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Eidmann A, Vinke W, Jakuscheit A, Rudert M, Stratos I. The influence of partial weight bearing on plantar peak forces using three different types of postoperative shoes. Foot Ankle Surg 2022; 28:1384-1388. [PMID: 35872119 DOI: 10.1016/j.fas.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Therapeutic shoes and partial weight bearing regimes are used after foot surgery to prevent the operated region from excessive load. It remains unclear to which extent partial weight bearing reduces the plantar peak forces. Therefore, we investigated the correlation of weight bearing and plantar peak forces in commonly used therapeutic shoes. METHODS Three different weight bearing regimes (20 kg, 40 kg, full weight) were investigated in 20 healthy volunteers. Sensor insoles were used to measure peak forces of the forefoot, midfoot, heel and the complete foot using four kind of shoes (bandage shoe, forefoot relief shoe, short walker and standard sneaker). Peak forces were compared between shoes using one-way ANOVA. The influence of partial weight bearing relative to the peak forces was examined by linear regression analysis. RESULTS All therapeutic shoes reduced significantly peak forces of the fore- and midfoot when compared to the reference shoe; the largest reduction was achieved by the forefoot relief shoe (-70 % at forefoot). Weight load and the resulting peak force showed a positive linear correlation for all regions and shoe types. Partial weight bearing significantly reduced the forefoot's force ratio compared to full weight bearing for all shoes except the forefoot relief shoe. CONCLUSIONS Partial weight bearing is a strong instrument to reduce plantar peak forces of the forefoot, additionally to the proven offloading effect of therapeutic shoes.
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Affiliation(s)
- Annette Eidmann
- Julius-Maximilians University Wuerzburg, Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074 Wuerzburg, Germany
| | - Wiebke Vinke
- Julius-Maximilians University Wuerzburg, Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074 Wuerzburg, Germany
| | - Axel Jakuscheit
- Julius-Maximilians University Wuerzburg, Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074 Wuerzburg, Germany
| | - Maximilian Rudert
- Julius-Maximilians University Wuerzburg, Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074 Wuerzburg, Germany
| | - Ioannis Stratos
- Julius-Maximilians University Wuerzburg, Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074 Wuerzburg, Germany.
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Rougereau G, Marty-Diloy T, Rougereau G, Boisrenoult P, Langlais T. Litigation after hallux valgus surgery in France between 2000 and 2020: A review of the two national legal research databases. Foot Ankle Surg 2022; 28:497-502. [PMID: 35063363 DOI: 10.1016/j.fas.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/18/2021] [Accepted: 01/10/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND The objectives of this review were to: 1) describe reasons for lawsuits following primary hallux valgus surgery in France from 2000 to 2020; 2) to compare private and public practice. METHODS Civil (private practice) and administrative (public practice) court decisions in France between 2000 and 2020 were collected using the two leading legal data sources (Legifrance, Doctrine). RESULTS Seventy-two court decisions related to hallux valgus surgery were included. An appeal was filed in 93% of cases. Finally, 70.8% of the verdicts were in favor of the complainants. The average compensation awarded to a plaintiff was €55,333. The main reasons for complaint after hallux valgus surgery were: a failure to provide preoperative information (47.2%), post-operative pain/stiffness (38.9%), and infection (30.6%). A proven lack of information increased the risk of recognizing the occurrence of post-operative pain and stiffness as faulty from 13.3% to 61.5% (p = 0.01), and the average compensation from €25,330 to €76,716 (p = 0.04). The duration of the procedure was about 1.5 years longer in civil proceedings (p = 0.04). There was no significant difference between private and public activity litigation. CONCLUSION Clear and adapted patient information and its traceability could be a way to reduce the number of complaints and their consequences in case of disappointing results.
