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Alan Garrett, DPM

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NCBI: db=pubmed; Term=(Garrett A[Author]) AND (John Peter Smith[Affiliation] OR JPS Health Network[Affiliation] OR JPS [Affiliation] NOT Japan Pancreas Society[Affiliation])
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Ten-Year Follow-Up of Metatarsal Head Resurfacing Implants for Treatment of Hallux Rigidus.

Wed, 01/30/2019 - 07:24
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Ten-Year Follow-Up of Metatarsal Head Resurfacing Implants for Treatment of Hallux Rigidus.

J Foot Ankle Surg. 2017 Sep - Oct;56(5):1052-1057

Authors: Hilario H, Garrett A, Motley T, Suzuki S, Carpenter B

Abstract
Controversy remains regarding the use of arthroplasty versus arthrodesis in the surgical treatment of late-stage hallux rigidus. The purpose of our retrospective study was to report the long-term follow-up results of the metatarsal head resurfacing implant used for hemiarthroplasty. The patient assessments were conducted using the American Orthopaedic Foot and Ankle Society (AOFAS) metatarsophalangeal clinical rating system and a satisfaction questionnaire. A total of 59 consecutive implantations were performed from January 2005 to December 2009 at our institution. Of the 59 patients, 2 had died and 12 were lost to follow-up, for a 76.3% follow-up rate (45 of 59 procedures) at a mean of 117.67 (range 96 to 143) months. The mean overall AOFAS scale score was 90.6 ± 7.6. The AOFAS pain scale score was 37.78 ± 4.71. One implant was removed, and all remaining patients were happy with their outcome and would repeat the procedure on their other foot, if needed. A subset of patients from a previous mid-term study at our institution showed no significant change in the AOFAS scale scores. Of these 32 patients, 30 (93.75%) were available for follow-up examination at a mean of 122.62 (range 96 to 143) months. We were able to obtain long-term results for 32 implants (30 patients), resulting in a 10-year follow-up rate of 93.7%. With the minimal resection required for this implant, salvage arthrodesis remains a viable option if revision is needed. The surgical treatment of late-stage hallux rigidus with metatarsal head resurfacing allows for low-risk and excellent outcomes at long-term follow-up point.

PMID: 28842091 [PubMed - indexed for MEDLINE]

Plantar Shear Stress in Individuals With a History of Diabetic Foot Ulcer: An Emerging Predictive Marker for Foot Ulceration.

Wed, 01/30/2019 - 07:24
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Plantar Shear Stress in Individuals With a History of Diabetic Foot Ulcer: An Emerging Predictive Marker for Foot Ulceration.

Diabetes Care. 2017 02;40(2):e14-e15

Authors: Yavuz M, Ersen A, Hartos J, Schwarz B, Garrett AG, Lavery LA, Wukich DK, Adams LS

PMID: 27899495 [PubMed]

Comparing the Knotless Tension Band and the Traditional Stainless Steel Wire Tension Band Fixation for Medial Malleolus Fractures: A Retrospective Clinical Study.

Wed, 01/30/2019 - 07:24
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Comparing the Knotless Tension Band and the Traditional Stainless Steel Wire Tension Band Fixation for Medial Malleolus Fractures: A Retrospective Clinical Study.

Scientifica (Cairo). 2016;2016:3201678

Authors: Downey MW, Duncan K, Kosmopoulos V, Motley TA, Carpenter BB, Ogunyankin F, Garrett A

Abstract
The traditional stainless steel wire tension band (WTB) has been popularized for small avulsion fractures at the medial malleolus. Despite the tension band principle creating a stable construct, complications continue to arise utilizing the traditional stainless steel WTB with patients experiencing hardware irritation at the tension band site and subsequent hardware removal. Coupled with hardware irritation is fatigue failure with the wire. The goal of this investigation was to retrospectively compare this traditional wire technique to an innovative knotless tension band (KTB) technique in order to decrease costly complications. A total of 107 patients were reviewed with a minimum follow-up of 1 year. Outcome measures include descriptive data, fracture classification, results through economic costs, and fixation results (including hardware status, healing status, pain status, and time to healing). The KTB group had a 13% lower true cost as compared to the WTB group while the fixation results were equivocal for the measured outcomes. Our results demonstrate that the innovative KTB is comparable to the traditional WTB while offering a lower true cost, an irritation free reduction all without the frustration of returning to the operating room for additional hardware removal, which averages approximately to $8,288.

