Robert B Anderson

Weil Foot and Ankle Institute, Chicago, Illinois, United States

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Publications (64)71.86 Total impact

  • Craig R Lareau · Andrew R Hsu · Robert B Anderson
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    ABSTRACT: Background: Jones fractures commonly occur in professional athletes and operative treatment remains the standard of care in this patient population. In our clinical experience, an aggressive postoperative rehabilitation protocol for National Football League (NFL) players with an average return to play (RTP) between 8 and 10 weeks can have successful outcomes with few complications. The purpose of this study was to quantify RTP and rate of complications, including nonunion, refracture, and reoperation among a cohort of NFL players with operatively treated Jones fractures.
    09/2015; DOI:10.1177/1071100715603983
  • Craig R. Lareau · Robert B. Anderson
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    ABSTRACT: ➢ Percutaneous fixation of Jones fractures with an intramedullary screw is the standard of care for athletes, who experience unacceptably high rates of nonunion, refracture, and delayed return to activities with nonoperative treatment.➢ Fixation should use the largest solid partially threaded screw, usually 5.5 or 6.5 mm in diameter, that can be inserted without displacing or comminuting the fracture.➢ Autogenous bone graft should be used to supplement intramedullary fixation in cases of nonunion, refracture, and implant failure.➢ An understanding of risk factors for refracture and nonunion, including cavus and/or varus foot alignment and nutritional and hormonal deficiency, is critical.➢ Return to normal walking or sport activities is dependent on clinical and radiographic healing. Computed tomography (CT) can be especially helpful as a confirmatory test in elite athletes, but may not be necessary or cost-effective in non-athletes.Proximal fifth metatarsal metaphyseal (often termed Jones) fractures are one of the most common forefoot injuries in the general population and occur especially in athletes and patients with deformity resulting in disproportionate loading of the lateral aspect of the foot1. Delayed union can occur because these injuries occur in an area with a tenuous, retrograde blood supply2,3. Additionally, the repetitive shear stresses endured by athletes both cause this injury and contribute to nonunion and refracture. Because elite and competitive athletes experience an unacceptably high rate of complications with nonoperative treatment, primary fixation remains the standard of care in this population4-7. In contrast, acute Jones fractures are typically treated initially in a non-weight-bearing cast in non-athletes. It is critical to identify and to address biomechanical, nutritional, and behavioral factors that can both predispose patients to these injuries and impede a successful outcome. Despite appropriate surgical treatment, nonunion, delayed union, and refracture …
    07/2015; 3(7). DOI:10.2106/JBJS.RVW.N.00100
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    Andrew R Hsu · Craig R Lareau · Robert B Anderson
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    ABSTRACT: Infolding and retraction of an avulsed deltoid complex after ankle fracture can be a source of persistent increased medial clear space, malreduction, and postoperative pain and medial instability. The purpose of this descriptive case series was to analyze the preliminary outcomes of acute superficial deltoid complex avulsion repair during ankle fracture fixation in a cohort of National Football League (NFL) players. We found that there is often complete avulsion of the superficial deltoid complex off the proximal aspect of the medial malleolus during high-energy ankle fractures in athletes. Between 2004 and 2014, the cases of 14 NFL players who underwent ankle fracture fixation with open deltoid complex repair were reviewed. Patients with chronic deltoid ligament injuries or ankle fractures more than 2 months old were excluded. Average age for all patients was 25 years and body mass index 34.4. Player positions included 1 wide receiver, 1 tight end, 1 safety, 1 running back, 1 linebacker, and 9 offensive linemen. Average time from injury to surgery was 7.5 days. Surgical treatment for all patients consisted of ankle arthroscopy and debridement, followed by fibula fixation with plate and screws, syndesmotic fixation with suture-button devices, and open deltoid complex repair with suture anchors. Patient demographics were recorded with position played, time from injury to surgery, games played before and after surgery, ability to return to play, and postoperative complications. Return to play was defined as the ability to successfully participate in at least 1 full regular-season NFL game after surgery. All NFL players were able to return to running and cutting maneuvers by 6 months after surgery. There were no significant differences in playing experience before surgery versus after surgery. Average playing experience before surgery was 3.3 seasons, 39 games played, and 22 games started. Average playing experience after surgery was 1.6 seasons, 16 games played, and 15 games started. Return to play was 86% for all players. There were no intraoperative or postoperative complications noted, and no players had clinical evidence of medial pain or instability at final follow-up with radiographic maintenance of anatomic mortise alignment. Superficial deltoid complex avulsion during high-energy ankle fractures in athletes is a distinct injury pattern that should be recognized and may benefit from primary open repair. The majority of NFL players treated surgically for this injury pattern are able to return to play after surgery with no reported complications or persistent medial ankle pain or instability. Level IV, retrospective case series. © The Author(s) 2015.
