Calcaneal insufficiency fractures following ipsilateral total knee arthroplasty

Kato, Michitaka; Warashina, Hideki; Kataoka, Akito; Andô, Tsuyoshi; Mitamura, Shingo

doi:10.1016/j.injury.2021.05.008

Cited by 4 publications

(4 citation statements)

References 28 publications

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“…Similarly, the findings of this study revealed that preoperative HKA angle deviation has a detrimental influence on patients’ short-term benefits after surgery. HKA can serve as an important indicator for measuring the lower limb force line after TKA 34 , 35 . Cohort studies have reported a wider distribution of HKA in patients undergoing TKA compared with patients with early diagnosis or risk factor of OA 36 .…”

Section: Discussionmentioning

confidence: 99%

Prediction of early functional outcomes in patients after robotic-assisted total knee arthroplasty: a nomogram prediction model

Duan

Zhao

Zhang

et al. 2023

International Journal of Surgery

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Background: Robotic-assisted total knee arthroplasty (RA-TKA) is becoming more and more popular as a treatment option for advanced knee diseases due to its potential to reduce operator-induced errors. However, the development of accurate prediction models for postoperative outcomes is challenging. This study aimed to develop a nomogram model to predict the likelihood of achieving a beneficial functional outcome. The beneficial outcome is defined as a postoperative improvement of the functional Knee Society Score (fKSS) of more than 10 points, 3 months after RA-TKA by early collection and analysis of possible predictors. Methods: This is a retrospective study on 171 patients who underwent unilateral RA-TKA at our hospital. The collected data included demographic information, preoperative imaging data, surgical data, and preoperative and postoperative scale scores. Participants were randomly divided into a training set (N=120) and a test set (N=51). Univariate and multivariate logistic regression analyses were employed to screen for relevant factors. Variance inflation factor was used to investigate for variable collinearity. The accuracy and stability of the models were evaluated using calibration curves with the Hosmer–Lemeshow goodness-of-fit test, consistency index and receiver operating characteristic curves. Results: Predictors of the nomogram included preoperative hip-knee-ankle angle deviation, preoperative 10-cm Visual Analogue Scale score, preoperative fKSS score and preoperative range of motion. Collinearity analysis with demonstrated no collinearity among the variables. The consistency index values for the training and test sets were 0.908 and 0.902, respectively. Finally, the area under the receiver operating characteristic curve was 0.908 (95% CI 0.846–0.971) in the training set and 0.902 (95% CI 0.806–0.998) in the test set. Conclusion: A nomogram model was designed hereby aiming to predict the functional outcome 3 months after RA-TKA in patients. Rigorous validation showed that the model is robust and reliable. The identified key predictors include preoperative hip-knee-ankle angle deviation, preoperative visual analogue scale score, preoperative fKSS score, and preoperative range of motion. These findings have major implications for improving therapeutic interventions and informing clinical decision-making in patients undergoing RA-TKA.

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Section: Discussionmentioning

confidence: 99%

Prediction of early functional outcomes in patients after robotic-assisted total knee arthroplasty: a nomogram prediction model

Duan

Zhao

Zhang

et al. 2023

International Journal of Surgery

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“…Several risk factors have been identified, including female sex, older age, prior physical inactivity with a peak of activity (weekend athletes), smokers, vitamin D deficiency, total knee arthroplasty, calcaneonavicular coalition and menstrual disturbances. 4 Treatment of risk factors should be associated, such as smoking cessation and gradual return to physical activity with a delay of impact loading activities. Lappe et al presented a decrease of 20% of stress fractures in female navy recruits being administrated preventative calcium and vitamin D. 13 In patients with hypovitaminosis-D that have already sustained a stress fracture, such as our patient, prescribing 25(OH)D supplementation can help with fracture consolidation, and if left untreated can lead to delayed fracture consolidation, Inklebarger et al…”

Section: Discussionmentioning

confidence: 99%

“…3 Several risk factors have been identified as high intensity training, female sex, smoking, poor nutrition and biomechanical predisposition such as cavus alignment, calcaneonavicular coalition or total knee arthroplasty. 4,5…”

Section: Introductionmentioning

confidence: 99%

Calcaneus stress fracture: a case report

M. Rodrigues,

Marques,

Teixeira

et al. 2024

Int J Res Orthop

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“…1,2 Furthermore, fragility fractures may occur in severe osteoporosis. 3-6 Even after ankle arthrodesis, a reduction in bone density in the calcaneus could persist for many years after fusion. 7,8 Studies on ankle and calcaneal fractures have shown that reduced bone density alters clinical outcomes after fracture fixation.…”

mentioning

confidence: 99%

Changes in Calcaneal Bone Density and Correlation With Clinical Outcomes Following Ankle Fractures

Wiebking,

Kohake,

O'Loughlin

et al. 2024

JAAOS Glob Res Rev

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Introduction: The study investigates the long-term bone quality and its influence on clinical results after surgical treatment of Weber B-type fractures. Methods: Surgery treated isolated Weber B-type fractures between 2006 and 2016 were included. Bone density was determined by ultrasonography densitometry of the calcaneus. American Orthopedic Foot and Ankle Society (AOFAS), Foot Function Index, Olerud-Molander-Ankle-Score, Hannover-Score, and Short Form Health Survey SF 36 were recorded. Results: Sixty patients were followed up. Mean follow-up was 6.6 years (range, 2 to 12 years). Mean bone density T-score of the treated foot was significantly lower than that of the contralateral untreated side (−0.6 versus −0.3; P = 0.05). Higher T-scores on the injured side were significantly and positively correlated with improved outcomes in the AOFAS, Olerud-Molander-Ankle-Score, and SF-36 physical component summary but negatively correlated with the Hannover score (P ≤ 0.05). A significant correlation existed only between the pain scores of the AOFAS and Foot Function Index. Controlling for potential confounding variables, such as age and smoking status, in a linear regression model, increased bone density was only associated with the AOFAS score. Discussion: A significant reduction in bone density persists for more than eight years in some individuals. Statistically significant correlation between reduced bone density and clinical outcomes was found only for the AOFAS scoring system.

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Calcaneal insufficiency fractures following ipsilateral total knee arthroplasty

Cited by 4 publications

References 28 publications

Prediction of early functional outcomes in patients after robotic-assisted total knee arthroplasty: a nomogram prediction model

Prediction of early functional outcomes in patients after robotic-assisted total knee arthroplasty: a nomogram prediction model

Calcaneus stress fracture: a case report

Changes in Calcaneal Bone Density and Correlation With Clinical Outcomes Following Ankle Fractures

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