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Category: Other; Hindfoot; Midfoot/Forefoot Introduction/Purpose: The interplay between forefoot and hindfoot alignment has been well established in the literature for pathologies such as the flexible cavovarus foot. However, no study has evaluated the relationship between hindfoot alignment and first metatarsal axial rotation. Therefore, the purpose of this study is to determine the relationship, if any, between hindfoot alignment and first metatarsal axial rotation in patients with mild, moderate, and severe hindfoot varus/valgus deformity using weight bearing computed tomography (WBCT). We hypothesize that patients with hindfoot valgus alignment will be associated with a first metatarsal pronation/eversion deformity. Conversely, we hypothesize that patients with hindfoot varus alignment will be associated with a first metatarsal supination/inverted deformity. Methods: Patients who underwent weight bearing radiographs (WBR) and WBCT between 2015 and 2018 were evaluated with inclusion/exclusion criteria. Patients with prior foot surgery/trauma were excluded. Hindfoot alignment was evaluated using the calcaneal moment arm (Figure 1; horizontal distance between the most inferior aspect of the calcaneus and an extended line approximating the longitudinal axis of the tibia). Six subgroups were created based on the severity of hindfoot malalignment 1) Moderate valgus, 2) moderate varus, 3) substantial valgus, 4) substantial varus, 5) severe valgus, and 6) severe varus. Moderate was 1/2-1 standard deviations (SD) from the mean. Substantial was 1-2 SDs from the mean. Severe was >2 SDs from the mean. Patients with CMA values within ½ SD of the mean were excluded to focus on patients with significant hindfoot malalignment. First metatarsal axial rotation was measured using the Kim and Saltzman angles (Figure 1). Meary's angle was obtained using WBR. Results: 196 patients were included (average age - 52.6 years). The average CMA was +6.0+-16.2mm (valgus). The average Kim and Saltzman angles were 7.7+-12.9 and 2.8+-13.1 degrees (pronated). The average Meary's angle was 182.0+-11.9 degrees (>180 degrees-apex dorsal measurement). There was a significant association between hindfoot alignment and the Saltzman (r=0.641, p

Background: Prosthetic joint infection (PJI) after total ankle arthroplasty (TAA) is a serious complication that results in significant consequences to the patient and threatens the survival of the ankle replacement. PJI in TAA may require debridement, placement of antibiotic spacer, revision arthroplasty, conversion to arthrodesis, or potentially below the knee amputation. While the practice of TAA has gained popularity in recent years, there is some minimal data regarding wound complications in acute or chronic PJI of TAA. However, of the limited studies that describe complications of PJI of TAA, even fewer studies describe the criteria used in diagnosing PJI. This review will cover the current available literature regarding total ankle arthroplasty infection and will propose a model for treatment options for acute and chronic PJI in TAA. Methods: A review of the current literature was conducted to identify clinical investigations in which prosthetic joint infections occurred in total ankle arthroplasty with associated clinical findings, radiographic imaging, and functional outcomes. The electronic databases for all peer-reviewed published works available through January 31, 2018, of the Cochrane Library, PubMed MEDLINE, and Google Scholar were explored using the following search terms and Boolean operators: “total ankle replacement” OR “total ankle arthroplasty” AND “periprosthetic joint infection” AND “diagnosis” OR “diagnostic criteria.” An article was considered eligible for inclusion if it concerned diagnostic criteria of acute or chronic periprosthetic joint infection of total ankle arthroplasty regardless of the number of patients treated, type of TAA utilized, conclusion, or level of evidence of study. Results: No studies were found in the review of the literature describing criteria for diagnosing PJI specific to TAA. Conclusions: Literature describing the diagnosis and treatment of PJI in TAA is entirely reliant on the literature surrounding knee and hip arthroplasty. Because of the limited volume of total ankle arthroplasty in comparison to knee and hip arthroplasty, no studies to our knowledge exist describing diagnostic criteria specific to total ankle arthroplasty with associated reliability. Large multicenter trials may be required to obtain the volume necessary to accurately describe diagnostic criteria of PJI specific to TAA. Level of Evidence: Level III, systematic review.