    07/2015; DOI:10.1177/1071100715593374
  • Andrew R Hsu · Robert B. Anderson · Bruce E. Cohen
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    ABSTRACT: Intra-articular calcaneus fractures are commonly sustained after high-energy trauma, and a variety of techniques exists for anatomic reduction and surgical fixation. Traditional approaches using an extended L-shaped lateral incision with lateral plating for open reduction and internal fixation have relatively high complication rates. Common complications include hematoma formation, skin edge necrosis, wound breakdown, and superficial or deep infection. As a result, less invasive techniques have been developed in recent years, including limited-incision sinus tarsi open reduction and internal fixation, percutaneous fixation, and arthroscopic-assisted fixation. These techniques are associated with lower complication rates and equivalent clinical and radiographic outcomes in certain fracture patterns and patient populations. Copyright 2015 by the American Academy of Orthopaedic Surgeons.
    The Journal of the American Academy of Orthopaedic Surgeons 07/2015; 23(7):399-407. DOI:10.5435/JAAOS-D-14-00287 · 2.53 Impact Factor
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    ABSTRACT: Background: Limited incision techniques for acute Achilles tendon ruptures have been developed in recent years to improve recovery and reduce postoperative complications compared with traditional open repair. The purpose of this retrospective cohort study was to analyze the clinical outcomes and postoperative complications between acute Achilles tendon ruptures treated using a percutaneous Achilles repair system (PARS [Arthrex, Inc, Naples, FL]) versus open repair and evaluate the overall outcomes for operatively treated Achilles ruptures.
    Foot & Ankle International 06/2015; DOI:10.1177/1071100715589632 · 1.51 Impact Factor
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    ABSTRACT: Chronic insertional Achilles tendinopathy is a common pathology that can be difficult to manage. Some experts have advocated augmentation with the flexor hallucis longus (FHL) tendon in patients over age 50 and those with more severe tendon disease. We hypothesized that FHL augmentation would be associated with superior clinical outcome scores and greater ankle plantar flexion strength compared with Achilles debridement alone. Consecutive patients older than 50 years who had failed nonoperative treatment for chronic insertional Achilles tendinopathy were randomly assigned to Achilles decompression and debridement alone (control group) or Achilles decompression and debridement augmented with FHL transfer (FHL group). Outcome measures included American Orthopaedic Foot & Ankle Society (AOFAS) ankle/hindfoot score, visual analog scale (VAS) for pain, ankle and hallux plantar flexion strength, and a patient satisfaction survey. A total of 39 enrolled patients had a minimum 1-year follow-up, 18 in the control group and 21 in the FHL transfer group. The average patient age was 60.5 years. AOFAS and VAS scores improved in both groups at 6 months and 1 year with no difference between groups. There was greater ankle plantar flexion strength in the FHL group at 6 months and at 1 year compared with the control group (P < .05). There was no difference between the 2 groups in hallux plantar flexion strength preoperatively and at 1 year after surgery. Some 87% of patients were satisfied with the outcome of their procedure. There was no significant increase in wound complications in the FHL group (P < .05). We found no differences in pain, functional outcome (as measured by the AOFAS ankle/hindfoot scale), and patient satisfaction when comparing patients treated with Achilles debridement alone versus FHL augmentation for chronic Achilles tendinopathy. Ankle plantar flexion strength appeared to be improved with FHL transfer, with no loss of hallux plantar flexion strength. Although FHL transfer was a safe adjunct to tendon debridement and partial ostectomy for insertional Achilles tendinopathy in older patients with little compromise in function, it may not be necessary for primary cases. Level 1, prospective randomized trial. © The Author(s) 2015.
