Vinod K Panchbhavi

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• MD FACS FAOA FABOS
• Professor (Full) at The University of Texas Medical Branch at Galveston

Background Patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA) often report fluctuations in pain levels associated with weather conditions. Despite common clinical observations, the literature remains inconclusive. This study aimed to evaluate the correlation between postoperative pain scores and weather parameters, c...

Base of fifth metatarsal fractures are treated according to fracture zones. Proximal tuberosity avulsions (zone 1) are typically treated conservatively, while proximal metaphyseal-diaphyseal junction fractures (zone 2) or proximal diaphyseal fractures (zone 3) are usually treated with intramedullary screw fixation. We performed a systematic review...

Charcot foot, a debilitating neuroarthropathy of the foot and ankle, can be catastrophic for patients who experience the condition. Adequate treatment is crucial to restoring and preserving function and pain management in these patients. Several treatment approaches are described in the current literature, one of which is the beaming screw techniqu...

Methods • Study Design and Data Source: Retrospective cohort study using de-identified patient data from the TriNetX Research Network, analyzing adults (≥18 years) who underwent ORIF for bimalleolar ankle fractures between 2004-2023. • Cohort Definitions: o Cohort A: Nicotine users (tobacco and non-tobacco nicotine). o Cohort B: Non-tobacco nicotin...

This study examines postoperative complication rates in patients with nicotine dependence compared to non-users to clarify the risks associated with nicotine in pilon fracture recovery.

Category Ankle Arthritis; Ankle Introduction/Purpose Total Ankle Replacement (TAR) has rapidly grown in popularity over the last fifteen years as a treatment for ankle arthritis. With this growth, it is imperative to understand risk factors that may predispose patients to complications following the procedure. This information can be valuable in g...

Intertrochanteric fractures are a common occurrence in the general population; however, in patients with above-knee amputations, they are relatively rare. In this patient population, positioning on a fracture table presents a particularly difficult problem prior to the fixation of an intertrochanteric fracture. Here, we describe a 57-year-old man w...

Background Displaced diaphyseal fractures can be reduced using the push-pull technique, wherein a plate is affixed to the distal fragment of the fracture, a post screw is placed proximal to the plate, and a lamina spreader creates distraction. This study evaluated the load to failure and mechanism of failure of bicortical and unicortical post screw...

Category Ankle; Sports Introduction/Purpose Lateral ankle sprains are common orthopedic injuries that may progress on as chronic lateral ankle instability (CLAI). Great care must be taken to restore precise anatomic relationships of the lateral ankle ligament complex (LALC) in the surgical management of CLAI. This study aimed to quantify the radio...

Category Bunion; Midfoot/Forefoot Introduction/Purpose Patients who undergo a successful surgical correction of hallux valgus have relieved toe pain and improvements in foot appearance. Prior studies have shown hallux valgus correction using a distal Chevron osteotomy with a concomitant Akin osteotomy has the potential to reduce forefoot width. Th...

There is a growing interest in the surgical treatment of Charcot foot arthropathy following the increase in the prevalence of diabetes. The current gold standard of treatment is total contact casting for early deformity, but in recent years, surgery has been performed earlier in the disease process to create a clinically and radiographically planti...

Background When lateral ankle sprains progress into chronic lateral ankle instability (CLAI), restoring precise anatomic relationships of the lateral ankle ligament complex (LALC) surgically is complex. This study quantifies the radiographic relationships between the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and prominen...

Background Nicotine is a modifiable risk factor that is well demonstrated to cause deleterious effects on tendon healing and overall health. Individuals that have a dependence on nicotine may be at an elevated risk for numerous postoperative complications when compared to nondependent patients. The purpose of this study is to evaluate the complicat...

Injury to the deltoid ligamentous complex is frequently observed in ankle fractures and multidirectional instability. While open deltoid repair has traditionally been performed, arthroscopic repair techniques have also been described. We present a new method to perform a knotless medial ligament complex repair utilizing an all-inside technique and...

Purpose: We analyzed the published literature on return-to-driving (RTD) recommendations following lower extremity orthopedic surgery, including knee and hip arthroplasty and ankle and foot surgery. Methods: We conducted a PubMed MEDLINE database search for the relevant literature spanning from 1988 to 2022. Data were extracted from the selected...

Background Inversion ankle injuries are extremely common, sometimes causing injury to the peroneus brevis tendon. If more than 50% of the tendon is injured, it oftentimes requires tenodesis to the adjacent peroneus longus tendon. Both Pulvertaft (PT) and side-to-side (SS) techniques have been used for joining the 2 tendons. The purpose of this stud...

