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Background Ankle arthroplasty, commonly known as ankle replacement, is a surgical procedure for treating end-stage ankle osteoarthritis. Whilst evidence shows good clinical results after surgery, little is known of the long-term survival of ankle replacements and the need for ankle revision. Using more recent implant data and long-term data, there is now opportunity to examine at a population-level the survival rate for ankle implants, to examine between-country differences in ankle revision surgery, and to compare temporal trends in revision rates between countries. Methods Four national joint registries from Australia, New Zealand, Norway and Sweden provided the necessary data on revision outcome following primary ankle replacement, for various periods of observation – the earliest starting in 1993 up to the end of 2019. Data were either acquired from published, online annual reports or were provided from direct contact with the joint registries. The key information extracted were Kaplan-Meier estimates to plot survival probability curves following primary ankle replacement. Results The survival rates varied between countries. At 2 years, across all registries, survival rates all exceeded 0.9 (range 0.91 to 0.97). The variation widened at 5 years (range 0.80 to 0.91), at 10 years (range 0.66 to 0.84) and further at 15-years follow-up (0.56 to 0.78). At each time point, implant survival was greater in Australia and New Zealand with lower rates in Sweden and Norway. Conclusions We observed variation in primary ankle replacement survival rates across these national registries, although even after 5 years, these population derived data show an 80% revision free survival. These data raise a number of hypotheses concerning the reasons for between-country differences in revision-free survival which will require access to primary data for analysis.

Supplemental Material, sj-pdf-4-pch-10.1177_21501351211007102 for “No Official Help Is Available”—Experience of Parents and Children With Congenital Heart Disease During COVID-19 by L. V. Marino, R. Wagland, D. J. Culliford, T. Bharucha, S. C. Sodergren and Anne-Sophie E. Darlington in World Journal for Pediatric and Congenital Heart Surgery

Supplemental Material, sj-pdf-5-pch-10.1177_21501351211007102 for “No Official Help Is Available”—Experience of Parents and Children With Congenital Heart Disease During COVID-19 by L. V. Marino, R. Wagland, D. J. Culliford, T. Bharucha, S. C. Sodergren and Anne-Sophie E. Darlington in World Journal for Pediatric and Congenital Heart Surgery

Supplemental Material, sj-pdf-1-pch-10.1177_21501351211007102 for “No Official Help Is Available”—Experience of Parents and Children With Congenital Heart Disease During COVID-19 by L. V. Marino, R. Wagland, D. J. Culliford, T. Bharucha, S. C. Sodergren and Anne-Sophie E. Darlington in World Journal for Pediatric and Congenital Heart Surgery

Supplemental Material, sj-pdf-2-pch-10.1177_21501351211007102 for “No Official Help Is Available”—Experience of Parents and Children With Congenital Heart Disease During COVID-19 by L. V. Marino, R. Wagland, D. J. Culliford, T. Bharucha, S. C. Sodergren and Anne-Sophie E. Darlington in World Journal for Pediatric and Congenital Heart Surgery

Supplemental Material, sj-pdf-3-pch-10.1177_21501351211007102 for “No Official Help Is Available”—Experience of Parents and Children With Congenital Heart Disease During COVID-19 by L. V. Marino, R. Wagland, D. J. Culliford, T. Bharucha, S. C. Sodergren and Anne-Sophie E. Darlington in World Journal for Pediatric and Congenital Heart Surgery

Objective. To investigate the prevalence and distribution of forefoot bursae (FFB) in individuals with osteoarthritis (OA), individuals with rheumatoid arthritis (RA), and healthy controls (HCs), and to identify mechanical or inflammatory factors predicting FFB count. Methods. A cross-sectional observational study was completed in 3 cohorts: OA (n = 50), RA (n = 56), and HC (n = 50). FFB were recorded as present if detectable in 2 ultrasound (US) scanning planes. The comparative probabilities of FFB presence between groups were expressed as odds ratios. Mechanical factors, including joint deformity, range of motion, and foot posture, were determined for both patient groups. Inflammatory factors, including serology, Disease Activity Score in 28 joints, and US-detected metatarsophalangeal joint hypertrophy and metatarsal head erosion, were determined for RA patients. Multiple linear regression analyses were used to determine factors related to FFB count in the patient groups. Results. FFB were highly prevalent in both the OA and RA groups (94 per 100 patients and 88 per 100 patients, respectively) compared with the HC group (56 per 100 participants). FFB distribution significantly differed between the patient groups (RA-OA: χ2 = 15.64, P ≤ 0.001). In OA patients, FFB were commonly located in the medial/lateral forefoot region, but were located across all regions for RA patients. In OA patients, reduced ankle joint range of motion predicted FFB count (R2 = 0.09, P = 0.037). In RA patients, erosion presence was related to FFB count (R2 = 0.18, P ≤ 0.001). Conclusion. FFB were highly prevalent in patients with OA and RA. FFB distribution significantly differed between the patient groups. FFB in patients with OA may be related to mechanical factors. Copyright © 2014 by the American College of Rheumatology.

OBJECTIVE: To determine the prevalence and natural history of foot-related disability in patients with rheumatoid arthritis (RA). A secondary aim was to identify explanatory variables, including forefoot bursae, that are either associated with or predictive of disabling foot complications in patients with RA. METHODS: A longitudinal prospective cohort study recruited patients with RA from a rheumatology outpatient clinic. Data were collected at baseline (n = 149) and 1-year (n = 120) and 3-year followup (n = 60). Patient-reported disabling foot complications were evaluated using the subscales of the Foot Impairment Score (FIS): foot impairment/footwear restriction (FIS(IF)) and activity limitation/participation restriction (FIS(AP)). Explanatory variables investigated included ultrasound-detectable forefoot pathology and markers of disease activity. RESULTS: Disabling foot complications were highly prevalent on all occasions. Changes in foot impairment and activity limitation were significantly associated with fluctuations in disease activity (Disease Activity Score in 28 joints using the erythrocyte sedimentation rate [DAS28-ESR]: r = 0.455, P < 0.0001; ESR: r = -0.356, P = 0.008 and DAS28-ESR: r = 0.433, P = 0.001; ESR: r = -0.439, P = 0.001 for the FIS(IF) and FIS(AP), respectively), and approaching a significant association with changes in forefoot bursae (FIS(IF): r = 0.255, P = 0.063 and FIS(AP): r = 0.255, P = 0.063). The presence of disease duration and forefoot bursae was a significant prognostic indicator of foot impairment (P = 0.009 and P = 0.012, respectively), explaining 16% of score variability in the final regression model. Disease duration, forefoot bursae, and erosion presence were identified as significant prognostic indicators of activity limitation (P = 0.002, P = 0.006, and P = 0.019, respectively), explaining 35% of score variability in the final regression model. CONCLUSION: Despite advances in disease management, patients report disability associated with foot problems. Forefoot bursae should be considered for targeted therapy.