosegmental stenosis of the spinal canal in the lumbar spine
Authors: Akhmetyanov Sh. A. , Azizkhonov A. A. , Mushkachev E. A. , Sanginov A. J. , Isakov I. D. , Peleganchuk A. V.
Published: December 2023

Objective.To evaluate the long-term results of surgical treatment of patients with monosegmental stenosis of the lumbar spine after using minimally invasive and standard open techniques.

Material and Methods.The open cohort randomized prospective study included 132 patients. Long-term results were assessed in 110 patients, some patients discontinued participation in the study for natural reasons. Patients were operated on in 200–2011 in the volume of minimally invasive decompression and stabilization surgery (Group 1) and decompression and stabilization surgery through conventional posteromedial approach (Group 2). The following parameters were analyzed: Oswestry Disability Index and VAS pain intensity. Formation of an interbody block was assessed using the Tan scale, and the fatty degeneration of the paravertebral muscles – according to the Goutallier scale. Development or aggravation of the course of degeneration of the adjacent segment was also evaluated. Statistical analysis was performed using the R packages for data processing and plotting.

Results.At long-term follow-up (144 months), when assessing back pain according to VAS and ODI, a statistically significant difference p < 0.001 in favor of minimally invasive interventions was revealed. Both surgical methods resulted in high rates of fusion and low reoperation rates. In the group of minimally invasive surgical interventions, there is a lower incidence of fatty degeneration of the paravertebral muscles and damage to the adjacent segment.

Conclusions.Open and minimally invasive surgical interventions have comparable long-term clinical and morphological results. Open surgical interventions in the long term are fraught with aggravation of fatty degeneration of the paravertebral muscles and more frequent development of the adjacent level syndrome. Minimally invasive techniques are an effective and safe alternative to traditional open surgery and can reduce trauma, preserve the intact posterior support complex of the spine at adjacent levels, while performing adequate decompression and stabilization, followed by the formation of a bone block.
Microbiological spectrum of SSI pathogens in patients with chronic infectious spondylitis requiring revision surgery: results of continuous monocentric 5-year monitoring
Authors: Naumov D. G. , Vishnevskiy A. A. , Solovieva N. S. , Masalova N. Yu. , Yablonsky P. K. , Karpushin A. A.
Published: December 2023

Objective. To analyze the results of the continuous monocentric 5-year microbiological monitoring of causative agents of surgical site infection (SSI) in patients who underwent primary surgery for chronic infectious spondylitis and required revision surgery.

Material and Methods. The study included patient data from 2018 to 2022. The primary cohort included 569 consecutively operated patients with chronic infectious spondylitis of nonspecific (n1 = 214) and tuberculous (n2 = 355) etiology. The analyzed sample was formed taking into according to inclusion and exclusion criteria. Thus, in 99 patients who required revision surgical interventions due to the development of SSI, a continuous microbiological monitoring of pathogens was performed, including the assessment of drug resistance and the timing of the development of infectious complications. Periodization of the time of SSI development was performed according to the accepted classification of Prinz et al. (2020), the assessment of drug resistance spectrum was performed according to the EUCAST recommendations (2020) and taking into account the approved methodological recommendations.

Results. In the general structure of surgical interventions for chronic infectious spondylitis, the share of revision interventions due to the development of SSI was 17.4 %. The highest incidence of complications was noted in the late postoperative period (χ2 = 9.237; p = 0.009). Bacterial detection from the material of vertebral localization was noted in 43 cases (48.3 %), pathogen strains were isolated in urine in 28 (60.8 %), in decubital ulcers in 11 (23.9 %) and in hemoculture in 7 (15.2 %) patients. Culture negative SSI was detected in 10 cases (10.1 %) in the late period. Infectious complications in the setting of chronic non-specific spondylitis were detected more frequently than in spondylitis of tuberculous etiology (χ2 = 21.345; p < 0.001). Gram-positive multidrug-resistant and Gram-negative bacteria with extreme resistance prevailed in the microbiological landscape of late SSI, and Gram-positive strains without drug resistance in that of early and delayed SSI (χ2 = 17.516; p = 0.0032).

Conclusion. Drug-resistant Gram-positive bacteria predominate in the structure of SSI with a significantly higher frequency of complication development. Nonspecific etiology of spondylitis is associated with a significantly higher incidence of SSI. In the absence of a positive result of bacteriological examination of the material of vertebral localization, it is advisable to collect blood, decubital ulcer secretion and urine sampling.