| 1. |
- Alfredson, Håkan, et al.
(författare)
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Clinical presentation and surgical management of chronic Achilles tendon disorders : a retrospective observation on a set of consecutive patients being operated by the same orthopedic surgeon
- 2018
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Ingår i: Foot and Ankle Surgery. - : Elsevier. - 1268-7731 .- 1460-9584. ; 24:6, s. 490-494
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Tidskriftsartikel (refereegranskat)abstract
- Background: Non-invasive treatment is not always successful in patients with Achilles tendon disorders, and surgical treatment is instituted as the next step. There is sparse knowledge about the diagnoses, pain levels before surgery, surgically confirmed pathologies and postoperative complications in large patient groups.Aims: To study the diagnoses, pain scores before surgery, macroscopic surgical findings and postoperative complications in a series of patients treated for Achilles disorders.Material and methods: One surgeon operated on 771 Achilles tendons of 481 men and 290 women during a 10-year period. The clinically and ultrasound confirmed diagnoses, pre-operative pain and functional scores (Visual Analogue Scale, VAS, range 0-100; Victorian Institute Sports Tendon Assessment - Achilles questionnaire, VISA-A), macroscopic findings during surgery and postoperative complications, were retrospectively collected from a database.Results: Clinically, by ultrasound and during surgery midportion Achilles tendinopathy was confirmed in 519 (67%) patients, 41% of them had a thickened plantaris tendon located close the Achilles tendon. Partial midportion rupture was found in 31 (4%) patients, chronic midportion rupture in 12 (2%) patients and insertional Achilles tendinopathy, including superficial and retro-calcaneal bursitis, Haglund deformity, distal Achilles tendinopathy, plantaris tendon pathology, and bone spurs, in 209 (27%) patients. The mean pre-operative pain scores for midportion Achilles tendinopathy were 73 (VAS) and 45 (VISA-A), and for insertional Achilles tendinopathy 77 (VAS) and 39 (VISA-A). For midportion Achilles tendinopathy there were 14 (3%), and for insertional Achilles tendinopathy 10 (5%), postoperative complications.Conclusions: Patients presenting high pain scores from midportion Achilles tendinopathy were the most common. Plantaris tendon involvement is a frequent observation. For insertional Achilles tendinopathy the combination of pathology in the subcutaneous and retrocalcaneal bursa, a Haglund deformity and distal Achilles tendinopathy/tendinosis was most frequent.
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| 2. |
- Carmont, Michael R, 1972, et al.
(författare)
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The reliability, reproducibility and utilization of the radiographic Achilles Tendon Loading Angle in the management of Achilles Tendon rupture.
- 2021
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Ingår i: Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons. - : Elsevier BV. - 1460-9584. ; 27:7, s. 760-766
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Tidskriftsartikel (refereegranskat)abstract
- During management of Achilles tendon rupture, determination of tendon-end approximation, either clinically or by ultrasound is difficult, following brace application of during loading. The Radiographic Achilles Tendon Loading Angle (RadATLA) is proposed as a method of measuring ankle position whilst loading in a brace during the management of Achilles tendon rupture. This study aims to determine the reliability and reproducibility of the RadATLA.A loaded true lateral ankle radiograph including the fifth metatarsal head was taken when wearing a brace at the 6-week time point in 18 patients (19 ankles). following Achilles tendon repair or reconstruction. The RadATLA was compared with the Tibio-talar angle, other radiographic and clinical measures used to quantify foot and ankle position during the first 6 weeks of early rehabilitation in a resting position and during loading.The intra-rater reliability of both angles was found to be good (>0.8). The RadATLA was found to have an excellent intra-rater reliability with Intra-class correlation of (ICC) 0.992-0.996 (95%CI 0.889-0.999), standard error of the measurement (SEM) 1.03-3.65 and Minimal Detectable Change (MDC) 2.86-10.12. The inter-rater reliability was good with ICC of 0.798-0.969 (95%CI-0.03 to 0.964), SEM 2.9-7.6, and MDC 8.1-20.9. The RadATLA loaded at 6 weeks in all patients was at mean (SD) (range) 41.9˚ (16.5), (18.5-75.9). There was a significant difference between the patients in the Repair group compared with patients in the Reconstruction group both in RadATLA loaded at 6 weeks: 35.6˚ (11.2), (18.5-56.5) versus 55.5˚ (19), (20-75.9), (p = 0.01). The amount loaded in all patients was at mean (SD) (range) 29.2Kg (17.7), (2-56) and the percentage Body Weight was 30.7% (19), (2.1-63.2). There were no differences between the groups neither in amount loaded nor in percentage Body weight (p = 0.614-0.651).The RadATLA is a reliable and reproducible angle and can be used to determine the position of the ankle, when loaded in a brace during rehabilitation following Achilles tendon rupture.
