Total knee arthroplasty significantly improves functional outcomes in obese patients, but is also riskier than in normal-weight patients. As the number of obese patients with knee osteoarthritis continues to rise, clinicians are being challenged to find a balance between the risks and the benefits.
By Susan M. Odum, PhD, and Bryan D. Springer, MD
When more conventional approaches lead to inconsistent or inexplicable findings, researchers sometimes find that assessing the variability of an outcome can provide a valuable perspective. But researchers still have a great deal to learn about how much variability is too much, or too little, with regard to lower extremity issues.
Jordana Bieze Foster, Editor
Special Section: Pediatrics
One of the most rewarding aspects of pediatric lower extremity care is the knowledge that early intervention can have a positive effect on a child’s entire adult life—a theme that is repeated throughout this special publication dedicated to lower extremity pediatrics.
Patients with Charcot-Marie-Tooth disease showing the greatest increase in speed appear to respond to and utilize the energy storing and releasing properties of a carbon fiber composite ankle foot orthosis differently from those who had smaller increases in walking speed.
By Janet S. Dufek, PhD; Edward S. Neumann, PhD, PE, CP; M. Cameron Hawkins, PhD; and Brendan J. O’Toole, PhD
Despite the documented benefits of supervised exercise in patients with claudication, its effect on actual clinical practice has been disappointing due to a lack of reimbursement. But practitioners and researchers have been investigating other options, with encouraging preliminary results.
By Cary Groner
Transcranial magnetic stimulation research suggests cortical excitability may be able to help differentiate healthy, previously injured, and functionally unstable ankle joints, and underscores the need to clinically target both mechanical and proprioceptive deficits in patients with FAI.
By Alan R. Needle, PhD
Studies show that lower extremity amputation rates in patients with diabetes vary widely, sometimes even within individual healthcare systems. What’s more difficult to determine is why these variations exist and what can be done to improve access to care for all patients.
By Larry Hand
The etiology of Achilles tendon rupture is multifactorial, but the injury occurs most frequently in the athletic population. Clinicians still miss 24% of ruptures acutely, particularly in older patients, those in whom sports was not the causative mechanism, and those with high BMIs.
By Steven M. Raikin, MD