Daniel L Latt

Interests

Research

Dr. Latt's research interest is in using the principles of biomechanics to solve clinical problems in orthopaedics. He has four major research areas (1) Degenerative disease of tendons (tendinosis), (2) The role of alignment in the health and disease of the lower extremity, (3) Movement analysis as a functional outcome measure, and (4) Optimization of medical workflow using task analysis and modeling.

Teaching

Teaching - Dr. Latt has been active as a teacher in every part of his work. He has utilized a variety different teaching methods, including: informal teaching during clinic, didactic teaching through medical grand rounds and engineering course lectures, and mentorship of students in the lab.Clinical teaching – Dr. Latt has worked with medical students, orthopaedic surgery residents, family medicine residents and emergency medicine residents in both the clinic and in the operating room since starting in practice. Over the past 5 years, he has trained 15 orthopaedic residents and approximately 4 times as many primary care residents on the sports medicine rotation. During these informal teaching sessions he has focused on critical thinking and on the application of basic principles of anatomy and biomechanics to the diagnosis and treatment decision making for musculoskeletal disorders.Didactic teaching – Dr. Latt has also engaged in formal teaching through grand rounds, biomedical engineering lectures, and public colloquia. Over the past 5 years, he has given 15 orthopaedic, rheumatology, and emergency medicine grand rounds lectures covering clinical topics in foot and ankle surgery and sports medicine. He has also given 7 lectures for biomedical engineering undergraduate and graduate students including BME 295C-Challenges in biomedical engineering, BME 497G- clinical topics in biomedical engineering, and BME 566 - biomechanics. Finally, He has given 10 public talks covering a wide variety of topics from ankle arthritis, to overuse injuries in cycling, to training for a career as a clinician-scientist. He has made these lectures engaging and interactive.Research mentorship - Over the past 3 years, he has had the privilege of teaching the students in his lab about research design, research methodology, musculoskeletal anatomy and orthopaedic biomechanics. Over 60 graduate and undergraduate students from biomedical engineering, mechanical engineering, systems and industrial engineering, honors physiology, and nursing students have participated in his lab. He particularly enjoys providing career mentoring for a number of physiology and biomedical engineering undergraduate students who have gone on to medical school. He has on the masters thesis committee for 5 engineering students and on the doctoral dissertation committee for 2 engineering students.

Courses

Scholarly Contributions

Chapters

• Latt, D. L. (2024). Chapter 18: Débridement, Repair, and Regeneration of Osteochondral Lesions of the Talus. . In Master Techniques in Orthopaedic Surgery: The Foot and Ankle, 4th Edition(pp 299-316). Wolters Kluwer.
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  Master Techniques in Orthopaedic Surgery: The Foot and Ankle, 4th Edition. Chapter 18: Débridement, Repair, and Regeneration of Osteochondral Lesions of the Talus. Editor: Scott Ellis, MD. Wolters Kluwer Publisher, May 2024. Pages 299-316
• Latt, D. L. (2015). Complications of Total Ankle Arthroplasty. In The Atlas of Ankle Replacement. London, UK: Imperial College Press.
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  DeOrio JK, Latt LD. Complications of Total Ankle Arthroplasty. The Atlas of Ankle Replacement Cooke P and Goldberg A Editors. London, UK: Imperial College Press. In Press.
• Latt, D. L. (2018). High-Resolution Ultrasound and MRI Imaging of Peroneal Tendon Injuries.. In Peroneal Tendons – A Clinical Guide to Evaluation and Management..
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  Latt LD, Taljanovic MS. High-Resolution Ultrasound and MRI Imaging of Peroneal Tendon Injuries. Peroneal Tendons – A Clinical Guide to Evaluation and Management. Mark Sobel, MD, Editor. Springer Publishing. Manuscript chapter in process.
• Latt, D. L. (2020). Complications of Total Ankle Arthroplasty. In The Atlas of Ankle Replacement. World Scientific.
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  DeOrio JK, Latt LD. The Atlas of Ankle Replacements. Chapter 11: Complications of Total Ankle Replacement. Andrew Goldberg and Paul Cooke, Eds. December 2020, World Scientific Publishing. Pages 301–344.
• Latt, D. L. (2020). High Resolution Ultrasound and MRI Imaging of Peroneal Tendon Injuries. In The Peroneal Tendons – A Clinical Guide to Evaluation and Management.. Springer Publishing.
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  Latt LD, Kuyumcu G, Taljanovic MS. The Peroneal Tendons – A Clinical Guide to Evaluation and Management. Chapter 5: High Resolution Ultrasound and MRI Imaging of Peroneal Tendon Injuries. Mark Sobel, MD, Editor. June 2020, New York, NY: Springer Publishing. Pages 97-124.

Journals/Publications

• Ambus, N., Swiergol, M., Sherman, N., & Latt, L. (2024). Lower Extremity Hockey Puck Impaction Fractures in Professional Hockey Players: A Case Series and Review of the Literature. Foot and Ankle Specialist. doi:10.1177/19386400241268354
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  Hockey is a contact sport notorious for injuries. The hockey puck is a projectile that can impart substantial energy when it impacts a player. Hockey puck impact is a frequent and underreported cause of injury. This case report describes the clinical course of 3 professional hockey players who sustained injuries to the lower leg and ankle from projectile hockey pucks. Each player sustained a unique injury with associated complications affecting return to play. We aim to bring attention to this injury mechanism that can cause significant morbidity among players. Levels of Evidence: IV
• Ayala, A. E., Khwaja, A., Goodison, B. C., Smith, S. L., Kim, S. Y., Irwin, J. T., & Latt, L. D. (2024). Effect of Fibular Malrotation on Tibiotalar Joint Contact Mechanics in a Weber B Ankle Fracture Model. Foot and Ankle Specialist, 17(Issue 6). doi:10.1177/19386400221127835
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  Background: In minimally displaced Weber B ankle fractures, the distal fibular fracture fragment can be externally rotated. This malrotation is difficult to detect on radiographs and, when left malreduced through nonoperative treatment, may contribute to altered joint mechanics, predisposing to posttraumatic osteoarthritis. This study evaluates the effects of fibular malrotation on tibiotalar joint contact mechanics. Methods: Six cadaveric ankles were tested using a materials testing system (MTS) machine. A tibiotalar joint sensor recorded contact area and pressure. Samples were tested in the intact, neutrally rotated, and malrotated state. Each trial applied a 686N axial load and a 147N Achilles tendon load in neutral position, 15° dorsiflexion, and 15° plantarflexion. Results: In the comparison of malrotated to intact ankles, peak contact pressure was found to be significantly greater at neutral flexion (intact 5.56 MPa ± 1.39, malrotated 7.21 MPa ± 1.07, P =.03), not significantly different in dorsiflexion, and significantly decreased in plantarflexion (intact 11.2 MPa ± 3.04, malrotated 9.01 MPa ± 1.84, P =.01). Significant differences in contact area were not found between conditions. Conclusion: The findings suggest that fibular malrotation contributes to significant alterations in tibiotalar joint contact pressures, which may contribute to the development of posttraumatic osteoarthritis. When malrotation of the fibula is suspected on plain radiographs, a computer tomography (CT) scan should be obtained to evaluate its extent and further consideration should be given to surgical treatment. Levels of Evidence: Level V: Bench testing
• Estes, W., Latt, L., Robishaw-Denton, J., Repp, M., Suri, Y., Chadaz, T., Boulton, C., & Riaz, T. (2024). Musculoskeletal manifestations of lower-extremity coccidioidomycosis: a case series. Journal of Bone and Joint Infection, 9(4). doi:10.5194/jbji-9-197-2024
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  Background: Coccidioidomycosis is a fungal infection endemic to the southwestern United States. Musculoskeletal manifestations are uncommon and seen in disseminated disease. While the involvement of the axial skeleton has been well described, the literature is limited on diseases involving the lower extremity. Methods: We identified three patients, at two regional academic medical centers in southern Arizona, who demonstrated different manifestations of osteoarticular coccidioidomycosis involving the lower extremity. Results: Case 1 is a 41-year-old male, with a history of HIV/AIDS and vertebral coccidioidomycosis, who presented with abscesses in the left hemipelvis and left proximal femoral osteomyelitis. He was treated with staged surgical debridement, including the use of amphotericin B impregnated beads. He remains on indefinite oral posaconazole suppression. Case 2 is a 46-year-old female, who presented with suspected right knee osteoarthritis. An MRI revealed septic arthritis and osteomyelitis. Necrotic bone was debrided, and synovial fluid cultures were positive for Coccidioides. She underwent a resection of the native knee joint with the insertion of an amphotericin B and voriconazole impregnated spacer. She continues oral itraconazole and awaits a total knee arthroplasty. Case 3 is a 76-year-old male, who presented with a draining right heel ulcer. Radiographs revealed bony destruction consistent with Charcot arthropathy. Irrigation and debridement revealed the gelatinous destruction of the talus and calcaneus, and cultures confirmed Coccidioides infection. A polymethyl methacrylate voriconazole spacer was placed. He subsequently underwent arthrodesis and remains on lifelong fluconazole. Conclusion: Lower-extremity osteoarticular coccidioidomycosis has various debilitating presentations that frequently mimic non-infectious etiologies. Treatment warrants surgical debridement, and prolonged antifungal therapy should be considered.
• Latt, D. L. (2024).

  Ambus NG, Swiergol M, Sherman NC, Latt LD. Lower Extremity Hockey Puck Impaction Fractures in Professional Hockey Players: A Case Series and Review of the Literature. Foot & Ankle Specialist 2024;0(0):19386400241268354. doi: 10.1177/19386400241268354.

  . Foot & Ankle Specialist. doi:10.1177/19386400241268354.
• Latt, D. L. (2024).

  Estes W, Latt LD, Robishaw-Denton J, et al. Musculoskeletal manifestations of lower-extremity coccidioidomycosis: a case series. Journal of Bone and Joint Infection July 2024;9(4):197-205. doi: 10.5194/jbji-9-197-2024