    05/2015; 36(9). DOI:10.1177/1071100715586182
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    ABSTRACT: Background: Preoperative computer navigation and patient-specific instrumentation have had promising results in total knee arthroplasty and in a previous cadaveric total ankle arthroplasty (TAA) study. Potential benefits of patient-specific guides include improved implant alignment and decreased surgical time. The purpose of this retrospective case series was to evaluate the accuracy, reproducibility, and limitations of TAA tibia and talar implant placement and radiographic alignment using preoperative computed tomography (CT) scan-derived instrumentation in a clinical setting.
    05/2015; DOI:10.1177/1071100715585561
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    Andrew R Hsu · Robert B Anderson
    Orthopedics 11/2014; 37(11):724-6. DOI:10.3928/01477447-20141023-02 · 0.96 Impact Factor
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    Andrew R Hsu · Robert B Anderson · Bruce E Cohen
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    ABSTRACT: End-stage ankle arthritis is a painful and functionally limiting condition that can significantly worsen quality of life. Ankle arthrodesis, a common surgical procedure for ankle arthritis, provides good pain relief, patient satisfaction, and clinical outcomes when fusion is achieved. Potential disadvantages include malunion and nonunion, malalignment, limited range of motion (ROM), altered gait mechanics, and development of adjacent joint arthritis requiring reoperation.
    American journal of orthopedics (Belle Mead, N.J.) 10/2014; 43(10):451-7.
  • Kenneth J. Hunt · Robert B. Anderson
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    ABSTRACT: Fractures of the proximal fifth metatarsal metaphysis, commonly referred to as a Jones fracture, is a relatively common injury in athletes 1. This injury has been associated with unacceptably high rates of non-union, refracture, and delayed return to activities with non-operative treatment. As such, primary fixation is the accepted standard of care for the elite athlete.2, 3 and 4 Fixation of the fracture allows safe, accelerated rehabilitation, higher healing rates, and earlier return to play. However, delayed union, non-union, and refracture can occur despite surgical fixation and stabilization with evidence of healing.2 and 3 This paper reviews indications and techniques for surgical treatment of Jones fractures, including refractures and non-unions, in the athletic patient.
    Operative Techniques in Sports Medicine 09/2014; 22(4). DOI:10.1053/j.otsm.2014.09.010 · 0.20 Impact Factor
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    ABSTRACT: Background: The optimal method for treating intra-articular fractures of the calcaneus remains controversial. Extensile approaches allow excellent fracture exposure, but high rates of wound complications are seen. Newer minimally invasive techniques for calcaneus fracture fixation offer a potentially lower wound complication rate, but long-term clinical results are not available. The aim of this study was to compare the outcomes of intra-articular calcaneus fractures treated with open reduction and internal fixation via an extensile approach versus those with a minimally invasive sinus tarsi approach.