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| 3. |
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| 4. |
- Cöster, Maria C., et al.
(författare)
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Swefoot : The Swedish national quality register for foot and ankle surgery
- 2022
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Ingår i: Foot and Ankle Surgery. - : Elsevier. - 1268-7731 .- 1460-9584. ; 28:8, s. 1404-1410
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPopulation-based register data could be used to improve our knowledge of patients surgically treated for foot and ankle disorders. The quality register Swefoot was recently created to collect surgical and patient-reported data of foot and ankle surgery. This manuscript aims to describe the development and current use of the register.MethodsThe development of Swefoot started in 2014 and currently, data on 16 different diagnoses are collected in 49 units performing foot and ankle surgery. Registrations are performed by the surgeon and the patient.ResultsBetween 2014 and 2020 approximately 20,000 surgical procedures have been registered. 75.1% of the registered patients were women, 9.3% were smokers, 9.3% had a concomitant rheumatoid disease, and 18.4% a BMI larger than 30 kg/m2.ConclusionsThe Swefoot is a unique national register for foot and ankle surgery. It is by now possible to present demographic, surgical, and outcome parameters based on Swefoot.
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| 5. |
- Cöster, Maria, et al.
(författare)
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Surgery for adult acquired flatfoot due to posterior tibial tendon dysfunction reduces pain, improves function and health related quality of life
- 2015
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Ingår i: Foot and Ankle Surgery. - London : Elsevier. - 1268-7731 .- 1460-9584. ; 21:4, s. 286-289
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with adult acquired flatfoot deformity (AAFD) due to posterior tibial tendon dysfunction (PTTD) may require surgery but few reports have evaluated the outcome.METHODS: We evaluated 21 patients with a median age of 60 (range 37-72) years who underwent different surgical reconstructions due to stage II AAFD before and 6 and 24 months after surgery by the validated Self-Reported Foot and Ankle Score (SEFAS), Short Form 36 (SF-36) and Euroquol 5 Dimensions (EQ-5D).RESULTS: The improvement from before to 24 months after surgery was in SEFAS mean 12 (95% confidence interval 8-15), SF-36 physical function 21 (10-22), SF-36 bodily pain 28 (17-38), EQ-5D 0.2 (0.1-0.3) and EQ-VAS 11 (2-21).CONCLUSION: Surgery for AFFD due to PTTD results in reduced pain and improved function and health related quality of life. The outcome scores have been demonstrated as useful. It has also been shown, since there is a further improvement between 6 and 24 months after surgery, that a minimum follow-up of 2 years is needed.LEVEL OF CLINICAL EVIDENCE: III - prospective observational cohort study.2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.
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| 6. |
- Haapasalo, H, et al.
(författare)
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Epidemiology of calcaneal fractures in Finland
- 2017
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Ingår i: Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons. - : Elsevier BV. - 1460-9584. ; 23:4, s. 321-324
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Tidskriftsartikel (refereegranskat)
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| 7. |
- Henricson, Anders, et al.
(författare)
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Total ankle replacement and contralateral ankle arthrodesis in 16 patients from the Swedish Ankle Registry : Self-reported function and satisfaction
- 2016
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Ingår i: Foot and Ankle Surgery. - : Elsevier BV. - 1268-7731 .- 1460-9584. ; 22:1, s. 32-34
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Tidskriftsartikel (refereegranskat)abstract
- Background: Both total ankle replacement (TAR) and ankle arthrodesis do show some problems in long-term studies. To choose either of these surgical options is a delicate task. There are no randomized studies reported in the literature and no previous studies in which patients constitute the own controls. Methods: Patients with a TAR and a contralateral ankle arthrodesis were identified in the Swedish Ankle Register. A self-reported foot and ankle specific questionnaire (SEFAS) was sent to these patients who also were asked to report their grade of satisfaction from 1 to 5. Results: The median SEFAS score was 32 (16-44) for the prostheses and 27 (14-47) for the arthrodeses. The median satisfaction score was 2 (1-4) for the prostheses and 2 (1-5) for the arthrodeses. There were no statistically significant difference between the prosthetic side and the fused side regarding these scores. Conclusion: Patients who had undergone ankle arthrodesis on one side and had the contralateral ankle replaced, were equally satisfied with both procedures.