  . Journal of Bone and Joint Infection 2024, 197-205. doi:10.5194/jbji-9-197-2024
• Latt, D. L. (2024). Latt LD, Kim W, Caruso CC, Krupinski EA, Zuniga AAN, Syal A, Taljanovic MS. Ultrasound Shear Wave Elastography of the Arch-Supporting Structures in Symptomatic Flatfoot: A Pilot Study. Foot Ankle Orthop. 2024 Oct 8;9(4):24730114241281894. doi: 10.1177/24730114241281894. PMID: 39429533; PMCID: PMC11490983.. Foot Ankle Orthop, 9(4).
• Latt, D. L. (2024). Melville DM, Taljanovic MS, Gimber LH, Miller M, Ahmad A, Sepich D, Latt LD. Comparison of Ultrasound and MRI with Intraoperative Findings in the Diagnosis of Peroneal Tendinopathy, Tears, and Subluxation. J Clin Med. 2024 Jan 27;13(3):740. doi: 10.3390/jcm13030740. PMID: 38337434; PMCID: PMC10856550.. J Clin Med, 13(3). doi:doi: 10.3390/jcm13030740
• Latt, D. L. (2024). Renfree S, Malakoutikhah H, Borgstrom M, Latt LD. An ex vivo sequential ligament transection model of flatfoot. Clin Biomech (Bristol). 2024 Aug;118:106302. doi: 10.1016/j.clinbiomech.2024.106302. Epub 2024 Jul 6. PMID: 39047409.. Clin Biomech (Bristol. doi:doi: 10.1016/j.clinbiomech.2024.106302
• Latt, L., Kim, W., Caruso, C., Krupinski, E., Zuniga, A., Syal, A., & Taljanovic, M. (2024). Ultrasound Shear Wave Elastography of the Arch-Supporting Structures in Symptomatic Flatfoot: A Pilot Study. Foot and Ankle Orthopaedics, 9(4). doi:10.1177/24730114241281894
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  Background: The posterior tibial tendon (PTT), deltoid ligament, and spring ligament are often torn or attenuated in patients with progressive collapsing foot deformity. The goal of this pilot study was to measure the ultrasound shear wave velocity (SWV) of these arch-supporting structures in feet with varying degrees of deformity to improve our understanding of their role in the progression of deformity. Methods: Two observers measured the SWV of the supramalleolar and inframalleolar PTT in long and short axes, in the tibiospring portion of the deltoid ligament, and in the superomedial band of the spring ligament in 8 neutrally aligned feet, 5 asymptomatic flatfeet, and 7 symptomatic flatfeet. Each measurement was repeated 3 times both with and without an applied eversion stress. Results: Average SWV was lower at all locations in the symptomatic flatfeet compared with normal feet, but these differences were statistically significant only for the inframalleolar PTT and the spring ligament. Externally applied stress led to an increase in the SWV of the ligaments but a paradoxical decrease in the SWV in the supramalleolar PTT. The SWV of the PTT was lower along the short axis compared with the long axis. Conclusion: SWV may be useful in evaluating the severity of degenerative disease of arch-supporting structures, but further study is needed before this technique can be applied clinically. Level of Evidence: Level III, case-control study.
• Melville, D. M., Taljanovic, M. S., Gimber, L. H., Miller, M., Ahmad, A., Sepich, D., & Latt, L. D. (2024). Comparison of Ultrasound and MRI with Intraoperative Findings in the Diagnosis of Peroneal Tendinopathy, Tears, and Subluxation. Journal of Clinical Medicine, 13(Issue 3). doi:10.3390/jcm13030740
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  Suspected peroneal tendinopathy, tears, and subluxation are often confirmed preoperatively using magnetic resonance imaging (MRI) or diagnostic ultrasound (US). No study has directly compared the accuracy of these tests for the diagnosis of peroneal tendon pathology. The purpose of this study is to directly compare MRI and US to intraoperative findings in patients who underwent surgery for suspected peroneal pathology to determine the imaging diagnostic accuracy. Operative records and diagnostic images for 21 consecutive patients who had both MRI and US prior to surgery for suspected peroneal tendinopathy, tears, or subluxation were retrospectively reviewed. The results of this review are compared with the intraoperative findings to yield the sensitivity and specificity for each imaging modality. For the diagnosis of peroneal tendon tears, US was found to have a sensitivity of 88% and specificity of 100%, compared to 100% sensitivity and specificity for MRI. In the diagnosis of peroneal tendinopathy, both US and MRI had a sensitivity and specificity of 100%. In diagnosing peroneal subluxation, US was 100% sensitive compared to 66% for MRI, and both were 100% specific. In conclusion, US was found to be more effective in diagnosing peroneal subluxation and MRI was slightly more accurate in the diagnosis of peroneal tendon tears.
• Renfree, S., Malakoutikhah, H., Borgstrom, M., & Latt, L. (2024). An ex vivo sequential ligament transection model of flatfoot. Clinical Biomechanics, 118(Issue). doi:10.1016/j.clinbiomech.2024.106302
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  Background: The ligaments implicated in the earliest stages of developing a progressive collapsing foot deformity are poorly understood. Commonly employed cadaveric flatfoot models are created from simultaneous transection of multiple ligaments, making it difficult to assess early changes in pressure distribution from ligaments critical for maintaining load distribution. A serial transection of ligaments may provide insight into changes in pressure distribution under the foot to identify a potential combination of ligaments that may be involved in early deformities. Methods: Specimens were loaded using a custom designed axial and tendon loading system. Plantar pressure data for the forefoot and hindfoot were recorded before and after six sequential ligament complex transections. Findings: Sectioning the plantar fascia (first) and short/long plantar ligaments (second) failed to generate appreciable differences in load distribution. Dividing the spring ligament (third) led to changes in hindfoot load distribution with a shift towards the lateral column indicative of hindfoot valgus angulation. All subsequent conditions resulted in similar patterns in hindfoot plantar load distribution. An anterior shift in the center of pressure only occurred after transection of all six ligament complexes. Interpretation: Loss of the plantar fascia and short/long plantar ligaments are not critical in maintaining plantar load distribution or contact area. However, the additional loss of the spring ligament caused notable changes in hindfoot load distribution, indicating the combination of these three ligament complexes is particularly critical for preventing peritalar subluxation. Minimal changes in load distribution occurred when performing additional transections to reach a complete flatfoot deformity.
• Daniel Latt, L. (2023). Republication of “FAO: The Open Source for High-quality Peer Reviewed Orthopaedic Foot and Ankle Content”. Foot and Ankle Orthopaedics, 8(Issue 3). doi:10.1177/24730114231188081
• Daniel Latt, L., & Farber, D. (2023). Republication of “FAO Essential Reviews”. Foot and Ankle Orthopaedics, 8(3). doi:10.1177/24730114231195064
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  Anatomic lateral ankle ligament reconstruction using free tendon graft with osseous tunnels has become a popular technique for revision reconstruction of the lateral ankle ligaments. With the procedure’s burgeoning popularity, an accompanying increase in postoperative complications is likely to occur. We report on one such complication: traumatic distal fibula fracture through the transosseous tunnels.
• Latt, D. L. (2023). Malakoutikhah H, Latt LD. Disease-Specific Finite element Analysis of the Foot and Ankle. Foot Ankle Clin. 2023 Mar;28(1):155-172. doi: 10.1016/j.fcl.2022.10.007. Epub 2023 Jan 2. PMID: 36822685. Foot and Ankle Clinics.
• Latt, L. D. (2023). Republication of “Editor’s Response to ‘Letter Regarding: A Novel Casting Technique for Tongue-Type Calcaneus Fractures with Soft Tissue Compromise’”. Foot and Ankle Orthopaedics, 8(Issue 3). doi:10.1177/24730114231188119
• Malakoutikhah, H., Madenci, E., & Latt, L. D. (2023). A computational model of force within the ligaments and tendons in progressive collapsing foot deformity. Journal of Orthopaedic Research, 41(Issue 2). doi:10.1002/jor.25380
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  Progressive collapsing foot deformity results from degeneration of the ligaments and posterior tibial tendon (PTT). Our understanding of the relationship between their failures remains incomplete. We sought to improve this understanding through computational modeling of the forces in these soft tissues. The impact of PTT and ligament failures on force changes in the remaining ligaments was investigated by quantifying ligament force changes during simulated ligament and tendon cutting in a validated finite element model of the foot. The ability of the PTT to restore foot alignment was also evaluated by increasing the PTT force in a foot with attenuated ligaments and comparing the alignment angles to the intact foot. We found that failure of any one of the ligaments led to overloading the remaining ligaments, except for the plantar naviculocuneiform, first plantar tarsometatarsal, and spring ligaments, where removing one led to unloading the other two. The combined attenuation of the plantar fascia, long plantar, short plantar, and spring ligaments significantly overloaded the deltoid and talocalcaneal ligaments. Isolated PTT rupture had no effect on foot alignment but did increase the force in the deltoid and spring ligaments. Moreover, increasing the force within the PTT to 30% of body weight was effective at restoring foot alignment during quiet stance, primarily through reducing hindfoot valgus and forefoot abduction as opposed to improving arch collapse. Our findings suggest that early intervention might be used to prevent the progression of deformity. Moreover, strengthening the PTT through therapeutic exercise might improve its ability to restore foot alignment.
• Latt, D. L. (2018). Gait alterations in posterior tibial tendonitis: a systematic review and meta-analysis". Foot & Ankle International.
• Latt, D. L. (2019). Evaluation and treatment of chronic plantar fasciitis.. Foot & Ankle Orthopaedics., TBD.
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  Latt LD, Jaffe D, Tang Y, Taljanovic M. Evaluation and treatment of chronic plantar fasciitis.” Accepted for publication November 27, 2019 in Foot & Ankle Orthopaedics.
• Latt, D. L. (2019). Peer Reviewed Abstract: Tracking Patient Outcomes Following Foot and Ankle Surgery: The OFAR experience 2018-2019. AOFAS Annual Meeting, September 12-15, 2019, Chicago, IL..
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  Hunt K, Latt LD. Tracking Patient Outcomes Following Foot and Ankle Surgery: The OFAR experience 2018-2019. Abstract submitted and pending acceptance for the AOFAS Annual Meeting, September 12-15, 2019, Chicago, IL.
• Latt, D. L. (2022).

  Estes W, Syal A, Latt LD. Biomechanical Effects of Surgical Reconstruction for Flexible Progressive Collapsing Foot Deformity: A Systematic Review. Foot Ankle Spec. 2022 Dec 13:19386400221139335. doi: 10.1177/19386400221139335. Epub ahead of print. PMID: 36510833.