    Foot & Ankle International 03/2013; 34(6). DOI:10.1177/1071100713477607 · 1.51 Impact Factor
  • Kenneth John Hunt · Robert B Anderson
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    ABSTRACT: Many procedures have been described for surgical treatment of symptomatic hallux rigidus. Dorsal cheilectomy of the metatarsophalangeal joint combined with a dorsal-based closing wedge osteotomy of the proximal phalanx (i.e., Moberg procedure) has been described as an effective procedure. For patients with hallux rigidus and clinically significant hallux valgus interphalangeus, the authors previously described a dorsal cheilectomy combined with a biplanar closing wedge osteotomy of the proximal phalanx, combining a Moberg osteotomy with an Akin osteotomy. The purpose of this study was to describe the clinical results of this procedure. This article is a retrospective review of prospectively gathered data that reports the clinical and radiographic results of dorsal cheilectomy combined with a biplanar oblique closing wedge proximal phalanx osteotomy (i.e., Moberg-Akin procedure) for patients with symptomatic hallux rigidus and hallux valgus interphalangeus. Consecutive patients were followed and evaluated for clinical and radiographic healing, satisfaction, and ultimate need for additional procedure(s). Thirty-five feet in 34 patients underwent the procedure. All osteotomies healed. At an average of 22.5 months of follow-up, 90% of patients reported good or excellent results, with pain relief, improved function, and fewer shoe wear limitations following this procedure. Hallux valgus and hallux interphalangeal angles were radiographically improved. Other than one patient who requested hardware removal, no patients required additional surgical procedures. Dorsal cheilectomy combined with a Moberg-Akin procedure was an effective and durable procedure with minimal morbidity in patients with hallux rigidus combined with hallux valgus interphalangeus.
    Foot & Ankle International 12/2012; 33(12):1043-50. DOI:10.3113/FAI.2012.1043 · 1.51 Impact Factor
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    ABSTRACT: Sprains of the first metatarsophalangeal (MTP) joint, referred to colloquially as "turf toe," are a debilitating sports injury because the hallux is pivotal to an athletes' ability to accelerate and cut. Severe sprains may require weeks to full recovery, and injuries requiring surgery may prevent an athlete from full athletic participation for months. Whereas the diagnosis and treatment of turf toe are well documented in the literature, less is known about the biomechanics of this joint and the mechanical properties of the structures that compose it. Nevertheless, this information is vital to those, such as equipment designers, who attempt to develop athletic footwear and surfaces intended to reduce the likelihood of injury. To that end, this review summarizes the literature on the anatomy of the first MTP joint, on biomechanical studies of the first MTP joint, and on the incidence, mechanisms, and treatment of turf toe. Furthermore, gaps in the literature are identified and opportunities for future research are discussed. Only through a thorough synthesis of the anatomic, biomechanical, and clinical knowledge regarding first MTP joint sprains can appropriate countermeasures be designed to reduce the prevalence and severity of these injuries.
    Critical Reviews in Biomedical Engineering 01/2012; 40(1):43-61. DOI:10.1615/CritRevBiomedEng.v40.i1.30
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    ABSTRACT: An avulsion fracture of the proximal fifth metatarsal may result in a symptomatic nonunion and hinder athletic performance. Nonoperative management is often successful in alleviating symptoms. When symptoms persist, surgery can be undertaken to repair the nonunion or excise the avulsed fragment. The excision of the avulsed bone fragment is evaluated in the management of symptomatic nonunions. Study Case series; Level of evidence, 4. Excision of the avulsed fifth metatarsal fragment was performed in 6 male high-performance athletes with symptomatic nonunions. The remaining edge of bone was contoured and smoothed. All 6 patients experienced an uneventful operation and recovery, returning to competitive play at a mean of 11.7 weeks. Activity-related pain and discomfort abated after the excision and rehabilitation. No surgical complications were noted. Surgical excision of the avulsed fragment from the proximal fifth metatarsal is a safe and effective alternative intervention when nonoperative methods fail.
