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The true impact of surgery for flatfoot deformities on patient’s quality of life and health status remains poorly defined. The aim of this study is to evaluate the quality of life and the return to daily tasks and sports or physical activities in young adults after surgical correction of flatfoot deformity. Patients treated for bilateral symptomatic flat foot deformity were retrospectively studied. The healthy control group comprised a matched reference population with no history of foot surgery or trauma that was voluntary recruited from the hospital community. All subjects were asked to fill out questionnaires centered on the assessment of the health-related quality of life (Short-form 36; SF-36) and physical activity (International Physical Activity Questionnaire; IPAQ). Most study group SF-36 subscales were lower when compared to the control group. Among the study group, post-operatively, 36.6% of patients managed to resume low levels of sports activity, 40% were sufficiently active and were able to perform moderate sports activity (an activity that requires moderate physical effort and which forces the patient to breathe with a frequency only moderately higher than normal), while 23.3% of them were active or very active and were able to perform intense physical activity. Most IPAQ scores were statistically different from the control group. The present study suggests that patients treated with medializing calcaneal osteotomy and navicular-cuneiform arthrodesis for symptomatic flafoot had lower levels of quality of life and physical activity when compared to healthy subjects. After surgery, patients showed a significant improvement in the clinical scores.

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Category: Ankle, Sports, Radiographic assessment Introduction/Purpose: To evaluate the applicability and reproducibility of the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score for morphological evaluation of osteochondral lesions of the talus (OLT) repaired using the autologous matrix-induced chondrogenesis (AMIC) technique. Methods: Two radiologists (R1-R2) and two orthopaedic surgeons (O1-O2) independently reviewed 26 MRI scans of the ankle performed on 13 patients (6 females, 7 males; age: 38.9±15.9, range 14-63) with OLT repaired using the AMIC technique between November 2011 and July 2015 at our institution. Out of 13, 7 were treated with biomimetic osteochondral scaffold implantation, while 6 were treated with bone-marrow derived cell transplantation. The MRI scans were performed at 6 and 12 months after treatment. For inter- and intra-observer agreement evaluation for each variable of the MOCART score we used Cohen’s kappa coefficient. Progression of MOCART score between 6 and 12 months evaluation was assessed using the Wilcoxon test. Results: The inter-observer agreement between R1-R2 ranged from poor (adhesions, k=0.124) to almost perfect (subchondral bone, k=0.866), while between O1-O2 ranged from absent (effusion, k=-0.190) to poor (surface, k=0.172). The intra-observer agreement of R1 ranged from poor (signal intensity, k=0.031) to substantial (subchondral lamina, k=0.677), while that of O1 ranged from absent (subchondral bone, k=-0.061) to substantial (surface, k=0.663). There was a statistically significant increase of MOCART score between 6-month and 12-month evaluation of R1 (Z=-2.672; P=0.008), R2 (Z=-2.721; P=0.007) and O1 (Z=- 3.034; P=0.002). Conversely, the increase of MOCART score between the 6-months and 12-months evaluation of O2 was not statistically significant (Z=-1.665; P=0.096). Conclusion: MRI certainly has a crucial role in the follow-up of surgical repaired OLT but the MOCART score does not seem to be sufficiently reliable and reproducible to be applied for this purpose.