  . Foot & Ankle Specialist.
• Latt, D. L. (2022). The Contribution of the Ligaments in Progressive Collapsing Foot Deformity: A Comprehensive Computational Study. . Journal of Orthopaedic Research. doi:https://doi.org/10.1002/jor.25244
• Latt, D. L. (2022). The The impact of ligament tears on joint contact mechanics in progressive collapsing foot deformity: A finite element study. . Clinical Biomechanics, 94.
• Latt, D. L. (2022). A Computational Model of Force within the Ligaments and Tendons in Progressive Collapsing Foot Deformity.. Journal of Orthopaedic Research. doi:doi.org/10.1002/jor.25380
• Latt, D. L. (2022). Biomechanical effects of surgical reconstruction for flexible progressive collapsing foot deformity: A systematic review. . Foot & Ankle Specialist. doi:DOI: 10.1177/19386400221139335
• Latt, D. L. (2022). Postural Control Differences between Patients with Posterior Tibial Tendon Dysfunction and Healthy People during Gait.. International Journal of Environmental Research and Public Health, 19(3).
• Latt, D. L. (2022). See attached: The contribution of the ligaments in progressive collapsing foot deformity: A comprehensive computational study. Journal of Orthopaedic Research. doi:DOI: 10.1002/jor.25244
• Latt, D. L., & Latt, D. L. (2022). Postural Control Differences between Patients with Posterior Tibial Tendon Dysfunction and Healthy People during Gait (as part of the Special Issue Advances in Kinesiology and Health. International Journal of Environmental Research and Public Health.
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  From: ijerph@mdpi.comDate: January 24, 2022 at 08:14:28 MSTTo: Jwang@khu.ac.kr, "Latt, Daniel L - (dlatt)" , RDMartin@uams.edu, erinmannen@boisestate.eduCc: billing@mdpi.com, website@mdpi.com, ijerph@mdpi.com, ristov@mdpi.com, isobel.luan@mdpi.comSubject: [EXT][IJERPH] Manuscript ID: ijerph-1556379; doi: 10.3390/ijerph19031301. Paper has been published.Reply-To: isobel.luan@mdpi.com, ijerph@mdpi.comExternal EmailDear Authors,We are pleased to inform you that your article "Postural Control Differences between Patients with Posterior Tibial Tendon Dysfunction and Healthy People during Gait" has been published in IJERPH as part of the Special Issue Advances in Kinesiology and Health and is available online:Abstract: https://www.mdpi.com/1660-4601/19/3/1301PDF Version: https://www.mdpi.com/1660-4601/19/3/1301/pdfThe meta data of your article, the manuscript files and a publication certificate are available here (only available to corresponding authors after login):https://susy.mdpi.com/user/manuscripts/review_info/783055e29f2fe6a8dcfa25010993b7c8Special Issue: https://www.mdpi.com/journal/ijerph/special_issues/Kinesiology_HealthPlease note that this is an early access version. The complete PDF, HTML, and XML versions will be available soon. Please take a moment to check that everything is correct. You can reply to this email if there is a problem. If any errors are noticed, please note that all authors must follow MDPI's policy on updating published papers, found here: https://www.mdpi.com/ethics#16.
• Latt, D. L., Muthukumar, S., Valerdi, R., Monreal, J., Austin, E. T., & Head, L. (2016). Modeling Physician Workflow for Process Improvement. Journal of Enterprise Transformation..
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  Muthukumar SRK, Valerdi R, Latt LD, Monreal J, Head L, Austin ET. Modeling Physician Workflow for Process Improvement.” Manuscript ID#: UJET-2016-0008. Revised and resubmitted September 13, 2016 (original submission February 29, 2016) to Journal of Enterprise Transformation..
• Latt, L. D., Syal, A., & Estes, W. (2022). Biomechanical Effects of Surgical Reconstruction for Flexible Progressive Collapsing Foot Deformity: A Systematic Review. Foot and Ankle Specialist. doi:10.1177/19386400221139335
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  Symptomatic progressive collapsing foot deformity (PCFD) is frequently treated with reconstructive surgery. Multiple studies have documented successful treatment based on improvements in symptoms and physical examination findings. However, it is not well-established whether there are corresponding improvements in gait function following surgical treatment for PCFD.A systematic review of biomechanical outcomes of treatments for flexible PCFD was conducted on PubMed. The 4 articles chosen involved patients with symptomatic flexible PCFD who underwent a reconstructive surgery. Surgical interventions included osteotomy, tendon transfer, and/or ligament repair or reconstruction. Primary outcomes involved objective quantifiable measurements of kinematic, kinetic, or temporospatial parameters.The initial search yielded 605 articles, from which 26 were retained after screening the title and abstract. Twenty-two were eliminated yielding 4 articles. Temporospatial, kinematic, and kinetic parameters were all altered after the patients underwent surgical intervention. Specifically, stride length, cadence, and walking speed all improved postoperatively. Walking kinetics also improved with restoration of normal motion in the frontal and sagittal planes and improvements in the dorsiflexion angle. There were also improvements in sagittal power.Surgical intervention to treat flexible PCFD improves objective biomechanical outcomes; however, more follow-up studies are needed to establish the reliability and durability of these improvements.Level III: Systematic review.
• Malakoutikhah, H., de Cesar Netto, C., Madenci, E., & Latt, L. D. (2022). Evaluation of assumptions in foot and ankle biomechanical models. Clinical Biomechanics, 100(Issue). doi:10.1016/j.clinbiomech.2022.105807
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  Background: A variety of biomechanical models have been used in studies of foot and ankle disorders. Assumptions about the element types, material properties, and loading and boundary conditions are inherent in every model. It was hypothesized that the choice of these modeling assumptions could have a significant impact on the findings of the model. Methods: We investigated the assumptions made in a number of biomechanical models of the foot and ankle and evaluated their effects on the results of the studies. Specifically, we focused on: (1) element choice for simulation of ligaments and tendons, (2) material properties of ligaments, cortical and trabecular bones, and encapsulating soft tissue, (3) loading and boundary conditions of the tibia, fibula, tendons, and ground support. Findings: Our principal findings are: (1) the use of isotropic solid elements to model ligaments and tendons is not appropriate because it allows them to transmit unrealistic bending and twisting moments and compressive forces; (2) ignoring the difference in elastic modulus between cortical and trabecular bones creates non-physiological stress distribution in the bones; (3) over-constraining tibial motion prevents anticipated deformity within the foot when simulating foot deformities, such as progressive collapsing foot deformity; (4) neglecting the Achilles tendon force affects almost all kinetic and kinematic parameters through the foot; (5) the axial force applied to the tibia and fibula is not equal to the ground reaction force due to the presence of tendon forces. Interpretation: The predicted outcomes of a foot model are highly sensitive to the model assumptions.
• Turker, T., Latt, D. L., & Reyes, MS3, R. (2018). A cuneiform reformation following gunshot wound to the foot.. Foot & Ankle Orthopaedics Journal.
• Latt, D. L. (2021). Imaging and Treatment of Posttraumatic Ankle and Hindfoot Osteoarthritis. Journal of Clinical Medicine, 10(24), 5848. doi:doi.org/10.3390/jcm10245848
• Latt, D. L. (2021). Mechanical Effects of Lag Screw Retightening in a Simulated Hindfoot Arthrodesis Model.. Foot & Ankle Orthopaedics, 6(2).
• Latt, D. L. (2021). Return to Play Rates in NFL Wide Receivers and Running Backs After ACL Reconstruction: An Updated Analysis. Orthopaedic Journal of Sports Medicine, 9(1). doi:https://doi.org/10.1177/2325967120974743
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  ).
• Latt, D. L. (2021). Ultrasound Shear Wave Elastography of the Anterior Talofibular and Calcaneofibular Ligaments in Healthy Subjects. Journal of Ultrasound in Medicine, 21(85), e86-e94. doi:10.15557/JoU.2021.0017
• Latt, L. D., Taljanovic, M. S., Klauser, A., Krupinski, E. A., Zuniga, A. A., Caruso, C., & Gimber, L. H. (2021). Ultrasound shear wave elastography of the anterior talofibular and calcaneofibular ligaments in healthy subjects. Journal of Ultrasonography. doi:10.15557/jou.2021.0017
• Latt, L. D., & Farber, D. C. (2020). FAO Essential Reviews, Part III. Foot and Ankle Orthopaedics, 5(Issue 3). doi:10.1177/2473011420932183
• Latt, L. D., Alvarez, A., Son, M. M., Johnson, B. W., Requist, M. R., & Rugg, A. L. (2020). Does Lag Screw Retightening Improve Compression in Hindfoot Arthrodesis?. Foot & Ankle Orthopaedics. doi:10.1177/2473011420s00076
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  Category: Hindfoot; Ankle; Ankle Arthritis Introduction/Purpose: Non-union and delayed union are common complications following hindfoot arthrodesis. The failure to obtain and maintain compression at the arthrodesis site may be a causative factor. Partially threaded cannulated ‘lag’ screws are commonly used for fixation in hindfoot arthrodesis; however, the ability of these screws to maintain compression in the hindfoot bones has not been well-characterized. The goals of this work were to: 1) quantify the stress relaxation response of hindfoot bones when compressed with a lag screw, particularly compression change upon screw retightening, and 2) compare the results to prior studies on stress relaxation in direct bone compression. Methods: 12 pairs of calcaneus, talus and tibia bone cylinders, 25mm in diameter, were cut with a keyhole saw from fresh thawed cadaveric feet. The bone cylinders were prepared for simulated arthrodesis by removing the cartilage and flattening the subchondral surface with an oscillating saw. A Futek LTH 300 donut load cell and two metal washers were sandwiched between the two bone cylinders. An 8.0mm partially threaded cannulated lag screw (Smith and Nephew) was placed from the posterior- inferior aspect of the calcaneus cylinder to the anterior-superior aspect of the talus cylinder to simulate subtalar arthrodesis, or from the superior aspect of the tibia cylinder to the inferior aspect of the talus cylinder. Compression was recorded continuously as the screws were tightened by three-quarters of a turn and left untouched for 3 minutes. Recording continued as the screws were retightened one quarter-turn and then left untouched for 30 additional minutes. Results: Both initial and subsequent compression with a lag screw demonstrated a stress relaxation pattern, with increased maximum compression and slowed decay upon retightening. Maximum compression after three quarter-turns and retightening averaged 284 N and 351 N, respectively (n=12; t=-2.55; p=0.0136). Time to decay to 80% of maximum compression after three quarter-turns and retightening averaged 34 and 528 (n=9; t=-2.59; p=0.0159) seconds, respectively, compared to 21 seconds for direct compression. Compression loss 30 minutes after retightening averaged 25.5% (SD=8.8%), compared to 34.3% for direct compression. Conclusion: The maximum compression attained following retightening was significantly greater than the maximum compression attained after initial tightening. The time required to reach 80% of maximum compression was significantly longer after subsequent compared to initial maximum compression. These findings suggest that screw retightening before surgical wound closure may slow compression loss, which could increase the likelihood of successful arthrodesis. Lag screw compression resulted in a lower percent compression loss and loss rate compared to direct compression, which was previously used to describe bone viscoelasticity.
• Latt, L. D., Tang, Y., Taljanovic, M. S., Latt, L. D., & Jaffe, D. E. (2020). Evaluation and Treatment of Chronic Plantar Fasciitis. Foot & Ankle Orthopaedics, 5(1), 247301141989676. doi:10.1177/2473011419896763
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  Plantar fasciitis is the most common cause of chronic heel pain in adults, affecting both young active patients and older sedentary individuals. It results from repetitive stress to the plantar fas...
• Son, M., Rugg, A., Requist, M., Latt, L. D., Johnson, B., & Alvarez, A. (2020). Does Lag Screw Retightening Improve Compression in Hindfoot Arthrodesis. Foot & Ankle Orthopaedics, 5(4), 2473011420S0007. doi:10.1177/2473011420s00076
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  Category:Hindfoot; Ankle; Ankle ArthritisIntroduction/Purpose:Non-union and delayed union are common complications following hindfoot arthrodesis. The failure to obtain and maintain compression at ...
• Son, M., Rugg, A., Requist, M., Latt, L. D., Johnson, B., & Alvarez, A. (2020). Does Lag Screw Retightening Improve Compression in Hindfoot Arthrodesis. Foot & Ankle Orthopaedics, 5(4). doi:10.1177/2473011420s00076
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  Category:Hindfoot; Ankle; Ankle ArthritisIntroduction/Purpose:Non-union and delayed union are common complications following hindfoot arthrodesis. The failure to obtain and maintain compression at ...
• Sorenson, J., Manoharan, A., Latt, L. D., Khwaja, A. M., & Etebari, C. V. (2020). A Staged Treatment Algorithm for the Management of Severe Charcot Hindfoot Arthropathy, using Tibiotalocalcaneal Arthrodesis with Femoral Head Allograft. Foot & Ankle Orthopaedics, 5(4). doi:10.1177/2473011420s00285
• Wang, J., Mannen, E. M., Siddicky, S. F., Lee, J., & Latt, L. D. (2020). Gait alterations in posterior tibial tendonitis: A systematic review and meta-analysis.. Gait & posture, 76, 28-38. doi:10.1016/j.gaitpost.2019.11.002
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  Posterior tibial tendon dysfunction (PTTD) is a common and debilitating tendinopathy that can lead to a profound decrease in gait function. While the clinical diagnosis and treatment of this disorder are well described, the pathomechanics have not been adequately characterized. The purpose of this systematic review and meta-analysis is to compare foot/ankle kinematics and kinetics in patients with PTTD with healthy controls during gait..Relevant articles were selected thought Medline (Pubmed), Scopus, CINAHL, and Web of Science. Studies focused on foot/ankle kinematics and kinetics in patients with PTTD were involved. Articles were included if they: 1) compared patients with PTTD to healthy controls, 2) utilized kinematics or kinetics as the primary outcome measure, 3) evaluated gait tasks, and 4) were written in English..Eleven articles were included in this systematic review, and 8 studies were synthesized and analyzed. Our meta-analyses indicated increased dorsiflexion and abduction of the forefoot, as well as increased plantarflexion and eversion of hindfoot for patients with PTTD during stance of walking..Our results from the meta-analysis showed more conclusive changes in the forefoot (increased dorsiflexion and abduction) and hindfoot (increased plantarflexion and eversion) kinematics during stance of walking, which may be associated with a pathological process of PTTD. This review provides an improved understanding of gait function in patients with PTTD and preliminary knowledge for future research.
• Latt, D. L. (2019). Gait alterations in acquired flatfoot with posterior tibial tendonitis: a systematic review and meta-analysis. Gait Posture, 76, 28-38.
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  Wang J, Siddicky SF, Mannen EM, Lee JM, Latt LD. Gait alterations in acquired flatfoot with posterior tibial tendonitis: a systematic review and meta-analysis. Gait Posture. 2019 Nov 4;76:28-38.
• Latt, D. L. (2019). Peer Reviewed Abstract: Assessing Outcomes with a National Foot and Ankle Outcomes Registry. Western Orthopaedic Association (WOA) 83rd Annual Meeting.
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  Hunt K, Latt LD. Assessing Outcomes with a National Foot and Ankle Outcomes Registry. Abstract. Western Orthopaedic Association (WOA) 83rd Annual Meeting, July 31-Aug 3, 2019, Monterey, CA.
• Latt, D. L. (2019). Surgical Management of Lateral Ankle Instability in Athletes. Journal of Athletic Training, 54(6), 639-649.
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  Camacho LD, Roward ZT, Deng Y, Latt LD. Surgical Management of Lateral Ankle Instability in Athletes. Journal of Athletic Training. 2019 Jun;54(6):639-649.
• Latt, L. D., & Farber, D. C. (2019). FAO Essential Reviews, Part III:. Foot & Ankle Orthopaedics, 4(3), 247301141986969. doi:10.1177/2473011419869690
• Reyes, MS3, R., Latt, D. L., & Turker, T. (2019). A cuneiform reformation following gunshot wound to the foot.. Foot & Ankle Orthopaedics Journal.
• Reyes, R., Türker, T., & Latt, L. D. (2019). Spontaneous Regeneration of Medial Cuneiform Following Gunshot Wound. Foot & Ankle Orthopaedics, 4(3), 247301141987626. doi:10.1177/2473011419876261