Introduction: The incidence of total ankle arthroplasty (TAA) for ankle osteoarthritis has increased in the Medicare population by approximately 16.37% each year. This study examines the patient perception of orthopedic surgeon reimbursement for TAA by Medicare. Methods: A total of 78 patients were surveyed anonymously at 2 foot and ankle clinic...

This study investigated predictive factors for return to play among National Football League athletes after operative treatment of ankle fractures and the impacts of these injuries on career longevity and player performance. Athletes who underwent surgery to repair ankle fractures from the 2013 to 2017 seasons were identified from injury reserve li...

Introduction: Ankle arthritis adversely affects patients' function and quality of life. Treatment options for end-stage ankle arthritis include total ankle arthroplasty (TAA). A 5-item modified frailty index (mFI-5) has predicted adverse outcomes following multiple orthopaedic procedures; this study evaluated its suitability as a risk-stratificati...

Introduction: This study investigates the effects of the COVID-19 pandemic on medical education, research opportunities, and mental health in orthopaedic surgical training programs. Methods: A survey was sent to the 177 Electronic Residency Application Service-participating orthopaedic surgery training programs. The survey contained 26 questions...

This study evaluates the clinical efficacy and patient satisfaction for the Broström-Gould repair of the anterior talofibular ligament using an ultrasonically interdigitated suture anchor. Medical records for patients who underwent open Broström-Gould repair with ultrasound-assisted bioabsorbable suture anchors from 2017 to 2019 were analyzed for o...

Category Sports; Ankle; Trauma Introduction/Purpose Ankle fractures are common injuries in the National Football League (NFL). Yet, there is a need for deeper understanding about the impacts of surgically managed ankle fractures on athletes' careers. Purpose: To investigate return to play (RTP) for NFL players after operative ankle fractures and t...

Category Bunion; Midfoot/Forefoot Introduction/Purpose Hallux valgus is a foot deformity where the distal portion of the hallux deviates laterally, forming a bunion. Here we review three surgical techniques for correction of the deformity: lapidus arthrodesis (LA), minimally invasive surgery (MIS), or proximal chevron osteotomy (PCO). The purpose...

Ankle fractures are common injuries treated by orthopedists. Indications for operative repair of deltoid ligament (DL) injuries in ankle fracture patients are debated. The purpose of this review is to determine the indications for operative DL repair. Ovid MEDLINE, CINAHL, and Scopus were searched up to December 2019. Web of Science was searched up...

This study sought to evaluate the reliability, comprehensiveness, and readability of ankle arthroplasty information available on the Internet. We evaluated websites based on category, Journal of the American Medical Association (JAMA) criteria, Health on the Net (HON) code, DISCERN score, an author-created Ankle Replacement Index (ARI), and readabi...

Background Charcot neuroarthropathy (CN) is commonly associated with diabetic neuropathy and can predispose patients to amputations. Management remains a challenge, with no definitive treatment. This study examines major postoperative complications associated with open reduction with internal (intramedullary) nails, fixation, external fixation, or...

Insertional Achilles tendinopathy is a common condition that can lead to chronic, debilitating heel pain in athletes and nonathletes alike. Conservative treatment options include activity and shoe wear modification, physical therapy, injections, and extracorporeal shock wave therapy. When nonsurgical treatment fails, surgical treatment is recommend...

Category Ankle; Diabetes; Midfoot/Forefoot Introduction/Purpose Elevated HgbA1c are associated with higher postoperative complications. It is not as well understood whether the HgbA1c levels measured at the time of surgery, or those measured in the months prior to surgery, are more strongly associated with complications. We carried out a study of...

Category Ankle Arthritis; Ankle; Other Introduction/Purpose Ankle arthritis can significantly diminish the function and quality of life of affected individuals. Treatment options for end-stage ankle arthritis include total ankle arthroplasty (TAA). Ongoing research seeks to identify patient factors associated with a higher risk of post-operative c...

Category Ankle; Diabetes; Midfoot/Forefoot Introduction/Purpose Osteomyelitis is an invasive infection of the bone that commonly afflicts patients with diabetes mellitus. This bacterial infection can lead to the need for amputation of portions of the foot or ankle. While the association between Osteomyelitis and amputation has been studied, little...

Category Trauma; Ankle; Diabetes; Other Introduction/Purpose While amputation rates and amputation-related morbidity and mortality have been established for select populations, the impact of general demographic factors on postoperative surgical complications remains little studied. This study aims to analyze the influence of numerous demographic v...

