Abstract:
BACKGROUND:Conventional bacterial cultures frequently fail to identify the dominant pathogen in polymicrobial foot infections, in which Staphylococcus aureus is the most common infecting pathogen. Previous work has shown that species-specific immunoassays may be able to identify the main pathogen in musculoskeletal infections. We sought to investigate the clinical applicability of a S. aureus immunoassay to accurately identify the infecting pathogen and monitor its infectivity longitudinally in foot infection. We hypothesized that this species-specific immunoassay could aid in the diagnosis of S. aureus and track the therapeutic response in foot infections. METHODS:From July 2015 to July 2019, 83 infected foot ulcer patients undergoing surgical intervention (debridement or amputation) were recruited and blood was drawn at 0, 4, 8, and 12 weeks. Whole blood was analyzed for S. aureus-specific serum antibodies (mix of historic and new antibodies) and plasmablasts were isolated and cultured to quantify titers of newly synthesized antibodies (NSAs). Anti-S. aureus antibody titers were compared with culture results to assess their concordance in identifying S. aureus as the pathogen. The NSA titer changes at follow-ups were compared with wound healing status to evaluate concordance between evolving host immune response and clinically resolving or relapsing infection. RESULTS:Analysis of serum for anti-S. aureus antibodies showed significantly increased titers of 3 different anti-S. aureus antibodies, IsdH (P = .037), ClfB (P = .025), and SCIN (P = .005), in S. aureus culture-positive patients compared with culture-negative patients. Comparative analysis of combining antigens for S. aureus infection diagnosis increased the concordance further. During follow-up, changes of NSA titers against a single or combination of S. aureus antigens significantly correlated with clinically resolving or recurring infection represented by wound healing status. CONCLUSION:In the management of foot infection, the use of S. aureus-specific immunoassay may aid in diagnosis of the dominant pathogen and monitoring of the host immune response against a specific pathogen in response to treatment. Importantly, this immunoassay could detect recurrent foot infection, which may guide a surgeon's decision to intervene. LEVEL OF EVIDENCE:Level II, prospective comparative study.
journal_name
Foot Ankle Intjournal_title
Foot & ankle internationalauthors
Hao SP,Masters EA,Ninomiya MJ,Beck CA,Schwarz EM,Daiss JL,Oh Idoi
10.1177/1071100720965136subject
Has Abstractpub_date
2020-11-09 00:00:00pages
1071100720965136eissn
1071-1007issn
1944-7876pub_type
杂志文章abstract:BACKGROUND:The moment, a force applied at a distance, is responsible for movement and balance. A key component of the moment is the moment arm. The moment arms of nine muscles surrounding the ankle complex during motion in three planes, were studied. MATERIALS AND METHODS:Five cadaveric feet were mounted in a testing ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2011.0300
更新日期:2011-03-01 00:00:00
abstract::We hypothesized that the posterior-to-anterior (PA) calcaneal interlocking screw of the Biomet Ankle Arthrodesis Nail would increase rotational stability secondary to increased bone purchase compared with the standard lateral-to-medial (transverse) screw. Each of 10 fresh human cadaver lower limbs (five matched pairs)...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070102200908
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Among the various operative treatments of Morton's neuroma, deep transverse metatarsal ligament (DTML) release has been performed for decompression of neuroma. However, the main lesion of Morton's neuroma is located between the metatarsal head and the metatarsophalangeal (MTP) joint and more distal than the ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100713499905
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Management of large and deep heel ulcers (LDHUs) is a challenge in patients with diabetic foot lesions. We assessed outcomes of a treatment protocol to save feet with LDHUs from amputation. METHODS:We managed LDHUs (larger than 3 cm(2)) in diabetic feet using a multidisciplinary approach consisting of medic...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100712460228
更新日期:2013-02-01 00:00:00
abstract::The outcome of surgically treated mucous cysts of the foot is poorly documented in the orthopaedic literature. This study reports on the treatment of mucous cysts of the toes by simple excision and joint debridement. This is in contrast to treatment of similar lesions in the fingers which is often treated by excision ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070302400607
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Subtalar instability, which may cause persistent symptoms after severe inversion ankle sprains, often involves failure of the interosseous talocalcaneal ligament (ITCL). While several clinicians have reported surgical treatment for this pathology, nonsurgical management policy has not been well considered. P...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070302400811
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Tarsal tunnel pressure is increased when the foot and ankle are positioned in eversion or inversion from neutral, aggravating symptoms of tarsal tunnel syndrome in some patients. Space-occupying lesions may cause tarsal tunnel syndrome. We hypothesized that positional change of the foot and ankle from neutra...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070602700608
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Total ankle replacement (TAR) and ankle fusion (AF) are the 2 major operative options for treatment of advanced ankle arthropathy; there is, however, no large epidemiologic study comparing nationwide trends of these 2 procedures. The current study used a nationwide database to compare epidemiologic profiles ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100713517101
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Staged care with interval external fixation is a successful established treatment strategy for high energy periarticular fractures with often extensive soft tissue damage such as the tibial plateau and plafond. The aim of the current study was to determine whether staged care of high energy midfoot fracture/...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100714552077
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:One of the goals of the AOFAS website is to provide easily understandable information about orthopaedic foot and ankle conditions to the public. However, validation of this goal has not been conducted. Evaluation of text reading level is frequently performed using the Flesch-Kincaid formula (FKF). This study...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2009.0287
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:The nature of the sesamoid complex in the development of hallux rigidus or limitus (HL) has been poorly characterized and the role of the sesamoids in the surgical management of this condition has not been explored. Previous surgical approaches in younger active patients unsuited to destructive procedures ha...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2009.0640
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Microsurgical reconstruction has improved limb salvage in patients who because of many etiologies have soft-tissue loss from the lower extremities. Free-tissue transfer to the foot and ankle often interferes with postoperative function and footwear because of the bulk of a muscle flap. The foot and ankle oft...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070502600302