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  Level of Evidence: Level V, expert opinion.
• Slayton, M. H., Baravarian, B., Amodei, R. C., Compton, K. B., Christensen, D. N., Mcnelly, A., & Latt, L. D. (2019). Intense Therapeutic Ultrasound for Pain Relief in the Treatment for Chronic Plantar Fasciopathy. Foot & Ankle Orthopaedics, 4(3), 247301141986222. doi:10.1177/2473011419862228
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  Background:Intense therapeutic ultrasound (ITU) is an innovative ultrasound-based therapy where sound waves are concentrated into select musculoskeletal tissue. These focused waves generate thermal...
• Son, M. M., & Latt, L. D. (2019). Hindfoot Bone Viscoelasticity and Stress Relaxation. Foot & Ankle Orthopaedics, 4(4), 2473011419S0040. doi:10.1177/2473011419s00403
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  Category: Ankle, Ankle Arthritis, Basic Sciences/Biologics, Hindfoot Introduction/Purpose: Hindfoot arthrodeses have a non-union rate as high as 40%. Compression at the arthrodesis site plays a key role in stimulating bone growth leading to successful fusion. The ability to obtain and maintain compression depends not only on the surgical technique and the hardware which develop the compressive force but also on the response of the bone to compression. Bone, like other musculoskeletal tissues, is viscoelastic meaning that it has properties of both fluids and solids. Because bone is viscoelastic, it experiences stress relaxation (decrease in compressive force over time). The rate and magnitude of such stress relaxation is unknown. Our primary objective was to quantify stress relaxation of the hindfoot bones when subjected to a fixed compression displacement as would be done during arthrodesis. Methods: 10 human cadaveric bone cylinders measuring 10 mm in both diameter and height were cut from the articular surfaces of the talus, calcaneus, and distal tibia using a disposable cylindrical osteochondral harvester (OATS, Arthrex inc, Naples, FL). Each bone cylinder sample included subchondral and trabecular bone, and articular cartilage was removed during preparation. Each sample was scanned with a micro-computed tomography (uCT) scanner (Biomedical Micro CT Scanner, Scanco Medical, Switzerland) to quantify bone volume/total volume ratio (BV/TV), trabecular thickness, trabecular separation, trabecular number, and connectivity density. Each specimen was submerged in a saline bath and compressed by 1 mm at a strain rate of 1mm/sec using a material testing machine (System 810, MTS Systems, Eden Prairie, MN), and load data was gathered by an Interface load cell. Displacement was held constant for 3 hours, after which each sample was removed from the test machine and immediately rescanned with the uCT scanner. Results: The ensemble load curve of the ten samples displayed uniform exponential decay. After the initial load was placed on the bone, a steep, negative load velocity was apparent. Rapid decay occurred within the first 3 minutes, after which the load plateaued, holding constant over the subsequent 3 hours of compression. The average peak load was 515.53 N (SD: 254.58 N). The average percent load loss was 65.77% over 30 minutes (SD: 20.95%). Discrete time periods (B1, B2, B3, B4) were established corresponding to 0-3 min, 3-10 min, 10-20 min, and 20-30 min, respectively. Time periods B1, B2, B3, and B4 demonstrated an average percent load loss per time period of 43.35% (SD: 10.09%), 13.80% (SD: 14.77%), 18.65% (SD: 24.97%) and 7.95% (SD: 13.37%), respectively. Conclusion: Our data suggest that a significant percentage of compressive load placed across a bone is lost within the first 3 minutes as compared to any subsequent time period. Moreover, approximately 65.77% of the compressive load is lost over the first 30 minutes. These data suggest that when performing arthrodesis with compressive hardware, the majority of the initially applied compressive load may dissipate over the first 3-30 minutes, which may contribute to nonunion. Thus, a re-tightening of screws after 5-30 minutes or the use of a continuous compressive device may help to maintain compression at the arthrodesis site throughout healing.
• Latt, L. D. (2018). Editor’s Response to “Letter Regarding: A Novel Casting Technique for Tongue-Type Calcaneus Fractures with Soft Tissue Compromise”. Foot & Ankle Orthopaedics, 3(2), 247301141878297. doi:10.1177/2473011418782972
• Latt, L. D., & Farber, D. C. (2018). FAO Essential Reviews. Foot & Ankle Orthopaedics, 3(4), 247301141879651. doi:10.1177/2473011418796519
• Latt, L. D., Kim, S., Lopez, J., & Ayala, A. E. (2018). The Effect of Achilles Tendon Loading on Ankle Joint Contact Area and Peak Pressure. Foot & Ankle Orthopaedics, 3(3), 2473011418S0030. doi:10.1177/2473011418s00303
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  Category:AnkleIntroduction/Purpose:Increased tibiotalar peak pressure (PP) and decreased contact area (CA) following ankle fracture are associated with the development of post-traumatic osteoarthtr...
• Latt, L. D., Wild, J. R., Wild, J. R., Morin, M. L., Lawson, K. A., Latt, L. D., & Ayala, A. E. (2018). Ankle Fracture-Dislocations: A Review. Foot & Ankle Orthopaedics, 3(3), 247301141876512. doi:10.1177/2473011418765122
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  Ankle fractures are common musculoskeletal injuries that may result in tibiotalar joint dislocations. Ankle fracture-dislocations occur via similar mechanisms as ankle fractures, although the persi...
• Roward, Z., & Latt, L. D. (2018). Fracture Through a Distal Fibular Tunnel Used for an Anatomic Lateral Ankle Ligament Reconstruction. Foot & Ankle Orthopaedics, 3(2), 247301141876359. doi:10.1177/2473011418763593
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  Anatomic lateral ankle ligament reconstruction using free tendon graft with osseous tunnels has become a popular technique for revision reconstruction of the lateral ankle ligaments. With the proce...
• Latt, L. D., Hardy, J. C., Sherman, N. C., Sandberg, R. P., Latt, L. D., & Hardy, J. C. (2017). Cigar Box Arthroscopy: A Randomized Controlled Trial Validates Nonanatomic Simulation Training of Novice Arthroscopy Skills.. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 33(11), 2015-2023.e3. doi:10.1016/j.arthro.2017.04.022
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  The goal of this study was to validate the cigar box arthroscopy trainer (CBAT) as a training tool and then compare its effectiveness to didactic training and to another previously validated low-fidelity but anatomic model, the anatomic knee arthroscopy trainer (AKAT)..A nonanatomic knee arthroscopy training module was developed at our institution. Twenty-four medical students with no prior arthroscopic or laparoscopic experience were enrolled as subjects. Eight subjects served as controls. The remaining 16 subjects were randomized to participate in 4 hours of either the CBAT or a previously validated AKAT. Subjects' skills were assessed by 1 of 2 faculty members through repeated attempts at performing a diagnostic knee arthroscopy on a cadaveric specimen. Objective scores were given using a minimally adapted version of the Basic Arthroscopic Knee Skill Scoring System. Total cost differences were calculated..Seventy-five percent of subjects in the CBAT and AKAT groups succeeded in reaching minimum proficiency in the allotted time compared with 25% in the control group (P < .05). There was no significant difference in the number of attempts to reach proficiency between the CBAT and AKAT groups. The cost to build the CBAT was $44.12, whereas the cost was $324.33 for the AKAT..This pilot study suggests the CBAT is an effective knee arthroscopy trainer that may decrease the learning curve of residents without significant cost to a residency program. This study demonstrates the need for an agreed-upon objective scoring system to properly evaluate residents and compare the effectiveness of different training tools.
• Latt, L. D., Smith, K. E., & Dupont, K. M. (2017). Revision Tibiotalocalcaneal Arthrodesis With a Pseudoelastic Intramedullary Nail.. Foot & ankle specialist, 10(1), 75-81. doi:10.1177/1938640016656782
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  Hindfoot (tibiotalocalcaneal or TTC) arthrodesis is commonly used to treat concomitant arthritis of the ankle and subtalar joints. Simultaneous fusion of both joints can be difficult to achieve especially in patients with impaired healing due to smoking, diabetes mellitus, or Charcot neuroarthropathy. Conventional intramedullary fixation devices allow for compression to be applied at the time of surgery, but this compression can be lost due to bone resorption or settling, leading to impaired healing. In contrast, the novel pseudoelastic intramedullary nail is designed to maintain compression at the arthrodesis sites throughout the healing process by the use of an internal pseudoelastic element. We present 2 cases of revision TTC arthrodesis using the pseudoelastic intramedullary nail. In the first case, an 80-year-old diabetic man with previous ankle and failed subtalar fusion with screws underwent revision TTC arthrodesis. In the second case, a 66-year-old man with Charcot neuroarthropathy and a failed TTC arthrodesis with a static intramedullary nail underwent revision tibiotalar arthrodesis. In both cases, computed tomography scan demonstrated successful union and patients were allowed full weight bearing by 3 months after surgery. These cases provide early evidence that sustained compression via an intramedullary nail can lead to rapid successful hindfoot fusion when standard approaches have failed..Therapeutic, Level IV: Case study.
• Taljanovic, M. S., Gimber, L. H., Becker, G. W., Latt, L. D., Klauser, A. S., Melville, D. M., Gao, L., & Witte, R. S. (2017). Shear-Wave Elastography: Basic Physics and Musculoskeletal Applications.. Radiographics : a review publication of the Radiological Society of North America, Inc, 37(3), 855-870. doi:10.1148/rg.2017160116
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  In the past 2 decades, sonoelastography has been progressively used as a tool to help evaluate soft-tissue elasticity and add to information obtained with conventional gray-scale and Doppler ultrasonographic techniques. Recently introduced on clinical scanners, shear-wave elastography (SWE) is considered to be more objective, quantitative, and reproducible than compression sonoelastography with increasing applications to the musculoskeletal system. SWE uses an acoustic radiation force pulse sequence to generate shear waves, which propagate perpendicular to the ultrasound beam, causing transient displacements. The distribution of shear-wave velocities at each pixel is directly related to the shear modulus, an absolute measure of the tissue's elastic properties. Shear-wave images are automatically coregistered with standard B-mode images to provide quantitative color elastograms with anatomic specificity. Shear waves propagate faster through stiffer contracted tissue, as well as along the long axis of tendon and muscle. SWE has a promising role in determining the severity of disease and treatment follow-up of various musculoskeletal tissues including tendons, muscles, nerves, and ligaments. This article describes the basic ultrasound physics of SWE and its applications in the evaluation of various traumatic and pathologic conditions of the musculoskeletal system. ©RSNA, 2017.
• Latt, L. D. (2016). FAO The Open Source for High-quality Peer Reviewed Orthopaedic Foot and Ankle Content. Foot & Ankle Orthopaedics, 1(1), 247301141666609. doi:10.1177/2473011416666099
• Latt, L. D., Christensen, D. N., Mcnelly, A. L., Slayton, M. H., Amodei, R. C., & Fastje, C. D. (2016). Randomized Controlled Trial of Intense Therapeutic Ultrasound for the Treatment of Chronic Plantar Fasciitis. Foot & Ankle Orthopaedics, 1(1), 2473011416S0011. doi:10.1177/2473011416s00112
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  Category:SportsIntroduction/Purpose:Initial treatment of plantar fasciitis (PF), consisting of anti-inflammatories, stretching and in-shoe orthosis (heel pad, heel wedge, or arch support), leads to symptomatic resolution in over 90% of patients but takes 3-6 months. This study was conducted to test the effectiveness of a minimally invasive modality, intense therapeutic ultrasound (ITU), in accelerating the healing of chronic plantar fasciitis (PF). ITU uses high-frequency high-intensity focused ultrasound to create small thermal injury zones inside soft tissue without damage to surrounding structures. ITU has been shown to initiate a tissue repair cascade and promote collagen generation in dermal and musculoskeletal tissue and is FDA approved for use in non-surgical brow lifts [1,2]. The goal of this study was to determine if ITU when combined with standard therapy could speed the healing of chronic PF.Methods:47 patients with chronic (greater than 3 months) heel pain due to PF were randomized to standard...
• Latt, L. D., Smith, K. E., & Dupont, K. M. (2016). Revision Tibiotalocalcaneal Arthrodesis With a Pseudoelastic Intramedullary Nail: A Case Study. Foot & Ankle Specialist.
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  Hindfoot (tibiotalocalcaneal or TTC) arthrodesis is commonly used to treat concomitant arthritis of the ankle and subtalar joints. Simultaneous fusion of both joints can be difficult to achieve especially in patients with impaired healing due to smoking, diabetes mellitus, or Charcot neuroarthropathy. Conventional intramedullary fixation devices allow for compression to be applied at the time of surgery, but this compression can be lost due to bone resorption or settling, leading to impaired healing. In contrast, the novel pseudoelastic intramedullary nail is designed to maintain compression at the arthrodesis sites throughout the healing process by the use of an internal pseudoelastic element. We present 2 cases of revision TTC arthrodesis using the pseudoelastic intramedullary nail. In the first case, an 80-year-old diabetic man with previous ankle and failed subtalar fusion with screws underwent revision TTC arthrodesis. In the second case, a 66-year-old man with Charcot neuroarthropathy and a failed TTC arthrodesis with a static intramedullary nail underwent revision tibiotalar arthrodesis. In both cases, computed tomography scan demonstrated successful union and patients were allowed full weight bearing by 3 months after surgery. These cases provide early evidence that sustained compression via an intramedullary nail can lead to rapid successful hindfoot fusion when standard approaches have failed.
• Gao, L., Yuan, J. S., Heden, G. J., Szivek, J. A., Taljanovic, M. S., Latt, L. D., & Witte, R. S. (2015). Ultrasound elasticity imaging for determining the mechanical properties of human posterior tibial tendon: a cadaveric study. IEEE Transactions on Biomedical Engineering, 62(4), 1179-84.
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  Posterior tibial tendon dysfunction (PTTD) is a common degenerative condition leading to a severe impairment of gait. There is currently no effective method to determine whether a patient with advanced PTTD would benefit from several months of bracing and physical therapy or ultimately require surgery. Tendon degeneration is closely associated with irreversible degradation of its collagen structure, leading to changes to its mechanical properties. If these properties could be monitored in vivo, they could be used to quantify the severity of tendonosis and help determine the appropriate treatment. The goal of this cadaveric study was, therefore, to develop and validate ultrasound elasticity imaging (UEI) as a potentially noninvasive technique for quantifying tendon mechanical properties. Five human cadaver feet were mounted in a materials testing system (MTS), while the posterior tibial tendon (PTT) was attached to a force actuator. A portable ultrasound scanner collected 2-D data during loading cycles. Young's modulus was calculated from the strain, loading force, and cross-sectional area of the PTT. Average Young's modulus for the five tendons was (0.45 ± 0.16 GPa) using UEI, which was consistent with simultaneous measurements made by the MTS across the whole tendon (0.52 ± 0.18 GPa). We also calculated the scaling factor (0.12 ± 0.01) between the load on the PTT and the inversion force at the forefoot, a measurable quantity in vivo. This study suggests that UEI could be a reliable in vivo technique for estimating the mechanical properties of the PTT, and as a clinical tool, help guide treatment decisions for advanced PTTD and other tendinopathies.
• Latt, D. L. (2015). Advances in Lower Extremity Ultrasound. Current Radiology Reports, 3(6), 1-12.
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  Taljanovic MS, Melville DM, Klauser AS, Latt LD, Arif-Tiwari H, Gao L, Witte RS (2015) Advances in Lower Extremity Ultrasound. Current Radiology Reports. 2015;3(6):1-12