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Affiliation(s)
- Grégoire Rougereau
- Department of Orthopedics and Traumatology, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, 47-83 Boulevard de l'Hôpital, 75013 Paris, France.
| | - Thibault Marty-Diloy
- Department of Orthopedic and Trauma Surgery, University Hospital Center, 2 Rue de la Milétrie, 86021 Poitiers, France
| | - Guillaume Rougereau
- Department of Orthopedic Surgery, Clinique du Trocadéro, 62 Rue de la Tour, 75116 Paris, France
| | - Philippe Boisrenoult
- Department of Orthopedic and Trauma Surgery, André Mignot Hospital, University Île-de-France Ouest, 177 Rue de Versailles, 78150 Le Chesnay, France
| | - Tristan Langlais
- Department of Orthopedics Pediatrics, Children Hospital Purpan, Toulouse University, Toulouse, France
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Kasai T, Tsuji M, Takeda R, Chang SH, Anzai E, Nakajima K, Tanaka S, Ohta Y, Matsumoto T. Effect of gait protocols and postoperative shoes on off-loading of forefoot in preoperative patients for forefoot disorders. Mod Rheumatol 2021; 32:1186-1192. [PMID: 34850100 DOI: 10.1093/mr/roab093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/17/2021] [Accepted: 10/21/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVES The purpose of this study was to clarify the effect of gait protocols and postoperative shoes on forefoot load in preoperative patients for forefoot disorders and compare footwear comfort between different types of postoperative shoes. METHODS Fourteen subjects scheduled to undergo forefoot surgeries were recruited. The maximum force under the forefoot region was measured during 10 m straight walking in two gait patterns with six different shoe types. Visual analogue scale (VAS) scores for footwear comfort, subjective lower thigh pain, and electrical activities of lower thigh muscles were also evaluated. RESULTS The body weight-normalized maximum force under the forefoot region significantly decreased in step-to gait compared to normal gait regardless of the shoe types used. Under the same gait condition, no significant difference was observed in the forefoot off-loading effect between the different shoe types used. Significantly worse VAS scores, significantly higher tibialis anterior muscle activities, and complaints of lower thigh pain were demonstrated in the gait with the reverse camber shoe. CONCLUSIONS Gait protocol of step-to gait had more forefoot off-loading effect than postoperative shoes. The forefoot off-loading effect did not differ among the postoperative shoes, suggesting that postoperative shoes can be selected with an emphasis on footwear comfort.
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Affiliation(s)
- Taro Kasai
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Marina Tsuji
- Department of Human Life and Environmental Sciences, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
| | - Ryutaro Takeda
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Song Ho Chang
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Emi Anzai
- Faculty of Human Life and Environment, Nara Women's University, Nara, Japan
| | - Kanako Nakajima
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Kashiwa II Campus, University of Tokyo, Chiba, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuji Ohta
- Faculty of Core Research, Natural Science Division, Ochanomizu University, Tokyo, Japan
| | - Takumi Matsumoto
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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A comparison of two designs of postoperative shoe for hallux valgus surgery: A biomechanical study in a cadaveric model. Foot Ankle Surg 2021; 27:82-86. [PMID: 32156460 DOI: 10.1016/j.fas.2020.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 02/10/2020] [Accepted: 02/20/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Hallux Valgus Surgery success depends not only on the operative technique, but also on the care of the foot during the postoperative period. Orthopedic shoes have been developed to decrease the weight load on the first ray, an excess of which might lead to a loss of fixation or pseudoarthrosis. The goal of this study was to determine how the load distribution changed as the forced applied to the foot increased, with and without an orthopedic shoe. Also, we compared to different shoe models. METHODS Pressure sensors were placed under the first metatarsal head and the heel of twenty specimens of fresh cadaveric adult feet. Two orthopedic shoes were chosen, a double padded (MS) and a reverse camber shoe (RCS). 10 kg loads were progressively applied, up to 60 kg. We first compared three instances: no shoe, MS and RCS. A secondary analysis comparing barefoot versus shoes was performed. A mean comparison was performed (ANOVA/T-student). RESULTS The mean pressure of the heed and the first metatarsal showed that there were significant differences between groups (P < .005). The secondary analysis (no shoe vs orthopedic shoes) showed that the pressure without shoe was significantly higher than with any orthopedic shoe (P < .005). There were no statistically significant differences between models of shoes (P = .402). CONCLUSION After a surgical procedure for hallux valgus fixation, postoperative shoes should be indicated to decrease the pressure on the first metatarsal head and heel in order to avoid an overload of the postoperative area. LEVEL OF EVIDENCE Cadaveric study. Level V.