    The American Journal of Sports Medicine 08/2011; 39(11):2466-9. DOI:10.1177/0363546511417566 · 4.36 Impact Factor
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    ABSTRACT: Dorsal plate fixation is used commonly for arthrodesis of the hallux first metatarsophalangeal (MTP) joint. Custom dorsal plates incorporating locking technology have been developed recently for applications in the foot to provide relative ease of application and theoretically superior mechanical properties. The purpose of this study is to compare the radiographic and clinical outcomes of patients undergoing hallux MTP joint arthrodesis using a locked plate, or a nonlocked plate. We compared consecutive patients who underwent hallux MTP arthrodesis for a variety of diagnoses with either a precontoured locked titanium dorsal plate (Group 1) or a precontoured, nonlocked stainless steel plate (Group 2). All patients were evaluated with radiographs, visual analog pain scale, American Orthopaedic Foot and Ankle Society (AOFAS) hallux score, and a detailed patient satisfaction survey. There were 73 feet in Group 1 and 107 feet in Group 2. There was a trend toward a higher nonunion rate in Group 1 compared to Group 2. When considering only patients without rheumatoid arthritis (RA), the union rate was significantly higher in Group 2 compared to Group 1. Hardware failure and the overall complication rate was equivalent between the two Groups. As locked plate technology continues to gain popularity for procedures in the foot, it is important that clinical outcomes are reported. Locked titanium plates were associated with higher nonunion rates. Improved plate design, patient selection, and an understanding of plate biomechanics in this unique loading environment may optimize future outcomes for hallux MTP arthrodesis.
    Foot & Ankle International 07/2011; 32(7):704-9. DOI:10.3113/FAI.2011.0704 · 1.51 Impact Factor
  • Kenneth J Hunt · Robert B Anderson
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    ABSTRACT: Fractures of the proximal fifth metatarsal metaphysis (ie, the Jones fracture) can be problematic in the elite athlete because of a high incidence of nonunion and refracture with nonoperative treatment. Although these fractures are not common, athletes can suffer refracture or nonunion of a Jones fracture despite operative stabilization. This is often attributable to hardware of insufficient strength, aggressive postoperative rehabilitation, or biologic insufficiency at the fracture site. The authors review the results of revision intramedullary screw fixation with cancellous autologous bone grafting or bone-marrow aspirate combined with demineralized bone matrix after refracture or nonunion of Jones fractures in elite athletes. Study Case series; Level of evidence, 4. The authors retrospectively reviewed the clinical and radiographic outcomes and return to sport in 21 elite athletes undergoing treatment of Jones fracture refractures or nonunions. All patients underwent intramedullary screw fixation with autologous bone graft (12 patients), bone-marrow aspirate (BMA) + demineralized bone matrix (DBM) (8 patients), or no bone graft (1 patient). All athletes were able to return to their previous level of athletic competition at an average of 12.3 weeks. All fractures showed clinical and radiographic evidence of compete cortical healing. Only 1 patient subsequently suffered a refracture. The authors recommend revision fixation with a large, solid screw (5.5 mm or larger) and autologous bone grafting for symptomatic refractures and nonunions of the proximal fifth metatarsal in elite athletes. Additional investigation is needed to determine whether BMA combined with DBM is an effective substitute for cancellous autograft.
    The American Journal of Sports Medicine 06/2011; 39(9):1948-54. DOI:10.1177/0363546511408868 · 4.36 Impact Factor
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    ABSTRACT: As clinical suspicion increases and radiographic evaluation improves, navicular stress fractures are becoming a more recognized injury. To date, there is a small volume of literature examining these stress fractures, particularly as it pertains to outcomes of surgical management. To evaluate the clinical and computed tomography (CT) outcomes of surgically treated navicular stress fractures. Case series; Level of evidence, 4. Ten navicular stress fractures in 10 patients were available for follow-up at an average of 42.4 months postoperatively (range, 16.8-79.9). These patients underwent a clinical examination and a CT scan of their operatively treated foot. The American Orthopaedic Foot & Ankle Society (AOFAS) and SF-36 scores were completed for each fracture at the time of examination. The CT scans were blindly evaluated for bony union. According to the CT scan evaluation, 8 of 10 navicula (80%) had gone on to union. Clinical outcome scores on all patients were an average AOFAS hindfoot score of 88.5 and an average SF-36 score of 88.3. The feet with united fractures had an average AOFAS score of 92.1 (range, 83-100) and an average SF-36 score of 91.9 (range, 79-98). The 2 patients with nonunions had AOFAS scores of 74 and 74 and SF-36 scores of 70 and 78, respectively. Both nonunions were complete, displaced fractures on preoperative imaging. In our series of operatively treated navicular stress fractures, 80% went on to union, as verified by CT scan. Patients with united fractures had a clinically significant improvement in outcome, with higher AOFAS and SF-36 scores as compared with the 2 patients with nonunions. Patients with complete, displaced navicular stress fractures may be more likely to develop nonunions.
