Although posttraumatic osteoarthritis (OA) is a common and important entity in orthopedic practice, no data presently exist regarding its prevalence or its relative burden of disease. A population-based estimate was formulated, based on one large institution's experience in terms of its fraction of patients with OA presenting to lower-extremity adult reconstructive clinics with OA of posttraumatic origin. The relative proportion of these patients undergoing total joint replacement provided a basis for extrapolating institutional experience with posttraumatic OA to a populationwide estimate because the numbers of lower-extremity total joint arthroplasty procedures performed were reliably tabulated both within the institution and populationwide. By this methodology, approximately 12% of the overall prevalence of symptomatic OA is attributable to posttraumatic OA of the hip, knee, or ankle. This corresponds to approximately 5.6 million individuals in the United States being affected by posttraumatic OA sufficiently severe to have caused them to present for care by an orthopedic lower-extremity adult reconstructive surgeon. Further, based on the relative prevalence of OA versus rheumatoid arthritis, and their relative impacts as assessed by the SF-36 (Short-Form 36) lower-extremity physical composite scores, about 85.5% of the societal costs of arthritis are attributable to OA. The corresponding aggregate financial burden specifically of posttraumatic OA is Dollars 3.06 billion annually, or approximately 0.15% of the total U.S. health care direct cost outlay.

A modification of Cobey's method for radiographically imaging the coronal plane alignment of the hindfoot is described. Using this view, we estimated the moment arm between the weightbearing axis of the leg and the contact point of the heel. Normative data on 57 asymptomatic adult subjects are presented. The weightbearing line of the tibia falls within 8 mm of the lowest calcaneal point in 80% of subjects and within 15 mm of the lowest calcaneal point in 95% of subjects. The technique for measuring coronal plane hindfoot alignment is reliable, with an interobserver correlation coefficient of 0.97. This radiographic technique should help in the evaluation of complex hindfoot malalignments.

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By 24 months, ankles treated with STAR ankle replacement (in both the Pivotal and Continued Access Groups) had better function and equivalent pain relief as ankles treated with fusion.

This ad hoc committee was appointed to evaluate the methods of measurement in quantitating pre-and postoperative hallux valgus angles and make recommendations. The previous AOFAS research committee report had also done this in 1984. 37The most commonly used angular measurements to assess the severity of a pre-operative hallux valgus deformity and the magnitude of the postoperative correction are the hallux valgus angle and the 1-2 intermetatarsal angle. The use of these quantitative angular measurements in assessing hallux valgus deformities is based upon the belief that they are reliable, repeatable, and provide a constant value for comparison of different studies." While it has been demonstrated that both of these angles can be reliably measured from both an intra-observer and inter-observer standpolnt,"" there is considerable evidence that these angular measurements are obtained and reported in an inconsistent fashion.In evaluating published reports on hallux valgus correction, the information on angular measurements presented is variable. In few instances, a precise description as well as a consistent diagram and/or representative radiograph is presented,"> but generally there are either no recorded measure-