• Latt, D. L. (2015). Chronic plantar fasciitis is mediated by local hemodynamics: implications for emerging therapies.. North American Journal of Medical Sciences, 7(1), 1-5.
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  17. Miller L, Harris R, Latt LD. Chronic plantar fasciitis is mediated by local hemodynamics: implications for emerging therapies. N Am J Med Sci. 2015: 7(1): 1-5.
• Latt, L. D., Glisson, R. R., Adams, S. B., Schuh, R., Narron, J. A., & Easley, M. E. (2015). Biomechanical Comparison of External Fixation and Compression Screws for Transverse Tarsal Joint Arthrodesis. Foot & Ankle International, 36(10), 1235-42.
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  Transverse tarsal joint arthrodesis is commonly performed in the operative treatment of hindfoot arthritis and acquired flatfoot deformity. While fixation is typically achieved using screws, failure to obtain and maintain joint compression sometimes occurs, potentially leading to nonunion. External fixation is an alternate method of achieving arthrodesis site compression and has the advantage of allowing postoperative compression adjustment when necessary. However, its performance relative to standard screw fixation has not been quantified in this application. We hypothesized that external fixation could provide transverse tarsal joint compression exceeding that possible with screw fixation.
• Taljanovic, M. S., Alcala, J. N., Gimber, L. H., Rieke, J. D., Chilvers, M. M., & Latt, L. D. (2015). High-resolution US and MR imaging of peroneal tendon injuries--erratum. Radiographics : a review publication of the Radiological Society of North America, Inc, 35(2), 651.
• Taljanovic, M. S., Latt, L. D., Witte, R. S., Szivek, J. A., Heden, G. J., Yuan, J., & Gao, L. (2015). Ultrasound Elasticity Imaging for Determining the Mechanical Properties of Human Posterior Tibial Tendon: A Cadaveric Study. IEEE Transactions on Biomedical Engineering. doi:10.1109/tbme.2014.2381002
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  Posterior tibial tendon dysfunction (PTTD) is a common degenerative condition leading to a severe impairment of gait. There is currently no effective method to determine whether a patient with advanced PTTD would benefit from several months of bracing and physical therapy or ultimately require surgery. Tendon degeneration is closely associated with irreversible degradation of its collagen structure, leading to changes to its mechanical properties. If these properties could be monitored in vivo, they could be used to quantify the severity of tendonosis and help determine the appropriate treatment. The goal of this cadaveric study was, therefore, to develop and validate ultrasound elasticity imaging (UEI) as a potentially noninvasive technique for quantifying tendon mechanical properties. Five human cadaver feet were mounted in a materials testing system (MTS), while the posterior tibial tendon (PTT) was attached to a force actuator. A portable ultrasound scanner collected 2-D data during loading cycles. Young's modulus was calculated from the strain, loading force, and cross-sectional area of the PTT. Average Young's modulus for the five tendons was (0.45 ± 0.16 GPa) using UEI, which was consistent with simultaneous measurements made by the MTS across the whole tendon (0.52 ± 0.18 GPa). We also calculated the scaling factor (0.12 ± 0.01) between the load on the PTT and the inversion force at the forefoot, a measurable quantity in vivo. This study suggests that UEI could be a reliable in vivo technique for estimating the mechanical properties of the PTT, and as a clinical tool, help guide treatment decisions for advanced PTTD and other tendinopathies.
• Hepworth, J. T., Najafi, B., Latt, L. D., Taylor-piliae, R. E., Latt, L. D., Hoke, T. M., & Coull, B. M. (2014). Abstract P428: Effects of Tai Chi on Physical Function and Quality of Life in Chronic Stroke. Circulation, 129(suppl_1). doi:10.1161/circ.129.suppl_1.p428
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  Background: Poor physical function and quality of life are ubiquitous post-stroke. Effective interventions to improve physical function and quality of life for stroke survivors are critically needed. Objective: Examine the effect of a Tai Chi (TC) intervention on physical function and quality of life. Methods: In a single-blind randomized clinical trial community-dwelling stroke survivors, aged ≥ 50 years and ≥ 3 months post-stroke, were assigned to: Yang style 24-posture TC (n=53), SilverSneakers® (SS, n=44) strength and range of movement exercise, or Usual Care (UC, n=48) for 12 weeks. TC and SS attended a 1-hour class 3 times/week, while UC had weekly phone calls. Standardized measures for Physical Function were the Short Physical Performance Battery (SPPB), Fall Rates and 2-Minute StepTest; and for Quality of Life were the Medical Outcomes Study SF-36, Center for Epidemiological Studies Depression and Pittsburgh Sleep Quality Index. Results: A total of 145 stroke survivors (47% women, mean age=70 year...
• Hung, M., Baumhauer, J. F., Brodsky, J. W., Cheng, C., Ellis, S. J., Franklin, J. D., Hon, S. D., Ishikawa, S. N., Latt, L. D., Phisitkul, P., Saltzman, C. L., SooHoo, N. F., & Hunt, K. J. (2014). Psychometric Comparison of the PROMIS Physical Function CAT With the FAAM and FFI for Measuring Patient-Reported Outcomes.. Foot & ankle international, 35(6), 592-599. doi:10.1177/1071100714528492
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  Selecting optimal patient-reported outcome (PRO) instruments is critical to improving the quality of health care. The purpose of this study was to compare the reliability, responsiveness, and efficiency of three PRO measures: the Foot and Ankle Ability Measure-Activity of Daily Living subscale (FAAM_ADL), the Foot Function Index 5-point verbal rating scale (FFI-5pt), and the PROMIS Physical Function computerized adaptive test (PF CAT)..Data were aggregated from 10 clinical sites in the AOFAS's National Orthopaedic Foot and Ankle Research (OFAR) Network from 311 patients who underwent elective surgery for a disorder of the foot or ankle. Patients were administered the FAAM_ADL, FFI-5pt, and PF CAT at their preoperative visit and at 6 months after surgery. Reliabilities were evaluated using a Rasch model. Responsiveness was calculated using paired samples t test and efficiency was recorded as number of seconds to complete the instrument..Similar reliabilities were found for the three instruments. Item reliabilities for FAAM_ADL, FFI-5pt, and PF CAT were all .99. Pearson reliabilities for FAAM_ADL, FFI-5pt, and PF CAT were .95, .93, and .96, respectively. On average, patients completed the FAAM_ADL in 179 seconds, the FFI-5pt in 194 seconds, and the PF CAT in 44 seconds, ( P < .001). The PF CAT and FAAM_ADL showed significant improvement ( P = .01 and P = .001, respectively) in patients' physical function after treatment; the FFI-5pt did not show improvement..Overall, the PF CAT performed best in terms of reliability, responsiveness, and efficiency in this broad sample of foot and ankle patients. It can be a potential replacement for the conventional PRO measures, but further validation is needed in conjunction with the PROMIS Pain instruments..Level I, prospective comparative outcome study.
• Hunt, K. J., Alexander, I., Baumhauer, J., Brodsky, J., Chiodo, C., Daniels, T., Davis, W. H., Deland, J., Ellis, S., Hung, M., Ishikawa, S. N., Latt, L. D., Phisitkul, P., Soohoo, N. F., Yang, A., & Saltzman, C. L. (2014). The Orthopaedic Foot and Ankle Outcomes Research (OFAR) network: feasibility of a multicenter network for patient outcomes assessment in foot and ankle.. Foot & ankle international, 35(9), 847-54. doi:10.1177/1071100714544157
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  There is an increasing need for orthopaedic practitioners to measure and collect patient-reported outcomes data. In an effort to better understand outcomes from operative treatment, the American Orthopaedic Foot & Ankle Society (AOFAS) established the Orthopaedic Foot and Ankle Outcomes Research (OFAR) Network, a national consortium of foot and ankle orthopaedic surgeons. We hypothesized that the OFAR Network could successfully collect, aggregate, and report patient-reported outcome (PRO) data using the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS)..Ten sites enrolled consecutive patients undergoing elective surgery for 1 of 6 foot/ankle disorders. Outcome instruments were collected preoperatively and at 6 months postoperatively using the PROMIS online system: Foot and Ankle Ability Measure (FAAM), Foot Function Index (FFI), and PROMIS physical function (PF) and pain computerized adaptive tests (CAT). During the 3-month period, 328 patients were enrolled; 249 (76%) had completed preoperative patient-reported outcomes data and procedure-specific data. Of these, 140 (56%) also completed 6-month postoperative patient- reported outcomes data..Ankle arthritis and flatfoot demonstrated consistently worse preoperative scores. Five of 6 disorders showed significant improvement at 6 months on PF CAT and FAAM, 4 of 6 showed improvement on pain interference CAT, and no disorders showed improvement on FFI. Ankle arthritis and flatfoot demonstrated the greatest magnitude of change on most patient-reported outcomes scales..We were able to enroll large numbers of patients in a short enrollment period for this preliminary study. Data were easily aggregated and analyzed. Substantial loss of follow-up data indicates a critical area requiring further effort. The AOFAS OFAR Network is undergoing expansion with goals to ultimately facilitate large, prospective multicenter studies and optimize the quality and interpretation of available outcome instruments for the foot and ankle population..Level II, prospective comparative study.
• Latt, L. D., Fithian, D. C., Serack, B. J., Dezfuli, B., Burk, D. R., Nicolini, A., & Christopher, M. (2014). A validated cadaveric model of trochlear dysplasia. Knee Surgery, Sports Traumatology, Arthroscopy. doi:10.1007/s00167-014-3033-2
• Latt, L. D., Hepworth, J. T., Taylor-piliae, R. E., Najafi, B., Latt, L. D., Hoke, T. M., & Coull, B. M. (2014). Effect of Tai Chi on physical function, fall rates and quality of life among older stroke survivors.. Archives of physical medicine and rehabilitation, 95(5), 816-24. doi:10.1016/j.apmr.2014.01.001
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  To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life..Single-blind, randomized controlled trial..General community..Community-dwelling survivors of stroke (N=145; 47% women; mean age, 70y; time poststroke: 3y; ischemic stroke: 66%; hemiparesis: 73%) who were aged ≥50 years and were ≥3 months poststroke..Yang style 24-posture short-form TC (n=53), strength and range of movement exercises (SS) (n=44), or usual care (UC) (n=48) for 12 weeks. The TC and SS groups attended a 1-hour class 3 times per week, whereas the UC group had weekly phone calls..Physical function: Short Physical Performance Battery, fall rates, and 2-minute step test; quality of life: Medical Outcomes Study 36-Item Short-Form Health Survey, Center for Epidemiologic Studies Depression Scale, and Pittsburgh Sleep Quality Index..During the intervention, TC participants had two thirds fewer falls (5 falls) than the SS (14 falls) and UC (15 falls) groups (χ(2)=5.6, P=.06). There was a significant group by time interaction for the 2-minute step test (F2,142=4.69, P
• Schannen, A. P., Goshima, K., Latt, L. D., & DeSilva, G. L. (2014). Simultaneous soft tissue coverage of both medial and lateral ankle wounds: Sural and rotational flap coverage after revision fixation in an infected diabetic ankle fracture. Journal of Orthopaedics, 11(Issue 1). doi:10.1016/j.jor.2013.12.006
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  Aims: To describe a case of simultaneous medial and lateral soft tissue coverage for exposed orthopaedic implants in the setting of revision fixation of a non-united ankle fracture. This was achieved using a sural flap as well as a propeller flap. Methods: Case report. Results: Both the sural and posterior tibial artery based rotational propeller flap healed without incident. The underlying fracture healed successfully and the patient returned to normal shoe wear. Conclusions: The sural flap in conjunction with the posterior tibial artery based rotational flap is effective in providing simultaneous medial and lateral soft tissue coverage to the ankle. © 2013 Professor P K Surendran Memorial Education Foundation.
• Valerdi, R., Latt, L. D., Valerdi, R., Monreal, J., & Latt, L. D. (2014). A Systems Approach to Healthcare Efficiency Improvement. Procedia Computer Science, 28, 610-618. doi:10.1016/j.procs.2014.03.074
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  Abstract Healthcare patient outcomes and healthcare costs, in the context of the healthcare delivery system, is a prominent societal issue for the U.S. Although improvements have been achieved, they are silo-centric, specific to a single area or discipline. It is clear that improvements need to be transferred across the healthcare delivery system in a broader sense. To that end, the ability to measure a change in the system is paramount in determining progress and in what parts of the system are impacted. The research work presented describes a case of how an Electronic Medical Record (EMR) system implementation can be measured within a systems or systems engineering context. In the first phase, time motion study has been employed to assess physician workflow. In this manner, data collection, analysis, and inferences elicited can be quickly assessed by subject matter experts for effectiveness. The objective of this collaborative work is that it demonstrates a systems engineering driven application of the improvement of an orthopaedic office that may then be generalized to a broader context. This works employs a phased approach which allows for synchronization between one set of tools or methodologies from one phase that inform and provide insight for the next. Additionally it facilitates an iterative effort as each phase will assess and reassess the key stakeholders and take into account the process/product life cycle thus allowing refinement of the previous phase and its results. The progression from one phase to another provides the means of measuring the progress and impact. The partnership between the Department of Orthopaedics and the Department of Systems and Industrial Engineering at the University of Arizona, provides a real-life setting for testing our hypotheses. All of the features described in this implementation make up a methodological framework that will render implications for engineers, physicians, patients, and policy makers.
• Csintalan, R. P., Latt, L. D., Fornalski, S., Raiszadeh, K., Fithian, D. C., & Inacio, M. C. (2013). Medial Patellofemoral Ligament (Mpfl) Reconstruction for the Treatment of Patellofemoral Instability. Journal of Knee Surgery, 27(Issue 2). doi:10.1055/s-0033-1360652
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  Patellofemoral instability can be a disabling problem. Numerous techniques are employed for its treatment. Medial patellofemoral ligament (MPFL) reconstruction in combination with other procedures has been explored by many orthopedic surgeons. The purpose of the study was to determine the effectiveness of isolated MPFL reconstruction in treating the symptoms associated with patellofemoral instability, preventing recurrence of patella dislocation, and returning patients to preinjury level of activity. This is a case series study. We conducted a clinical follow-up study on 56 knees (49 patients) after MPFL reconstruction for recurrent patellar instability with a mean follow-up of 4.3 years (range, 1.1—6.8). A single MPFL reconstruction technique was performed in all cases. Patient outcomes were evaluated using: International Knee Documentation Committee (IKDC) subjective knee form, Tegner activity score, functional hop test, and radiographs. Mean age at time of surgery was 24 years old (range, 13—49). Females comprised 75% of the sample. Mean interval from injury to surgery was 7.2 ± 8.6 years (range, 51 days—37 years). At follow-up, there were no recurrent dislocations reported, patella subluxation in 6 (11%) cases, and radiographic degenerative changes were none to mild in all patients. The series mean IKDC scores at follow-up was 76.3 ± 19.2 (range, 30—99), and Tegner activity scores were 5.6 ± 2.5. MPFL reconstruction is an option for treating the symptoms of patellar instability, preventing recurrent dislocation, and returning patients near to their preinjury level of activity. The level of evidence is IV. © 2013, Thieme Medical Publishers. All rights reserved.
• Hung, M., Baumhauer, J. F., Latt, L. D., Latt, L. D., Saltzman, C. L., Soohoo, N. F., Soohoo, N. F., Hunt, K. J., & Latt, D. L. (2013). Validation of PROMIS ® Physical Function computerized adaptive tests for orthopaedic foot and ankle outcome research.. Clinical orthopaedics and related research, 471(11), 3466-74. doi:10.1007/s11999-013-3097-1