Category Ankle; Other Introduction/Purpose The Centers for Medicare & Medicaid Services (CMS) Open Payments public (OPP) database provides a means for increased transparency of physicians' financial relationships with industry. Total ankle arthroplasty is a procedure with long term clinical implications and variable outcomes published in the exist...

Category Ankle; Hindfoot; Midfoot/Forefoot Introduction/Purpose Antibiotic resistance has quickly become one of the most pressing current public health challenges. Many studies have analyzed general prescription trends, but little information exists about how antibiotic therapy is utilized in orthopedic practice- particularly in patients with Oste...

Verrucous carcinoma is a rare form squamous cell carcinoma which appears similar to a wart. When it occurs in the feet, it can be easily misdiagnosed. It rarely metastasizes or recurs posttreatment. We report a case of a septuagenarian with recurrence of verrucous carcinoma diagnosed within 6 months at the site of previous treatment. Unique feature...

Posterior tibial tendon subluxation in the setting of an ankle fracture is a rare occurrence and, to our knowledge, has not been reported in the trimalleolar ankle fracture subtype. We report a case of a 24-year-old male who sustained a right, closed trimalleolar ankle fracture and concomitant posterior tibial tendon anterior subluxation after a mo...

Aims Differentiating Charcot neuropathic osteoarthropathy (CN) from infection is challenging. The diagnosis of CN is often missed or delayed, resulting in inappropriate and delayed treatment. We hypothesized that the misdiagnosis of CN results in inappropriate antibiotic prescriptions and explore the sequelae of unnecessary antibiotic use. Methods...

Background This study assessed patient perceptions of the Physician Payments Sunshine Act and opinions toward physicians who receive gifts and/or payments from pharmaceutical or medical device companies. Methods During their office visit, patients attending different specialty clinics volunteered to complete our survey. The survey asks if the pati...

Background Use of popliteal nerve blocks (PNBs) as an alternative or adjunctive therapy to traditional methods of pain control (e.g., systemic or spinal anesthesia and opioids) is increasingly popular in foot and ankle surgery. Methods We reviewed online databases for literature on PNBs in foot and ankle surgery to analyze the various techniques a...

Background The Centers for Medicare & Medicaid Services (CMS) Open Payments public database provides a means for increased transparency of physicians’ financial relationships with industry. Total ankle arthroplasty is a procedure with long-term clinical implications and variable outcomes. We compared physician-reported conflict-of-interest (COI) di...

Background Although amputation rates, morbidity, and mortality have been established for select populations, the impact of general demographic factors on postoperative surgical complications remains little studied. Methods The American College of Surgeons’ National Surgical Quality Improvement Program database was searched for leg amputations from...

Background: Humerus fractures are common in the United States. The purpose of this study was to utilize the National Electronic Injury Surveillance System (1) to compare overall and age stratified incidence rates of proximal and distal arm fractures presenting to United States emergency departments, (2) to compare relative humerus fracture locatio...

Purpose Limb amputation is a life-altering procedure used to treat certain cancer patients. The influence of psychosocial factors (such as marital status) on outcomes is poorly understood, hindering the development of targeted resources for the specific needs of these patients. This study was conducted to characterize the influence of marital statu...

Introduction: First metatarsal phalangeal joint (MTPJ) arthroplasty has a high failure rate due to aseptic loosening, which leads to bone loss. The salvage procedure is conversion to an arthrodesis, but bone loss can make obtaining screw fixation difficult. Herein, we report a unique case of revision first-metatarsal arthrodesis without the use of...

Ankle fractures are an extremely common orthopaedic injury treated by surgeons on a routine basis. The deltoid ligament is torn in a large number of these fractures and is commonly seen with associated radiographic changes of medial clear space widening. The clinical relevance of addressing the injured deltoid ligament with acute surgical repair ha...

Introduction The superiority of primary arthrodesis (PA) versus open reduction and internal fixation (ORIF) in Lisfranc injuries has been debated. Meta-analyses comparing these surgical options have reached contradicting conclusions. The goal of this article is to determine why different conclusions were reached and provide clarity on the comparabl...

Introduction Traditional Kirschner wire (K-wire) stabilization of first metatarsal distal chevron osteotomy involves 1 cortex of fixation; however, unicortical fixation is associated with a high complication rate, including pin migration. A method of K-wire fixation utilizing 3 cortices may be biomechanically superior and potentially equivalent to...

