2025 AOFAS Annual Meeting-Paper Session 5C

Video Transcription

Video Summary

The session featured several presentations on orthopedic foot and ankle surgery topics. Dr. Won-Yong Lee analyzed U.S. physician reimbursement, finding that foot and ankle procedures, despite longer operative times and higher complication rates, receive lower work relative value units (work RBU) and reimbursement rates than other orthopedic procedures, suggesting undercompensation. A study on bone mineral density after hindfoot fusion used Hounsfield units from weight-bearing CT scans to assess regional differences and temporal changes, finding stable density post-op and significant topographical variation reflecting biomechanical forces, indicating potential for improved post-op management.<br /><br />Dr. Jae Young Kim presented on dome-shaped supramalleolar osteotomy (DOM-SMO) for varus ankle arthritis, revealing that correction involves significant internal rotation of the distal tibia, aiding talar tilt correction beyond coronal plane adjustments. Another study compared complication rates between retrograde intramedullary fixation (RIF) and tibiotalocalcaneal arthrodesis (TTCA) for trimalleolar fractures, showing TTCA had significantly higher complications, suggesting RIF remains preferable even for high-risk patients.<br /><br />Sarah Kiriluk explored outcomes of hindfoot arthrodesis related to graft type and BMI, finding improved outcomes and lower nonunion rates in patients with BMI<40, while graft choice (autograft vs. allograft) showed no significant effect. Lastly, Steven Cooperman’s cadaveric study compared percutaneous Achilles tenotomy at 3cm vs. 5cm from insertion, finding both effective but with differences in nerve injury rates and tendon gap formation.<br /><br />Overall, the session highlighted complexities in surgical outcomes, compensation, and anatomical considerations in foot and ankle orthopedics, emphasizing the need for nuanced understanding and further research.

Keywords

orthopedic foot and ankle surgery

physician reimbursement

work relative value units

bone mineral density

hindfoot fusion

dome-shaped supramalleolar osteotomy

trimalleolar fractures

hindfoot arthrodesis outcomes

percutaneous Achilles tenotomy