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| 8. |
- Jermander, E., et al.
(författare)
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Epidemiology, classification, treatment and mortality of Talus fractures: An observational study of 1794 talus fractures from the Swedish Fracture Register
- 2022
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Ingår i: Foot and Ankle Surgery. - : Elsevier BV. - 1268-7731 .- 1460-9584. ; 28:8, s. 1444-1451
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Tidskriftsartikel (refereegranskat)abstract
- Background: Epidemiological data on talus fractures from large nationwide and multicenter studies are rare. This study aims to describe the epidemiology, fracture classification and treatment regimens of talus fractures in a large adult Swedish population. Methods: This observational study is based on data from the Swedish Fracture Register (SFR) including talar fractures in patients ≥18 with a sustained fracture between 2012 and 2021. Epidemiological data on sex, age, injury date, injury mechanism and type (high or low energy trauma), fracture classification (side, type), initial treatment and mortality were analysed. Results: We included 1794 talus fractures (1757 patients, 60 % men). Mean age was 40.3 years (range 18–96), and a biphasic age distribution was seen in women. High-energy trauma caused 33 % of all talus fractures. Of all talus fractures, 817 (45.5 %) were classified as AO/OTA type A fractures (avulsion), 370 (20.6 %) as type B (neck) and 435 (24.2 %) as type C (body). The remaining 172 (9.6 %) talus fractures were not classified/unclassifiable. Men were in the majority in all fracture groups except A1. For type A1–3, B1 and C1–2 fractures, most patients were treated non-operatively; in B2–3 and C3 fractures most patients received operative management. Fracture fixation with screws was the dominating surgical treatment. The overall 30-day mortality was 0.2 %. Conclusion: Talus fractures are most commonly encountered in young and middle-aged men. In contrast to men, a biphasic age distribution was observed in women. Approximately half of the talus fractures are avulsions. Operative treatment, mostly screw fixation, is performed in more complex fracture configurations (B2, B3 and C3 fractures). Level of evidence: IV, retrospective observational cohort study.
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| 9. |
- Nilsdotter, A. K., et al.
(författare)
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Patient-reported outcome after hallux valgus surgery — a two year follow up
- 2019
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Ingår i: Foot and Ankle Surgery. - London, UK : Elsevier BV. - 1268-7731 .- 1460-9584. ; 25:4, s. 478-481
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with hallux valgus deformity may require surgery but prospective patient-reported data is scarce. Methods: We evaluated 53 patients with a mean age of 55.3 years (SD 14.1, 50 women), who underwent surgery due to hallux valgus. They completed the PROMs SEFAS, EQ-5D and SF-36 before and 6, 12 and 24 months after surgery. Results: All patient-reported outcomes improved at 6, 12 and 24 months compared with the preoperative status. The greatest improvement occurred at 6 months: SEFAS Δ 10.0 (95% confidence interval 7.8–12.2), EQ-5D Δ 0.22 (0.15–0.29), EQ-VAS Δ 8.4 (4.4–12.4), PF SF-36 Δ 22.0 (14.6–29.3) and BP SF-36 Δ 30.6 (23.1–38.1). Conclusions: Hallux valgus surgery considerably reduced pain and improved function already within 6 months after surgery. The improvement between 6 and 24 months’ follow-up was minimal measured with PROMs. Level of clinical evidence: III — prospective observational cohort study.
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| 10. |
- Nilsson, Gertrud, et al.
(författare)
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Unsatisfactory outcome following surgical intervention of ankle fractures
- 2005
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Ingår i: Foot and Ankle Surgery. - : Elsevier BV. - 1460-9584 .- 1268-7731. ; 11:1, s. 11-16
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate outcome after surgical intervention in patients with ankle fractures. Fifty-four patients consecutively operated were included. A standardised protocol was used to record a number of variables regarding patient characteristics, type of fracture and treatment. Radiographic examination was performed in all patients postoperatively and after 14 months. A questionnaire containing the Olerud–Molander Ankle Score (OMAS) and some supplementary questions was used 14 months and 3 years after surgery. The median OMAS was 75 at the 14-month and 85 at the 3-year follow-up. Patients <40 years of age scored significantly better. Only 50% returned to the same activity level 14 months after injury. Pain, stiffness and swelling were present among more than half of the patients and 40% reported instability and problems when using stairs. In conclusion, subjective outcome 3 years after surgical intervention for ankle fractures is poorer than expected.
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