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  In 2012, the American Orthopaedic Foot & Ankle Society(®) established a national network for collecting and sharing data on treatment outcomes and improving patient care. One of the network's initiatives is to explore the use of computerized adaptive tests (CATs) for patient-level outcome reporting..We determined whether the CAT from the NIH Patient Reported Outcome Measurement Information System(®) (PROMIS(®)) Physical Function (PF) item bank provides efficient, reliable, valid, precise, and adequately covered point estimates of patients' physical function..After informed consent, 288 patients with a mean age of 51 years (range, 18-81 years) undergoing surgery for common foot and ankle problems completed a web-based questionnaire. Efficiency was determined by time for test administration. Reliability was assessed with person and item reliability estimates. Validity evaluation included content validity from expert review and construct validity measured against the PROMIS(®) Pain CAT and patient responses based on tradeoff perceptions. Precision was assessed by standard error of measurement (SEM) across patients' physical function levels. Instrument coverage was based on a person-item map..Average time of test administration was 47 seconds. Reliability was 0.96 for person and 0.99 for item. Construct validity against the Pain CAT had an r value of -0.657 (p < 0.001). Precision had an SEM of less than 3.3 (equivalent to a Cronbach's alpha of ≥ 0.90) across a broad range of function. Concerning coverage, the ceiling effect was 0.32% and there was no floor effect..The PROMIS(®) PF CAT appears to be an excellent method for measuring outcomes for patients with foot and ankle surgery. Further validation of the PROMIS(®) item banks may ultimately provide a valid and reliable tool for measuring patient-reported outcomes after injuries and treatment.
• Taylor-Piliae, R. E., Hepworth, J. T., Latt, L. D., & Coull, B. M. (2013). Abstract TP370: Tai Chi and SilverSneakers® Interventions Improve Aerobic Endurance in Older Stroke Survivors. Stroke. doi:10.1161/str.44.suppl_1.atp370
• Taylor-Piliae, R. E., Latt, L. D., Hepworth, J. T., & Coull, B. M. (2012). Predictors of gait velocity among community-dwelling stroke survivors.. Gait & posture, 35(3), 395-9. doi:10.1016/j.gaitpost.2011.10.358
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  Gait velocity is an objective, fundamental indicator of post-stroke walking ability. Most stroke survivors have diminished aerobic endurance or paretic leg strength affecting their walking ability. Other reported underlying factors affecting gait velocity include functional disability, balance, cognitive impairment, or the distance they are required to walk..To examine the relationship between gait velocity and measures of physical and cognitive functioning in chronic stroke..Cross-sectional design using baseline data from community-dwelling stroke survivors enrolled in an exercise intervention study. Functional disability (modified Rankin Scale), aerobic endurance (2-min step-test), leg strength (timed 5-chair stand test), balance (single-leg stance) and cognitive impairment (Mini-Mental Status Exam) were assessed. Gait velocity was assessed using a timed 4-m walk test. Multiple linear regression was used to explore potential independent predictors of gait velocity..Subjects had an average gait velocity of 0.75±0.23m/s, categorized as limited community walkers. Approximately 37% of the variance in gait velocity, could be explained by the 5 independent variables, functional disability, aerobic endurance, leg strength, balance, and cognitive impairment (R(2)=0.37, F(5,74)=8.64, p
• Taylor-piliae, R. E., Latt, L. D., Taylor-piliae, R. E., Latt, L. D., & Coull, B. M. (2012). Abstract P276: Aerobic Endurance and Leg Strength are Predictive of Gait Velocity among Community-Dwelling Stroke Survivors. Circulation, 125. doi:https://doi.org/10.1161/circ.125.supp
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  Background: Gait velocity is an objective, fundamental indicator of post-stroke walking ability. Most stroke survivors have diminished aerobic endurance and paretic leg strength, with one or both o...
• Allen, K. D., Adams, S. B., Mata, B. A., Shamji, M. F., Gouze, E., Jing, L., Nettles, D. L., Latt, L. D., & Setton, L. A. (2011). Gait and behavior in an IL1β-mediated model of rat knee arthritis and effects of an IL1 antagonist. Journal of Orthopaedic Research, 29(Issue 5). doi:10.1002/jor.21309
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  Interleukin-1 beta (IL1β) is a proinflammatory cytokine that mediates arthritic pathologies. Our objectives were to evaluate pain and limb dysfunction resulting from IL1β over-expression in the rat knee and to investigate the ability of local IL1 receptor antagonist (IL1Ra) delivery to reverse-associated pathology. IL1β over-expression was induced in the right knees of 30 Wistar rats via intra-articular injection of rat fibroblasts retrovirally infected with human IL1β cDNA. A subset of animals received a 30 μl intra-articular injection of saline or human IL1Ra on day 1 after cell delivery (0.65 μg/μl hIL1Ra, n = 7 per group). Joint swelling, gait, and sensitivity were investigated over 1 week. On day 8, animals were sacrificed and joints were collected for histological evaluation. Joint inflammation and elevated levels of endogenous IL1β were observed in knees receiving IL1β-infected fibroblasts. Asymmetric gaits favoring the affected limb and heightened mechanical sensitivity (allodynia) reflected a unilateral pathology. Histopathology revealed cartilage loss on the femoral groove and condyle of affected joints. Intra-articular IL1Ra injection failed to restore gait and sensitivity to preoperative levels and did not reduce cartilage degeneration observed in histopathology. Joint swelling and degeneration subsequent to IL1β over-expression is associated limb hypersensitivity and gait compensation. Intra-articular IL1Ra delivery did not result in marked improvement for this model; this may be driven by rapid clearance of administered IL1Ra from the joint space. These results motivate work to further investigate the behavioral consequences of monoarticular arthritis and sustained release drug delivery strategies for the joint space. Copyright © 2010 Orthopaedic Research Society.
• Latt, L. D., Glisson, R. R., Montijo, H. E., Usuelli, F. G., & Easley, M. E. (2011). Effect of graft height mismatch on contact pressures with osteochondral grafting of the talus.. The American journal of sports medicine, 39(12), 2662-9. doi:10.1177/0363546511422987
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  Osteochondral allograft transplantation is technically demanding. It is not always possible to place the surface of the graft perfectly flush with the surrounding cartilage. One must often choose between placing at least some portion of the surface of the graft slightly elevated or recessed. The effect of this choice on joint contact pressure is unknown..This study was undertaken to determine the effect of graft height mismatch on joint contact pressure in the ankle..Controlled laboratory study..Ten human cadaveric ankles underwent osteochondral grafting by removal then replacement of an osteochondral plug. Six conditions were tested: intact, graft flush, graft elevated 1.0 mm, graft elevated 0.5 mm, graft recessed 0.5 mm, and graft recessed 1.0 mm. Joint contact pressures were measured with a Tekscan sensor while loads of 200 N, 400 N, 600 N, and 800 N were sequentially applied..The peak contact pressure at the graft site for the flush condition was not significantly different from the intact condition for either medial or lateral lesions. In contrast, peak pressure on the opposite facet of the talar dome was significantly increased during the flush condition for the medial but not the lateral grafts. Elevated grafts experienced significantly increased contact pressures, whereas recessed grafts experienced significantly decreased pressures. These changes were greater for lateral than for medial lesions. Reciprocal changes in joint contact pressures were found on the opposite facet of the talus with elevated grafts on the lateral side and recessed grafts on the medial side..Flush graft placement can restore near-normal joint contact pressure. Elevated graft placement leads to significant increases in joint contact pressure at the graft site. Recessed graft placement leads to a transfer of pressure from the graft site to the opposite facet of the talus..Osteochondral grafts in the talus should be placed flush if possible or else slightly recessed.
• Easley, M. E., Latt, L. D., Santangelo, J. R., Merian-Genast, M., & Nunley, J. A. (2010). Osteochondral lesions of the talus.. The Journal of the American Academy of Orthopaedic Surgeons, 18(10), 616-30. doi:10.5435/00124635-201010000-00005
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  Easley, Mark E. MD; Latt, Daniel L. MD, PhD; Santangelo, James R. MD; Merian-Genast, Marc MD; Nunley, James A. II MD Author Information
• Latt, L. D., Turcotte, R. E., Isler, M. H., & Wong, C. (2010). Case series. Soft-tissue sarcoma of the foot.. Canadian journal of surgery. Journal canadien de chirurgie, 53(6), 424-31.
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  We reviewed cases of soft-tissue sarcoma of the foot to gain insight into the presentation, treatments and outcomes for this rare disease and to determine whether limb-salvage surgery yields reasonable functional and oncological outcomes..We reviewed the cases of 16 patients treated by 2 of us (R.T. and M.I.) for soft-tissue sarcoma of the foot over a 15-year period. We extracted the following information from each patient's medical record: disease status at presentation, prior treatment, histological diagnosis, American Joint Committee on Cancer (AJCC) stage, details of treatment, oncological outcome and functional outcome. Functional outcome was assessed with the Toronto Extremity Salvage Score (TESS) and the Musculoskeletal Tumor Society (MSTS 1987)..Follow-up averaged 6 (range 2–15) years. Eight patients presented after unplanned excision. Histological diagnosis was synovial sarcoma for 7 of 16 patients.The tumours were evenly distributed among the hindfoot, midfoot and forefoot. Most patients (n = 13) presented with AJCC stage II or III disease. Amputation was necessary for 3 patients, whereas limb salvage was possible for the other 13. Free tissue transfer (n = 9) and radiation therapy (n = 12) were used in most cases. Surgical margins were microscopically positive in 4 of the 13 patients treated with limb salvage.Local disease recurred in 2 patients. Lung metastases occurred in 4 patients. At last follow-up, 11 of 16 patients were alive without disease, 2 with disease and 3 had died of their disease. Functional assessment with MSTS 1987 and the TESS averaged 28%and 90%, respectively, after limb salvage..In this series, we found that, first, patients frequently presented after unplanned excision, and this may have led to worse oncological outcomes compared with patients who presented primarily. Second, limb salvage was usually possible, but it required accepting marginal resections, relying on free tissue transfer to obtain coverage and using radiation therapy to obtain local control. Third, this combination yielded an acceptable local control rate and very good functional outcomes.
• Latt, L. D., Sparto, P. J., Furman, J. M., & Redfern, M. S. (2003). The steady-state postural response to continuous sinusoidal galvanic vestibular stimulation. Gait and Posture, 18(Issue 2). doi:10.1016/s0966-6362(02)00195-9
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  Galvanic vestibular stimulation (GVS) applied between the mastoids during quiet standing elicits postural sway. The aim of this study was to characterize the postural sway response to continuous sinusoidal GVS across various stimulus frequencies and amplitudes. Binaural bipolar sinusoidal GVS was applied to the skin overlying the mastoid processes of 10 subjects while they stood on a force plate with eyes closed. The position of the center of pressure (COP) at the feet was recorded from a forceplate, while the head displacement was measured with a magnetic position tracking system. The stimulus conditions included four frequencies (0.1, 0.25, 0.45, and 1.1 Hz) and five peak amplitudes (0.05, 0.1, 0.25, 0.5, and 1.0 mA). Each subject experienced one trial at each amplitude-frequency pair. Additionally, each subject underwent three trials in which a dual-frequency stimulus (0.1 plus 0.45 Hz at a peak of 0.5 mA each) was presented. The stimuli elicited sway in the frontal plane in all subjects, as evidenced by changes in the displacement of the COP and head. Sway magnitude decreased with increasing stimulus frequency and increased with increasing stimulus amplitude. However, the response magnitude saturated at higher stimulus amplitudes. Phase lag increased with increasing stimulus frequency. The response to the dual-frequency stimulus was reduced at 0.1 Hz and nearly equal at 0.45 Hz in comparison with the single-frequency responses. This study suggests that the postural sway response is nonlinear due to saturation and violation of the principle of superposition. © 2002 Elsevier Science B.V. All rights reserved.
• Smiley-oyen, A. L., Latt, L. D., Redfern, M. S., & Cheng, H. K. (2002). Adaptation of vibration-induced postural sway in individuals with Parkinson's disease.. Gait & posture, 16(2), 188-97. doi:10.1016/s0966-6362(02)00005-x
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  Postural control requires accurate integration of visual, vestibular, cutaneous, and proprioceptive sensory information. Previous research suggests that patients with Parkinson's disease (PD) may have difficulty with this integration process, particularly involving incongruent visual information. The purpose of this study was to determine whether PD patients also show difficulty in adaptation to erroneous proprioceptive information. Postural reactions to soleus muscle vibration were explored in 8 PD patients, 8 healthy elderly, and 8 young adults. Postural sway was recorded using an electromagnetic motion analysis system in four conditions (2 vision x 2 vibration) with four trials in each condition to test subjects' adaptation to the vibrator stimulus. The results showed that PD patients did adapt to the vibration across trials, similar to those of both control groups. It was concluded that PD patients in the early stages of the disease could override inaccurate proprioceptive inputs, relying more on true vestibular and/or visual information. These results suggest that the basal ganglia are not critical for this adaptation process in postural control.
• Ardic, F. N., Latt, L. D., & Redfern, M. S. (2000). Paraspinal muscle response to electrical vestibular stimulation.. Acta oto-laryngologica, 120(1), 39-46. doi:10.1080/000164800760370819
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  Galvanic (electrical) vestibular stimulation (GVS) has been used to study the role of the vestibular system in postural control by inducing postural sway in standing subjects. The purpose of this study was to determine the timing and pattern of activation in the paraspinal muscles in response to GVS and to compare these responses with those in the muscles of the lower leg. Binaural-bipolar GVS was applied to the skin overlying the mastoid processes of 10 subjects while they stood on a force plate with their eyes closed. The stimulus consisted of a 0.6 mA 5-pulse sequence. Each pulse lasted for 2 s, followed by 4 s of rest. The centre of pressure (COP) vs. time for each trial was calculated from the reaction forces and moments. Surface electromyographic (EMG) signals from the paraspinal and gastrocnemius muscles were recorded bilaterally. The EMG signals were rectified and integrated (iEMG). The iEMG from the muscles on the cathodal side of the body were then subtracted from the iEMG of the anodal side muscles, to yield a differential EMG (dEMG). Both the paraspinal and gastrocnemius muscles became activated in response to the stimulus. The pattern of activation was consistent with the changes observed in the centre of pressure. The primary response in both muscles acted to move the body toward the anode. This primary response began at 74 +/- 20 ms in the paraspinal muscles and at 118 +/- 18 ms in the gastrocnemius. A second component of the response began at 232 +/- 27 ms in the paraspinal muscles and 262 +/- 54 ms in the gastrocnemius muscles. This second phase of the response was opposite in direction to the primary response and was responsible for decelerating the body and maintaining the deviated position of the centre of mass over the base of support. Following the termination of the stimulus, the opposite pattern of muscle activation in both the paraspinal and the gastrocnemius muscles was observed. The results of this study suggest that the paraspinal muscles may play a significant role in the frontal plane response to vestibular stimulation during stance in humans.