PMID: 27293969 [PubMed]

Peak Plantar Shear and Pressure and Foot Ulcer Locations: A Call to Revisit Ulceration Pathomechanics.

Wed, 01/30/2019 - 07:24
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Peak Plantar Shear and Pressure and Foot Ulcer Locations: A Call to Revisit Ulceration Pathomechanics.

Diabetes Care. 2015 Nov;38(11):e184-5

Authors: Yavuz M, Master H, Garrett A, Lavery LA, Adams LS

PMID: 26370381 [PubMed]

Association Between Plantar Temperatures and Triaxial Stresses in Individuals With Diabetes.

Wed, 01/30/2019 - 07:24
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Association Between Plantar Temperatures and Triaxial Stresses in Individuals With Diabetes.

Diabetes Care. 2015 Nov;38(11):e178-9

Authors: Yavuz M, Brem RW, Glaros AG, Garrett A, Flyzik M, Lavery L, Davis BL, Hilario H, Adams LS

PMID: 26316629 [PubMed]

Surgical treatment of hallux rigidus using a metatarsal head resurfacing implant: mid-term follow-up.

Wed, 01/30/2019 - 07:24
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Surgical treatment of hallux rigidus using a metatarsal head resurfacing implant: mid-term follow-up.

J Foot Ankle Surg. 2010 Jul-Aug;49(4):321-5

Authors: Carpenter B, Smith J, Motley T, Garrett A

Abstract
The treatment of advanced hallux rigidus remains controversial, with many authors discussing arthrodesis versus arthroplasty. The purpose of this study is to report mid-term outcomes after implantation of a motion-preserving metatarsal head-resurfacing prosthetic and to present our technical considerations and modifications to the published technique to further enhance the clinical benefit of the procedure. Thirty-two implantations were performed in 30 patients. Twenty-three patients were women, 9 men. The average age was 62.8 years (range, 39-86 years). Patients were graded at baseline according to Hattrup and Johnson and completed the American Orthopaedic Foot & Ankle Surgery metatarsophalangeal clinical rating system preoperatively and postoperatively and a patient satisfaction question at final follow-up. Seventy-two percent of implantations were grade III hallux rigidus and 28% were grade II. The average follow-up was 27.3 months (range, 12-43 months). The mean change score for the overall American Orthopaedic Foot & Ankle Surgery scale was 236.8% (SD = 146.62, confidence interval [CI] = 186-287.6). A similar result was achieved between grade II (250.9%, SD = 240.3, CI = 93.9-407.9) and grade III (231.3%, SD = 95.83, CI = 195.14-270.46). No implants were revised or removed, and all patients stated that they were happy with their outcome and would repeat the procedure again if needed. In conclusion, metatarsal head resurfacing in combination with joint decompression, soft tissue mobilization, and debridement can achieve excellent results in grade II and III hallux rigidus. Salvage arthrodesis remains an option if future revisions are indicated.

PMID: 20610200 [PubMed - indexed for MEDLINE]

Evaluation of fibula free flap donor site morbidity.

Wed, 01/30/2019 - 07:24
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Evaluation of fibula free flap donor site morbidity.

Am J Otolaryngol. 2006 Jan-Feb;27(1):29-32

Authors: Garrett A, Ducic Y, Athre RS, Motley T, Carpenter B

Abstract
OBJECTIVE: To evaluate foot and ankle function in a series of patients undergoing fibula microvascular free tissue transfer.
STUDY DESIGN: A nonrandomized, nonblinded analysis was performed using the ankle-hindfoot scale as well as radiographic analysis to determine donor site morbidity.
RESULTS: Overall, foot ankle function was deemed to be good in this series of patients. Average ankle-hindfoot score was 84.82 of a possible 100 (range, 55-100). Radiographic analysis of donor and contralateral ankles showed no difference in the syndesmotic space or medial clear space. Only 1 patient had increased talar tilt compared with the contralateral side, although this patient had preservation of stability.
CONCLUSION: Fibula free flap harvest appears to be associated with acceptable donor site morbidity and preservation of good foot and ankle function in most individuals.

PMID: 16360820 [PubMed - indexed for MEDLINE]

Using a hook plate as alternate fixation for fifth metatarsal base fracture.

Wed, 01/30/2019 - 07:24
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Using a hook plate as alternate fixation for fifth metatarsal base fracture.

J Foot Ankle Surg. 2003 Sep-Oct;42(5):315-6

Authors: Carpenter B, Garrett A

PMID: 14566727 [PubMed - indexed for MEDLINE]