Category Midfoot/Forefoot Introduction/Purpose The superiority of Primary arthrodesis (PA) versus open reduction and internal fixation (ORIF) in Lisfranc injuries has been debated for decades. In recent years, researchers have attempted to use meta-analyses to reach a definitive conclusion. However, they have reached uncertain and contradicting co...

Category Ankle; Bunion; Hindfoot; Lesser Toes; Midfoot/Forefoot Introduction/Purpose There is a growing trend to perform surgical procedures at freestanding ambulatory surgical centers. No literature exists evaluating the rate of adverse events and overall safety of foot and ankle outpatient surgeries at a freestanding ambulatory surgery center (A...

Category Midfoot/Forefoot; Lesser Toes Introduction/Purpose The plantar plate stabilizes the metatarsophalangeal joint (MTPJ). When the plantar plate is disrupted the static forces resisting the strong extensor muscles are compromised, overwhelming the intrinsic muscles of the foot resulting in toe deformities. The proposed ‘knuckle test’ is a cli...

Category Ankle; Sports Introduction/Purpose Suture anchors provide an optimal way of fixating injured soft tissue to bone while promoting healing and structural integrity. With recent innovations, the development of biodegradable ultrasonic liquifying suture anchors has been of particular interest. These devices utilize ultrasound energy to liquif...

Certain risk factors for Achilles tendon repair complications, including tobacco use, diabetes mellitus, steroid use, and obesity, have been well reviewed. This study analyzes the impact of a range of demographic factors on unique surgical complications within the 30-day postoperative period. We extracted data from the American College of Surgeons...

Background Ankle osteoarthritis is increasing, thus creating greater demand for high-volume total ankle arthroplasty (TAA) surgeons. The Medicare Provider Utilization and Payment Data Public Use File (MPUPD-PUF) provides volume and reimbursement data for procedures performed by physicians participating in Medicare. This study analyzes surgeon preva...

Despite being first described in the 1800s, the Lisfranc injury remains one of the most controversial topics in foot and ankle surgery. From the basic anatomy of the ligament complex to the optimal diagnostic and management methods, new research both sharpens and yet confounds our understanding of this unique injury. This article reviews the litera...

Background. Intramedullary screw fixation of Jones fractures using partially threaded screws is a common method of fixation for these injuries, but refracture continues to be a problem. Various other fixation strategies, such as headless compression screws, plantar plating, and tension-band wiring. have been developed to mitigate these issues. Biom...

Background: Open reduction and internal fixation (ORIF) with transarticular screws to stabilize Lisfranc injuries may increase the risk of arthritis or affect outcomes. Joint-preserving fixation using staples, bridge plating, or Lisfranc screws avoids iatrogenic articular damage. This study analyzes functional outcomes and complications in Lisfran...

Background. Injury to the Lisfranc interosseous ligament is currently managed with a screw. However, this can potentially further disrupt the ligament. The objective of this study was to observe the proximity of the screw or disruption it can cause at the ligament attachment sites. Methods. Twenty-three feet were studied. A 40-mm, 4.0, partially th...

Objective: This case report explores an effective treatment modality in a medically complicated patient, with considerable wound dehiscence refractory to treatment with negative pressure wound therapy (NPWT). Case report: A 35-year-old woman with a past medical history of hypothyroidism, osteoporosis, and rheumatoid arthritis treated with tumor...

Background: Although ethnic Hispanics originate from diverse, global communities, clinical investigations rarely explore the health of distinct subpopulations. Cancer is the leading cause of death for Hispanics worldwide. The impact of soft-tissue sarcomas (STS) in particular lack description, limiting prognostic insight at a clinical level. To our...

Background. There has been historical debate as to whether the distal tibiofibular syndesmosis can be overtightened during operative fixation. We used finite-element analysis to determine if overtightening of syndesmotic screws can cause widening of the lateral gutter clear space in the ankle joint. Methods. A 3D finite-element model was constructe...

Haglund’s deformity is a common cause of foot pain, with high success rates of surgical intervention. Because early weightbearing rehabilitation correlates with better surgical results, the integrity of anchors employed in these surgeries needs to be evaluated for proper fixation strength, leading to improved postoperative outcomes. The ultrasonica...

Background This study evaluates the safety of foot and ankle outpatient surgeries at a freestanding ambulatory surgery centers. Methods A total of 1352 cases were evaluated for adverse events in a retrospective review of all foot and ankle cases performed over a 5-year period at a single center. Results The rate of adverse events was 2.3%, with 3...