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:In Charcot-Marie-Tooth (CMT) disease, selective weakness of the tibialis anterior muscle often leads to recruitment of the long toe extensors as secondary dorsiflexors, with subsequent clawing of the toes. Extensor hallucis longus (EHL) and extensor digitorum longus (EDL) tendon transfers offer the ability t...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100719901119
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:The tendo Achilles (TA) is a tendon very susceptible to injury. Biomechanical methodologies for exploring tendon strain are limited, however, as they are typically performed in vitro or by indirectly measuring the displacement of reference markers. By using panoramic ultrasound, this study reports a novel ap...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2010.0905
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:The Salto Talaris is a fixed-bearing implant first approved in the US in 2006. While early surgical outcomes have been promising, mid- to long-term survivorship data are limited. The aim of this study was to present the survivorship and causes of failure of the Salto Talaris implant, with functional and radi...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100720947030
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Tibiotalocalcaneal fusion with a straight rod has a risk of damaging the lateral plantar neurovascular structures and may interfere with maintaining normal heel valgus position.We report the results of a prospective study of tibiotalocalcaneal (TTC) arthrodesis with a short, anatomically curved interlocking,...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2010.1085
更新日期:2010-12-01 00:00:00
abstract::Congenital coalition of the middle and distal phalanges in the fifth toe are common. They have been reported to occur in up to 50% of American and European populations and in up to 73% of people of Japanese descent. Congenital interphalangeal coalition of the other toes is less common. We report two cases of fracture ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070002100812
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Rheumatoid arthritis (RA) can cause significant forefoot disorders. If forefoot deformity and pain are severe, surgical treatment can be considered. The aim of this study was to analyze the long-term outcomes of surgical forefoot correction per Tillmann, which involves resection of the metatarsal heads throu...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100719840814
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Although cross-sectional biomechanical studies have reported that wearing high-heeled shoes can change the musculoskeletal system of the lower extremities, the long-term effects of wearing such shoes on the ankle remain unknown. The aim of this study was to reveal changes in ankle range of motion and muscle ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100712468562
更新日期:2013-03-01 00:00:00
abstract::The purpose of this study is to report our experience with the Vacuum Assisted Closure (VAC) negative pressure technique in patients with non-healing wounds of the foot, ankle, and lower limb. We retrospectively reviewed 17 patients with non-healing wounds of the lower extremity who underwent treatment using the Vacuu...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070202301002
更新日期:2002-10-01 00:00:00
abstract::Traumatic injuries to the midtarsal joint are quite uncommon and usually involve fractures of adjacent bones. Pure dislocations without fracture are very rare. A patient sustained a pure dislocation that was treated with a nonweight-bearing cast for six weeks, but she went on to present with chronic subluxation at the...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070202300312
更新日期:2002-03-01 00:00:00
abstract::We report the a case of Nora's lesion (Bizarre Parosteal Osteochondromatous Proliferation) of the sesamoid. A 32-year-old woman presented with a painless, enlarging mass of two years duration on the plantar aspect of the first metatarsophalangeal joint of the left foot. Radiographs, Computerized Tomographs and Magneti...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070002100509
更新日期:2000-05-01 00:00:00
abstract:RECOMMENDATION:Transfer of synovial aspirate in blood culture bottles, obtaining deep biopsy of tissues and bone, obtaining multiple samples, increasing incubation period of cultures, and the use of molecular techniques for culture negative cases are some of the strategies that can help improve the ability to isolate t...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100719859887
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Studies using footprint-based estimates of arch height have indicated that obesity results in a lowered medial longitudinal arch in children. However, the potentially confounding effect of body composition on indirect measures of arch height, such as the arch index, has not been investigated. METHODS:This s...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070402500811
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:In Chopart-level amputations the heel often deviates into equinus and varus when, due to the lack of healthy anterior soft tissue, rebalancing tendon transfers to the talar head are not possible. Consequently, anterior and lateral wound dehiscence and ulceration may occur requiring higher-level amputation to...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100713495380
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Correction of hallux valgus deformity with distal chevron osteotomy is limited by the amount of lateral translation achieved. Since 1999, the senior author has performed a modified technique referred to as increased displacement distal chevron osteotomy in which the distal fragment is translated laterally as...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2008.0155
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Deep infection after open reduction internal fixation (ORIF) of ankle fractures represents a challenge to the orthopaedic surgeon, particularly in patients in whom conventional surgical treatments have failed. The aim of this study was to assess the results of a modified technique of tibiotalocalcaneal fusio...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100720939884
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Suture anchors have been developed for the fixation of ligaments, capsules, or tendons to bone. These devices have led to improved fixation, smaller incisions, earlier limb mobility, and improved outcomes. They were originally developed for use in shoulder reconstructions but are now used in almost all extre...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070502600703
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Ankle fractures in patients with diabetes mellitus (DM) can be difficult to manage, especially in the presence of peripheral neuropathy. In patients who fail initial operative management, attempts at limb salvage can be challenging, and no clear treatment algorithm exists. This study examined outcomes of dif...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100716676063
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:The Ludloff first metatarsal osteotomy is used to correct the increased 1-2 intermetatarsal angle associated with hallux valgus deformity. We studied the spatial geometry of this osteotomy to determine the ideal parameters of the osteotomy saw cut and its rotation to give an optimal correction. METHODS:Thre...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070502600809
更新日期:2005-08-01 00:00:00