Proceedings Publications

• Barton, J. K., Rice, P. S., Howard, C. C., Koevary, J. W., Danford, F., Gonzales, D. A., Vande Geest, J., Latt, L. D., Szivek, J. A., Amodei, R., & Slayton, M. (2018). Structural and functional assessment of intense therapeutic ultrasound effects on partial Achilles tendon transection. In Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XVI, 10484.
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  Tendinopathies and tendon tears heal slowly because tendons have a limited blood supply. Intense therapeutic ultrasound (ITU) is a treatment modality that creates very small, focal coagula in tissue, which can stimulate a healing response. This pilot study investigated the effects of ITU on rabbit and rat models of partial Achilles tendon rupture. The right Achilles tendons of 20 New Zealand White rabbits and 118 rats were partially transected. Twenty-four hours after surgery, ITU coagula were placed in the tendon and surrounding tissue, alternating right and left legs. At various time points, the following data were collected: ultrasound imaging, optical coherence tomography (OCT) imaging, mechanical testing, gene expression analysis, histology, and multiphoton microscopy (MPM) of sectioned tissue. Ultrasound visualized cuts and treatment lesions. OCT showed the effect of the interventions on birefringence banding caused by collagen organization. MPM showed inflammatory infiltrate, collagen synthesis and organization. By day 14- 28, all tendons had a smooth appearance and histology, MPM and OCT still could still visualize residual healing processes. Few significant results in gene expression were seen, but trends were that ITU treatment caused an initial decrease in growth and collagen gene expression followed by an increase. No difference in failure loads was found between control, cut, and ITU treatment groups, suggesting that sufficient healing had occurred by 14 days to restore all test tissue to control mechanical properties. These results suggest that ITU does not cause harm to tendon tissue. Upregulation of some genes suggests that ITU may increase healing response.
• Gao, L., Schmitz, H. A., Zuniga, A. A., Klewer, J. A., Szivek, J. A., Taljanovic, M. S., Latt, L. D., & Witte, R. S. (2016). Minimizing strain error for in vivo ultra-sound elasticity imaging of human tendon. In 2016 IEEE International Ultrasonics Symposium (IUS), 2016-.
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  Ultrasound elasticity imaging (UEI) is a noninvasive method for characterizing mechanical properties of soft tissue. This technique potentially provides important feedback for making treatment decision for advanced tendinopathies, such as posterior tibial tendon dysfunction (PTTD). Highly variable lateral strain along the length of the tendon has been observed during human experiments. To better understand the in vivo results, a dynamic ultrasound model of the PTT under cyclical loading was developed to analyze factors that affect tracking error (e.g., strain magnitude and out-of-plane motion) and compare different methods for calculating strain. The simulations demonstrated that linear fitting of the lateral displacement along the length of the tendon (“Method A”) produced less error for displacement and strain calculations compared to the median of the displacement gradients over the region-of-interest (“Method B”). Also, when out-of-plane motion was less than one acoustic wavelength, the strain error was 5.0 ± 4.2% for Method A and 8.3 ± 8.3% for Method B. Out-of-plane motion greater than one acoustic wavelength, produced large strain errors using either method. These results suggest that a linear fit of the displacements along the imaged portion of the tendon is an overall better approach for estimating lateral strain. Optimizing the imaging protocol and data analysis for UEI will lead to a more accurate and quantitative estimate of the mechanical properties of human tendon to help with the diagnosis, staging and treatment decisions for tendinopathies.
• Slayton, M., Amodei, R., Compton, K., Latt, D., & Kearney, J. (2016). Musculoskeletal treatments using intense therapy ultrasound: Clinical studies for chronic plantar fasciitis and lateral epicondylitis. In 2016 IEEE Healthcare Innovation Point-of-Care Technologies Conference, HI-POCT 2016.
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  Background/Objective: Intense Therapy Ultrasound (ITU) effectively creates thermal injury zones inside soft tissue, initiating a tissue repair cascade in the skin, promoting collagen generation. It may be feasible to promote a robust healing response in musculoskeletal tissue accelerating healing from injury [1]. The objectives of the studies were to establish the feasibility of treatment by High Frequency ITU for Plantar Fasciitis and Lateral Epicondylitis. Protocols/Methods: Chronic Plantar Fasciitis: Two treatments, 2 weeks apart, 38 patients, (27-treated, 11-sham group) consisted of 250-320 80 msec pulses creating matrices of small ablative thermal lesions of 4-5 joules at a pre-programmed pitch of 1.6 mm. Each treatment did not exceed 12 minutes. Treatment effects were assessed with diagnostic ultrasound imaging at 12 MHz. Ultrasound images were analyzed to determine changes in peri-fascial lesion size. Patients reported outcomes at 2, 4 6 and 12 weeks after initiating treatment [2]. Chronic Lateral Epicondylitis: Two treatments, 4 weeks apart, 24 patients, consisting of 80 14 msec pulses creating matrices of small ablative thermal lesions of 1 joule. Manually targeted area mapped by diagnostic ultrasound imaging. Each treatment was less than 10 minutes. Treatment effects were assessed with diagnostic ultrasound at 17MHz. Patient reported outcomes at 2, 4, 8 and 12 weeks after initial treatment. For both studies patients randomized, the principal investigator, sonographer and study coordinator administering the study were blinded to clinical assessments and diagnostic ultrasound results. Results/Conclusions: Plantar Fasciitis: Results of the double blinded, randomized, sham controlled study for the treatment of Plantar Fasciitis with ITU appeared to have significant positive results within 12 weeks' post-treatment in 81% of patients treated. Both quantitative measurements from diagnostic ultrasound imaging and applied standardized assessment protocols showed statistically significant coincidental improvements in treated patients vs. control group. Chronic Lateral Epicondylitis: Statistically significant improvements were seen in 75% of patients and diagnostic ultrasound images show significant reduction in free fluid at 8 weeks compared to baseline images in patients with no to mild peri-tendon calcifications. These patients correlated well with significantly improved PRTEE survey scores. Few patients with little or no improvement in PRTEE scores consistently presented with moderate to severe peri-tendon calcifications.

Presentations

• Latt, D. L. (2023).

  Presentations x 10 in 2023
  
  1) Renfree SP, Simeon S, Pinder-Newton P, Ayala A, Malakoutikhah H, Latt LD. A Cadaveric Model of Plantar Pressure in Progressive Collapsing Foot Deformity Caused by Serial Ligament Transections. Poster Presentation at the 2023 Western Medical Research Conference, January 19-21, 2023, Carmel, CA.

  2) Renfree S, Simeon S, Newton P, Alfonso A, Malakoutikhah H, Borgstrom M, Latt LD. The Impact of Ligament Tears on Plantar Pressure in Progressive Collapsing Foot Deformity: A Cadaveric Model. Poster Presentation at the ORS 2023 Annual Meeting, February 10-14, 2023, Dallas TX.

  3) Chaudhry A, Latt LD. Effects of Non-surgical Treatment for Progressive Collapsing Foot Deformity: A Systematic Review. Poster Presentation at the ORS 2023 Annual Meeting, February 10-14, 2023, Dallas TX.

  4) Estrada EE, Easley JT, Safranski DL, Latt LD, Shibuya N, Puttlitz CM, Gadomski BC. Tracking Bone Resorption with Sustained Dynamic Compression in a Novel Large Animal Model of Tarsal Fusion. Poster Presentation at the ORS 2023 Annual Meeting, February 10-14, 2023, Dallas TX.

  5) Chaudry A, Latt LD. Effects of Non-surgical Treatment For Progressive Collapsing Foot Deformity: A Systematic Review. Poster Presentation at the ORS 2023 Annual Meeting, February 10-14, 2023, Dallas TX.

  6) Pan P, Renfree S, Latt LD. Pedobarographic Analysis of Progressive Collapsing Foot Deformity in a Serial Ligament Transection Cadaveric Model. Poster Presentation at Central Alabama Regional Science and Engineering Fair (CARSEF), The UAB Center for Community Outreach Development (CORD), March 4, 2023, Birmingham, AL.
  
  7) Pan P, Renfree S, Latt LD. Pedobarographic Analysis of Progressive Collapsing Foot Deformity in a Serial Ligament Transection Cadaveric Model. Poster Presentation 2023Annual Research Frontier Symposium, Alabama State University, Montgomery, Alabama, March 15-16, 2023.
  
  8) Latt LD. The AOFAS Committee on Health Outcomes, Registries, and Data (CHORD) Patient Reported Outcome Measures: Soup to Nuts. Live webinar, May 18, 2023.
  
  9) Malakoutikhah H, Latt LD. The role of the plantar fascia in supporting the arch in flatfoot deformity. Poster Presentation at the 2023 AOFAS Annual Meeting, Louisville, KY, September 20-23, 2023.

