Knee scooter related injuries and satisfaction in patients following foot and ankle surgery

BACKGROUND

Knee scooters have become popular amongst foot and ankle surgeons for patients who are required to be non-weight bearing. Information is limited regarding falls and injuries sustained while using a knee scooter and potential contraindications to their use are ill-defined. No study has assessed patient reported injuries and satisfaction. This study aims to evaluates the patient's perspective with regards to the use of a knee scooter. As a secondary aim we assessed for risk factors associated with knee scooter related injuries to try make recommendations for the safe use of a knee scooter.

METHODS

Patients who used a knee scooter during 2018-2020 were emailed a questionnaire assessing (1) demographic data, (2) medical history, (3) falls and injuries sustained, including the management of these injuries, and (4) patient satisfaction. This study is a descriptive, cross-sectional survey analysis.

RESULTS

101/196 (51,5%) responses were received, which included 32 males and 69 females. The cohort had a mean age of 56.4 years, and BMI of 28.5. Mean time spent using the scooter was 6.7 weeks. Twenty-five respondents had fallen off the scooter, with 5 reporting injuries. One patient required medical attention for a shoulder injury. Cause of falls included hitting an obstacle, making a sharp turn, moving too fast, and moving downhill. There was no correlation between falls and patient comorbidities. Ninety-six percent of respondents reported a high satisfaction and preferred the scooter to crutches.

CONCLUSION

The knee scooter is a safe, and well-tolerated, mobility aid for patients requiring non-weight bearing during their recovery, with a high satisfaction rate. Educating patients on correct use and common causes for falling is important as a preventative measure.

LEVEL OF EVIDENCE

IV, retrospective case series.

Functional and patient reported outcomes following lateral hallucal sesamoidectomy

BACKGROUND

Lateral hallucal sesamoidectomy is an infrequently performed procedure indicated for patients with sesamoid pathology failing conservative treatment. Concerns exists regarding patient satisfaction, plantar scar pain, hallux malalignment and metatarsophalangeal joint (MTPJ) movement restriction following sesamoidectomy. This study aims to assess patient satisfaction after lateral hallucal sesamoidectomy via the plantar approach.

METHODS

In this retropective study with prospective follow-up, all patients who underwent lateral hallucal sesamoidectomy between January 2004 and December 2017 were reviewed. Twelve patients (14ft.) were available for final assessment. Outcome measures were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) clinical rating scale and the Self-Reported Foot and Ankle questionnaire (SEFAS). Patients were assessed clinically and radiologically. The average postoperative follow-up was 111.5 months (range 28-177 months).

RESULTS

All patients reported excellent outcome scores with a mean SEFAS score of 46.08 (range 43-48) and a mean AOFAS score of 92.33 (range 78-100) at final follow-up. All twelve patients reported their outcome as being excellent. No malalignment was noted clinically, however, three patients had a noticeable increase in the gap between the hallux and second toe when compared to the contralateral side. Range of motion at the MTPJ was preserved with a mean dorsiflexion of 80.83° (range 70-90°) and a mean plantarflexion was 25.83° (range 0-30°). None of the patients experienced any pain, discomfort or irritation related to the plantar scar. One patient developed neuroma like symptoms in the first web space.

CONCLUSION

Lateral hallucal sesamoidectomy via a plantar approach is an effective and reliable treatment option as demonstrated by the high levels of patient satisfaction, preservation of function, excellent PROM scores and limited complications in this study.

LEVEL OF EVIDENCE

Level 4.

Association Between Plantar Fasciitis and Isolated Gastrocnemius Tightness

BACKGROUND

An association between plantar fasciitis and isolated gastrocnemius tightness (IGT) has been postulated in the literature; however, there have been few studies to prove this relationship. This prospective cross-sectional cohort study was aimed at determining the association between plantar fasciitis and IGT.

METHODS

Three groups comprising 45 patients with plantar fasciitis (group 1), 117 patients with foot and ankle pathology other than plantar fasciitis (group 2), and 61 patients without foot and ankle pathology (group 3) were examined for the presence of IGT using the Silfverskiöld test. Statistical tests included chi-square test, Student t test, and analysis of variance.

RESULTS

Of the patients, 101 (45.3%) had IGT: 36 (80%) in group 1, 53 (45.3%) in group 2, and 12 (19.7%) in group 3. The difference in IGT prevalence between the groups was statistically significant at P < .001. The prevalence of IGT was similar between acute and chronic plantar fasciitis at 78.9% and 80.6%, respectively.

CONCLUSION

There was a very strong association between plantar fasciitis and IGT using group 3 as a reference. This study suggests that IGT should be actively sought out and managed in patients with plantar fasciitis.

LEVEL OF EVIDENCE

Level II, cross-sectional cohort prospective study.

Comparative radiographic analysis of parameters in feet with and without hallux valgus

This study involved the radiographic examination of 118 feet from 110 urban African female patients. Fifty-two of the 118 feet showed radiographic evidence of hallux valgus (valgus angle > 15 degrees). The parameters compared between feet with and without hallux valgus were sesamoid position, pes planus deformity, metatarsal length, and the cuneiform-metatarsal articulation. All radiographs were standardized, weightbearing anteroposterior and lateral views. The results were statistically analyzed. The findings showed no difference between the hallux valgus and control groups with respect to sesamoid position relative to the second metatarsal, incidence of pes planus, relative length of the first metatarsal, and the first metatarsal-medial cuneiform articulation.