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Fuchs MCHW, Hermans MMN, Kars HJJ, Hendriks JGE, van der Steen MC. Plantar pressure distribution and wearing characteristics of three forefoot offloading shoes in healthy adult subjects. Foot (Edinb) 2020; 45:101744. [PMID: 33010590 DOI: 10.1016/j.foot.2020.101744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 08/01/2020] [Accepted: 09/03/2020] [Indexed: 02/04/2023]
Abstract
Forefoot offloading shoes are used to reduce pressure on specific regions of the foot. Aim of the pressure reduction is to aid healing of the soft and bony tissues and prevent complications by treating foot disorders. A great variety of forefoot offloading shoes are available. In a first step to investigate the appropriate use of these footwear in orthopedic settings, we studied plantar pressure distribution and wearing characteristics of three forefoot offloading shoes namely the Mailand, OrthoWedge and Podalux in a healthy population. Twenty subjects walked in a randomized order wearing three forefoot offloading shoes and a reference shoe for six minutes. The Pedar system was used to measure the pressure in 7 regions. Peak pressure and pressure time integral were analyzed as measures of pressure distribution. Furthermore, wearing characteristics were addressed using a Numeric Rating Scale. Pressure distribution and wearing characteristics of the forefoot offloading shoes were compared to a reference shoe. The Mailand and OrthoWedge shoes significantly reduced peak pressure with more than 80% under the hallux and more than 45% under MTH1 (p<.001). The Podalux did not show significant peak pressure reduction under the forefoot compared to the reference shoe. Under the lesser toes, the MTH4-5 region and heel region the Podalux shoe showed even a significant increase in peak pressure (p=.001). Looking at wearing characteristics, the Podalux and reference shoe scored significantly better than the other two forefoot offloading shoes (p<.01). In this study the differences between different forefoot offloading shoes was assessed. The Mailand and OrthoWedge shoes gave the best pressure reduction in the forefoot but are less comfortable in use. The Podalux rocker shoe showed opposite results. Next step is a patient study to compare our results in a patient population.
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Affiliation(s)
- M C H W Fuchs
- Department of Orthopaedic Surgery, Catharina Hospital Eindhoven, Postbus 1350, 5602 ZA Eindhoven, The Netherlands; Orthopaedic Center Máxima, Máxima Medical Center, Postbus 90052, 5600 PD Eindhoven, The Netherlands.
| | - M M N Hermans
- Orthopaedic Center Máxima, Máxima Medical Center, Postbus 90052, 5600 PD Eindhoven, The Netherlands
| | - H J J Kars
- Fontys Hogeschool Eindhoven, Allied Health Professions, Dominee Theodor Fliednerstraat 2, 5631 BN Eindhoven, The Netherlands
| | - J G E Hendriks
- Department of Orthopaedic Surgery, Catharina Hospital Eindhoven, Postbus 1350, 5602 ZA Eindhoven, The Netherlands; Orthopaedic Center Máxima, Máxima Medical Center, Postbus 90052, 5600 PD Eindhoven, The Netherlands
| | - M C van der Steen
- Department of Orthopaedic Surgery, Catharina Hospital Eindhoven, Postbus 1350, 5602 ZA Eindhoven, The Netherlands; Orthopaedic Center Máxima, Máxima Medical Center, Postbus 90052, 5600 PD Eindhoven, The Netherlands
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