    The American Journal of Sports Medicine 04/2011; 39(8):1741-8. DOI:10.1177/0363546511401899 · 4.36 Impact Factor
  • Elly Trepman · David B Thordarson · Robert B Anderson · W Hodges Davis
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    ABSTRACT: The Twenty-fifth Annual Summer Meeting of the American Orthopaedic Foot and Ankle Society (AOFAS) was held 16-18 July 2009 at the Westin Bayshore Hotel in Vancouver, British Columbia, Canada. There were 521 registered attendees, including 339 (65%) individuals from 42 of the United States and 182 (35%) attendees from 32 countries outside the United States.
    Foot and Ankle Surgery 03/2011; 17(1):44-9. DOI:10.1016/j.fas.2009.12.004
  • Robert B Anderson · Alan Catanzariti · Shane Hollawell · Ari Kaz · Lowell Weil
    Foot & Ankle Specialist 02/2011; 4(1):46-53. DOI:10.1177/1938640010393325
  • Rahul Banerjee · Charles Saltzman · Robert B Anderson · Florian Nickisch
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    ABSTRACT: The potential for disabling malunion following calcaneal fracture is high, regardless whether a patient is treated nonsurgically or surgically. Fracture displacement typically results in loss of hindfoot height, varus heel position, and widening of the hindfoot, with possible subfibular impingement and irritation of the peroneal tendon and/or sural nerve. Frequently, the subtalar joint develops posttraumatic arthritis. In symptomatic patients with calcaneal malunion, systematic evaluation is required to determine the source of pain. Nonsurgical treatment, such as activity modification, bracing, orthoses, and injection, is effective in many patients. Surgical treatment may involve simple ostectomy, subtalar arthrodesis with or without distraction, or corrective calcaneal osteotomy. A high rate of successful arthrodesis and of patient satisfaction has been reported with surgical management.
    The Journal of the American Academy of Orthopaedic Surgeons 01/2011; 19(1):27-36. · 2.53 Impact Factor

Publication Stats

562 Citations
71.86 Total Impact Points


  • 2007–2015
    • Weil Foot and Ankle Institute
      Chicago, Illinois, United States
  • 2006–2013
    • OrthoCarolina
      Charlotte, North Carolina, United States
  • 2011
    • Stanford University
      • Department of Orthopaedic Surgery
      Palo Alto, California, United States
    • University of Kentucky
      Lexington, Kentucky, United States
  • 2004–2011
    • Carolinas Medical Center University
      Charlotte, North Carolina, United States
  • 2010
    • Washington University in St. Louis
      • Department of Orthopaedic Surgery
      Saint Louis, MO, United States
    • University of Michigan
      • Department of Orthopaedic Surgery
      Ann Arbor, MI, United States
    • Mercy Hospital Miami
      Miami, Florida, United States
  • 2002–2009
    • University of North Carolina at Charlotte
      Charlotte, North Carolina, United States
  • 2005
    • Rush University Medical Center
      Chicago, Illinois, United States
  • 2001–2004
    • Marshfield Clinic
      Marshfield, Wisconsin, United States