Distraction arthroplasty in osteoarthritis of the foot and ankle

Post-traumatic osteoarthritis(PTOA)is a complex and painful problem in the foot and ankle.Ninety percent of osteoarthritis cases in the foot and ankle can be classified as post-traumatic.PTOA can affect any of the 33 joints in the foot and the ankle.Distraction arthroplasty is a method for treatment of early arthritic joints without fusing or replacing them and its effectiveness has been well documented.The purpose of this case series is to present our successful experiences and positive results using distraction arthroplasty to treat PTOA in the ankle,subtalar,first metatarsophalangeal,and second tarsometatarsal joints,and to present distraction arthroplasty as a viable alternative to invasive joint sacrificing procedures such as arthrodesis or arthroplasty.Distraction Arthroplasty effectively and safely treats PTOA and improves the stability of joints in the Foot and Ankle.Additionally,the use of bone marrow aspirate concentrate as an adjuvant can improve the long-term functional and structural outcomes of the joint,and can prolong the need for further,more aggressive surgical interventions such as fusion or arthroplasty.

Pelvic region bone density,soft tissue mass,and injury frequency in female professional ballet dancers and soccer athletes

We recently observed a high prevalence of low pelvic bone mineral density(BMD)in female professional ballet performers.Because this population is susceptible to musculoskeletal overuse injuries,we aimed to determine which regions of the pelvis may be at greatest risk compared to general population females(GENPOP)as well as professional female soccer players(SOCCER,a comparison to other elite athletes regularly subjected to high degrees of loading).Three groups of age-matched females[(GENPOP;n=38,27±1yrs),(BALLET;single com-pany,n=36,26±3yrs),(SOCCER;single NWSL■club,n=34,25±1yrs)]consented to have their BMD and body composition assessed(DEXA,GE■).In addition to soft tissue and total and regional BMD analyses,a segmental analysis of the pelvis was performed to determine site-specific BMD for the iliac fossa,iliac fossa/iliac crest/ilium combined,pubic bone,ischium,and sacrum.A mixed-model ANOVA followed by a Tukey's post-hoc test was used to compare the groups(Type-I error;α=0.05).The BALLET group had lower pelvic BMD for all measures(Avg.%Diff.=15%-27%,p<0.001)compared to the SOCCER group and for the ischium(Avg.%Diff.=8%;p=0.007)and sacrum(Avg.%Diff.=7%;p=0.028)compared to the GENPOP group.The BALLET group had lower lean mass for all measures compared to the other groups(Avg.%Diff.=12%-18%;p<0.01).Professional ballet performers exhibit reduced pelvic region soft tissue and site-specific BMD not previously detected using standard DEXA analyses.These findings highlight which pelvic regions may benefit from preventative strength training and/or nutritional interventions.