Case: A 33-year-old woman with Glanzmann thrombasthenia presented to us with a distal tibia nonunion. We attempted to treat her with a multiplanar ring external fixator, but the patient was unable to tolerate the correction, so we resorted to a tibiotalocalcaneal fusion. Hemostasis was difficult to achieve despite the use of antithrombinolytics, f...

Background: Chondrosarcoma is the third most common primary bone malignancy. For tumors located within the extremities, surgeons must choose between limb-salvage surgery (LSS) and limb amputation (LA) to achieve sufficient resection margins. The outcomes from these procedures in chondrosarcoma patients has limited descriptions in current literature...

Introduction: Malignant bone tumors with metastasis have great heterogeneity in prognosis. We conducted a retrospective study of patients with metastasized bone tumors to elucidate expected survival based on extent of metastasis. Methods: Cases of primary bone cancer presenting with metastasis between 2010 and 2015 from the Surveillance, Epidemi...

Introduction: Although primary tumor resection (PTR) is often performed for metastasized osteosarcoma, there is a lack of literature verifying its clinical effectiveness. To address this gap, we conducted a retrospective study to assess the value of primary tumor resection when treating metastasized osteosarcoma. Methods: Primary osteosarcoma ca...

Introduction: Amputation is a life-altering procedure that is used to treat patients with malignant tumors. Although marital status has been shown to impact prognosis in numerous cancers, its value as a prognostic factor for survival in cancer amputees has not been explored. Methods: Cancer patients aged older than 25 years treated with amputation...

Introduction Although primary tumor resection (PTR) is often performed for metastasized osteosarcoma, there is a lack of literature verifying its clinical effectiveness. To address this gap, we conducted a retrospective study to assess the value of primary tumor resection when treating metastasized osteosarcoma. Methods Primary osteosarcoma case...

Introduction Amputation is a life-altering procedure that is used to treat patients with malignant tumors. Although marital status has been shown to impact prognosis in numerous cancers, its value as a prognostic factor for survival in cancer amputees has not been explored. Methods Cancer patients aged older than 25 years treated with amputation...

Introduction Malignant bone tumors with metastasis have great heterogeneity in prognosis. We conducted a retrospective study of patients with metastasized bone tumors to elucidate expected survival based on extent of metastasis. Methods Cases of primary bone cancer presenting with metastasis between 2010 and 2015 from the Surveillance, Epidemiol...

Category Ethics Introduction/Purpose The objective of our study was to analyze COI nondisclosure for US based research articles that were published to three prevalent orthopaedic journals from the beginning of 2014 to the end of 2016. Methods All US-based research articles published to FAI, JBJS, and JOA from the beginning of 2014 to the end of 2...

Category Ankle, Hindfoot, Midfoot/Forefoot Introduction/Purpose Opioid utilization after foot and ankle surgery has received more attention recently with several papers publishing guidelines on the number of opioids to prescribe following surgery. To our knowledge the patient populations that have been studied in all of these papers are all privat...

Category Ankle, Ankle Arthritis, Arthroscopy, Basic Sciences/Biologics, Bunion, Hindfoot, Lesser Toes, Midfoot/Forefoot, Sports, Trauma Introduction/Purpose Managing post-operative pain in patients has become a growing concern given the increasing focus on controlling opioid use. Over the counter (OTC) analgesics such as tylenol and ibuprofen have...

Background: The Centers for Medicare & Medicaid Services (CMS) Open Payments public database, resulting from the Physician Payments Sunshine Act of 2010, was designed to increase transparency of physicians' financial relationships with pharmaceutical manufacturers. We compared physician-reported conflict-of-interest (COI) disclosures in journal ar...

Background: Hallux valgus has been associated with a widened forefoot. Most surgical procedures for the correction of hallux valgus have the potential to reduce forefoot width. Success after hallux valgus surgery is correlated with relief of toe pain in conventional shoes and improvement in the appearance of the foot. Therefore, reduction in forefo...

Category Total Ankle Arthroplasty Introduction/Purpose Although demand for total ankle arthroplasty (TAA) is increasing, access to high-volume TAA surgeons may vary in different geographic regions. Given that low-volume TAA surgeons have demonstrated higher revision rates compared to higher-volume surgeons, access to these high-volume centers is a...

Background: The goal of this systematic review is to determine the most commonly used outcome measurement tools used by foot and ankle specialists and determine their limitations, such as whether they are validated, have floor/ceiling effects, and so on. Methods: A literature search was conducted to identify primary publications between January...