  . Refer to Title or Description section for the 9 Presentations.
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  1) Renfree SP, Simeon S, Pinder-Newton P, Ayala A, Malakoutikhah H, Latt LD. A Cadaveric Model of Plantar Pressure in Progressive Collapsing Foot Deformity Caused by Serial Ligament Transections. Poster Presentation at the 2023 Western Medical Research Conference, January 19-21, 2023, Carmel, CA.2) Renfree S, Simeon S, Newton P, Alfonso A, Malakoutikhah H, Borgstrom M, Latt LD. The Impact of Ligament Tears on Plantar Pressure in Progressive Collapsing Foot Deformity: A Cadaveric Model. Poster Presentation at the ORS 2023 Annual Meeting, February 10-14, 2023, Dallas TX.3) Chaudhry A, Latt LD. Effects of Non-surgical Treatment for Progressive Collapsing Foot Deformity: A Systematic Review. Poster Presentation at the ORS 2023 Annual Meeting, February 10-14, 2023, Dallas TX.4) Estrada EE, Easley JT, Safranski DL, Latt LD, Shibuya N, Puttlitz CM, Gadomski BC. Tracking Bone Resorption with Sustained Dynamic Compression in a Novel Large Animal Model of Tarsal Fusion. Poster Presentation at the ORS 2023 Annual Meeting, February 10-14, 2023, Dallas TX.5) Chaudry A, Latt LD. Effects of Non-surgical Treatment For Progressive Collapsing Foot Deformity: A Systematic Review. Poster Presentation at the ORS 2023 Annual Meeting, February 10-14, 2023, Dallas TX.6) Pan P, Renfree S, Latt LD. Pedobarographic Analysis of Progressive Collapsing Foot Deformity in a Serial Ligament Transection Cadaveric Model. Poster Presentation at Central Alabama Regional Science and Engineering Fair (CARSEF), The UAB Center for Community Outreach Development (CORD), March 4, 2023, Birmingham, AL.7) Pan P, Renfree S, Latt LD. Pedobarographic Analysis of Progressive Collapsing Foot Deformity in a Serial Ligament Transection Cadaveric Model. Poster Presentation 2023Annual Research Frontier Symposium, Alabama State University, Montgomery, Alabama, March 15-16, 2023.8) Latt LD. The AOFAS Committee on Health Outcomes, Registries, and Data (CHORD) Patient Reported Outcome Measures: Soup to Nuts. Live webinar, May 18, 20239) Malakoutikhah H, Latt LD. The impact of tendon lengthening following Achilles tendon repair on foot kinetics, a finite element analysis  Electronic Presentation at the 2023 AOFAS Annual Meeting, Louisville, KY, September 20-23, 2023.10) Malakoutikhah H, Latt LD. The role of the plantar fascia in supporting the arch in flatfoot deformity. Poster Presentation at the 2023 AOFAS Annual Meeting, Louisville, KY, September 20-23, 2023.
• Latt, D. L. (2018, September). Tracking patient outcomes following foot and ankle surgery: The OFAR experience 2018-2010. AOFAS 2019 Annual Meeting. Chicago, IL.
• Latt, D. L. (2020, Jan). Oral Presentation: Quantification of Bone Viscoelasticity With Lag Screw in Hindfoot Arthrodesis. 2020 Western Medical Research Conference, January 23-25, 2020. Carmel, CA: Western Medical Research Conference.
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  Johnson BW, Rugg AL, Requist MR, Alvarez A, Son MM, Latt LD. Quantification of Bone Viscoelasticity With Lag Screw in Hindfoot Arthrodesis. Oral presentation at the 2020 Western Medical Research Conference, January 23-25, 2020, Carmel, CA.
• Latt, D. L., Slayton, M. H., Amodei, R. C., Compton, K. B., & Kearney, J. (2016, Fall). Muscoloskeletal Treatments Using Intense Therapy Ultrasound: Clinical Studies for Chronic Plantar Fasciitis and Lateral Eipcondylitis. IEEE – NIH 2016 Special Topics Conference on Healthcare Innovations and Pointy-of-Care Technologies. Nov 9-11, 2016. Cancun, Mexico: IEEE - NIH.
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  Slayton MH, Amodei RC, Compton KB, Latt LD, Kearney J. Muscoloskeletal Treatments Using Intense Therapy Ultrasound: Clinical Studies for Chronic Plantar Fasciitis and Lateral Eipcondylitis. Podium presentation. IEEE – NIH 2016 Special Topics Conference on Healthcare Innovations and Pointy-of-Care Technologies. Nov 9-11, 2016, Cancun, Mexico.
• Latt, D. L. (2021, Summr). Data Acquisition System To Quantify Bone Viscoelasticity In Hindfoot and Midfoot Arthrodesis (Student paper competition finalist presentation). 2021 Summer Biomechanics, Bioengineering and Biotransport Conference (SB3C2021) held virtually, June 14 – 18, 202. Virtual: Summer Biomechanics, Bioengineering and Biotransport Conference (SB3C2021).
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  Requist M, Rugg A, Johnson B, Son M, Alvarez A, Latt LD. Data Acquisition System To Quantify Bone Viscoelasticity In Hindfoot and Midfoot Arthrodesis. Student paper competition finalist presentation. 2021 Summer Biomechanics, Bioengineering and Biotransport Conference (SB3C2021) to be held virtually, June 14 – 18, 2021.
• Latt, D. L. (2019, Feb). Podium/Slide Presentation: Postural stability in patients with posterior tibial tendon dysfunction during walking.. 2019 Mid-South Biomechanics Conference at the University of Memphis,. Memphis, TN: Mid-South Biomechanics Conference at the University of Memphis,.
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  Wang J, Bowers K, Fatsje C, Latt LD. “Postural stability in patients with posterior tibial tendon dysfunction during walking. Podium/Slide Presentation. 2019 Mid-South Biomechanics Conference at the University of Memphis, February 21-22, 2019, Memphis, TN.
• Gimber, L. H., Taljanovic, M., Latt, D. L., Chadaz, T., Krupinski, E. A., Caruso, C., Nuncio Zuniga, A. A., Nuncio Zuniga, A. A., Caruso, C., Krupinski, E. A., Chadaz, T., Latt, D. L., Taljanovic, M., Gimber, L. H., Taljanovic, M., Chadaz, T., Krupinski, E. A., Nuncio Zuniga, A. A., Caruso, C., , Latt, D. L., et al. (2018, March). Ultrasound shear wave elastography of the lateral ankle ligaments in healthy subjects at rest and stress. Society of Skeletal Radiology Annual Meeting. Austin, Texas: SSR.
• Taljanovic, M., Taljanovic, M., Chadaz, T., Chadaz, T., Krupinski, E. A., Krupinski, E. A., Nuncio Zuniga, A. A., Nuncio Zuniga, A. A., Caruso, C., Caruso, C., Latt, D. L., Latt, D. L., Gimber, L. H., & Gimber, L. H. (2018, Spring). Ultrasound shear wave elastography of the lateral ankle ligaments in healthy subjects at rest and stress. SSR 2018.
• Latt, D. L., Gao, L., Taljanovic, M., Szivek, J. A., Guerra, J. D., Klewer, J. A., Witte, R. S., Latt, D. L., Gao, L., Taljanovic, M., Szivek, J. A., Guerra, J. D., Klewer, J. A., & Witte, R. S. (2016, March). In Vivo Ultrasound Elasticity Imaging Differentiates Healthy From Diseased Tendons. Orthopaedic Research Society 2016 Annual Meeting. Orlando, Florida.
• Taljanovic, M., Latt, D. L., Gao, L., & Witte, R. S. (2016, March). In Vivo Ultrasound Tension Elastography Differentiates Healthy From Diseased Posterior Tibialis tendon. 39th Annual Meeting of the Society of Skeletal Radiology (SSR). New Orleans, LA: Society of Skeletal Radiology.
• Witte, R. S., Latt, D. L., Klewer, J. A., Gao, L., Guerra, J. D., Taljanovic, M., Szivek, J. A., Szivek, J. A., Guerra, J. D., Taljanovic, M., Gao, L., Klewer, J. A., Latt, D. L., & Witte, R. S. (2016, March). In Vivo Ultrasound Elasticity Imaging Differentiates Healthy From Diseased Tendons. ORS 2016 Annual Meeting. Orlando, Florida.

Poster Presentations

• Latt, D. L. (2015, August). Intense therapy ultrasound for the treatment of chronic plantar fasciitis: Preliminary results of clinical study.. IEEE Engineering in Medicine and Biology Society.. Milan, Italy: IEEE Engineering in Medicine and Biology Society Meeting, August 2015.
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  Slayton, MH, Amodei RC, McNelly A, Latt LD. Intense therapy ultrasound for the treatment of chronic plantar fasciitis: Preliminary results of clinical study. Poster Presentation. IEEE Engineering in Medicine and Biology Society. Aug 25-29, 2015, Milan, Italy.
• Latt, D. L. (2015, July). Comparison of Three Techniques for the Quantification of Hindfoot Alignment. Annual meeting of the American Orthopaedic Foot & Ankle Society. Long Beach, California.
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  McGlone S, Rabadam G, Grewal G, Najafi B, Latt LD. Comparison of Three Techniques for the Quantification of Hindfoot Alignment. E-Poster. Annual meeting of the American Orthopaedic Foot & Ankle Society, July 15-18, 2015, Long Beach, CA.
• Latt, D. L. (2015, July). Self-Reported Injuries and Treatments in Collegiate Dancers. Annual meeting of the American Orthopaedic Foot & Ankle Society, July 15-18, 2015.
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  Latt LD, Holman N, Amir N. Self-Reported Injuries and Treatments in Collegiate Dancers. E-Poster. Annual meeting of the American Orthopaedic Foot & Ankle Society, July 15-18, 2015, Long Beach, CA.
• Latt, D. L. (2020, Feb). Poster Presentation: Quantification Of Compression Maintenance Using A Lag Screw For Hindfoot Arthrodesis. ORS 2020 Annual Meeting, Feb 8-11, 2020. Phoenix, AZ: ORS.
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  Rugg AL, Requist MR, Johnson BW, Alvarez A, Son MM, Latt LD. Quantification Of Compression Maintenance Using A Lag Screw For Hindfoot Arthrodesis. Accepted for poster presentation. ORS 2020 Annual Meeting, February 8-11, 2020, Phoenix, AZ.
• Latt, D. L. (2020, Feb). Ultrasound shear wave elastography (SWE) of the tibialis posterior tendon (PTT) and tibiospring/spring ligaments at rest and stress in normal feet compared to asymptomatic and symptomatic acquired flatfoot deformity. International Symposium on Ligaments and Tendons (Feb 7, 2020). Phoenix, AZ: International Symposium on Ligaments and Tendons.
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  Taljanovic MS, Kim W, Caruso CC, Krupinski EA, Nuncio A, Latt LD. Ultrasound shear wave elastography (SWE) of the tibialis posterior tendon (PTT) and tibiospring/spring ligaments at rest and stress in normal feet compared to asymptomatic and symptomatic acquired flatfoot deformity. Abstract accepted Dec 16, 2019 for presentation at the International Symposium on Ligaments and Tendons, February 7, 2020, Phoenix, AZ
• Latt, D. L. (2020, Sept). The Effects of Fibular Malrotation on Tibiotalar Contact Area and Peak Pressure Distributions in Weber B Ankle Fractures. AOFAS Annual Meeting 2020, September 9-12, 2020. Virtual: AOFAS.
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  Khwaja AM, Latt LD. The Effects of Fibular Malrotation on Tibiotalar Contact Area and Peak Pressure Distributions in Weber B Ankle Fractures. Abstract. AOFAS Annual Meeting 2020, September 9-12, 2020, San Antonio, TX.
• Latt, D. L., Christensen, D. N., McNelly, A. L., Slayton, M. H., Amodei, R. C., & Fastje, C. D. (2016, July). Randomized Controlled Trial of Intense Therapeutic Ultrasound for the treatment of Chronic Plantar Fasciiti. Annual meeting of the American Orthopaedic Foot & Ankle Society, July 20-23, 2015. Toronto, Canada: AOFAS.
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  Latt LD, Christensen DN, McNelly AL, Slayton MH, Amodei RC, Fastje CD. Randomized Controlled Trial of Intense Therapeutic Ultrasound for the treatment of Chronic Plantar Fasciitis. Abstract accepted Jan 5, 2016 for Podium presentation. Annual meeting of the American Orthopaedic Foot & Ankle Society, July 20-23, 2016, Toronto, Ontario, Canada.
• Latt, D. L., Gao, L., Schmidt, H., Taljanovic, M., Witte, R. S., & Fastje, C. (2016, Fall). Dynamic Model to Optimize Ultrasound Elasticity Imaging of Tendon for Assessment of Tendinopathies. Biomedical Engineering Society Annual Meeting, Oct 5-8, 2016. Minneapolis, MN: Biomedical Engineering Society.
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  Schmitz H, Gao L, Zuiga A, Fastje C, Taljanovic J, Latt LD, Witte R. Dynamic Model to Optimize Ultrasound Elasticity Imaging of Tendon for Assessment of Tendinopathies. Poster Presentation. Biomedical Engineering Society Annual Meeting, Oct 5-8, 2016, Minneapolis, MN.
• Witte, R. S., Latt, D. L., Gao, L., Taljanovic, M., Schmidt, H., Szivek, J. A., Klewer, J., Klewer, J., Schmidt, H., Szivek, J. A., Gao, L., Taljanovic, M., Latt, D. L., & Witte, R. S. (2016, August). Minimizing strain error for in vivo ultrasound elasticity imaging of human tendon. IEEE Engineering in Medicine and Biology Society, August 16-20, 2016. Orlando, Florida: IEEE Engineering in Medicine and Biology Society.
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  Gao L, Schmitz H, Zuniga Z, Klewer J, Szivek J, Taljanovic M, Latt LD Witte R. Minimizing strain error for in vivo ultrasound elasticity imaging of human tendon. Poster presentation. IEEE Engineering in Medicine and Biology Society. Aug 16-20, 2016, Orlando, FL.
• Latt, D. L. (2019, Feb). In Vivo Ultrasound Elastography of Material Properties of Healthy and Diseased Human Posterior Tibial Tendon. ORS 2019 Annual Meeting, February 2-5, 2019, Austin, TX.. Austin, TX: ORS.
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  Latt LD, Zuniga AN, Schmitz HA, Lim AE, Roussas A, Tang Y, Klewer JA, Taljanovic MS, Witte RS. . In Vivo Ultrasound Elastography of Material Properties of Healthy and Diseased Human Posterior Tibial Tendon. Poster Presentation (Tendon & Ligament – Diseases & Disorders Category). ORS 2019 Annual Meeting, February 2-5, 2019, Austin, TX.
• Latt, D. L. (2019, March). ePoster: Ultrasound shear wave elastography (SWE) of the tibialis posterior tendon (PTT) and tibiospring/spring ligaments at rest and stress in normal feet compared to asymptomatic and symptomatic acquired flatfoot deformity.. 42nd Annual Meeting of the Society of Skeletal Radiology. Scottsdale, AZ: SSR.
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  Taljanovic MS, Kim W, Caruso CC, Krupinski EA, Nuncio A, Latt LD. Ultrasound shear wave elastography (SWE) of the tibialis posterior tendon (PTT) and tibiospring/spring ligaments at rest and stress in normal feet compared to asymptomatic and symptomatic acquired flatfoot deformity. ePoster. 42nd Annual Meeting of the Society of Skeletal Radiology, March 10-13, 2019. Scottsdale, AZ.
• Latt, D. L. (2019, Nov). Quantification Of Compression Maintenance Using A Lag Screw For Hindfoot Arthrodesis. American Medical Association EXPO. Carmel, CA: AMA.
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  Rugg AL, Requist MR, Johnson BW, Alvarez A, Son MM, Latt LD. Quantification Of Compression Maintenance Using A Lag Screw For Hindfoot Arthrodesis. Poster presentation at the American Medical Association EXPO, November 15, 2019, Carmel, CA.
• Latt, D. L. (2019, Oct). Quantification Of Compression Maintenance Using A Lag Screw For Hindfoot Arthrodesis. American College of Physicians – Arizona Chapter 2019 Annual Meeting Poster Competition. Phoenix, AZ: American College of Physicians.
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  Rugg AL, Requist MR, Johnson BW, Alvarez A, Son MM, Latt LD. Quantification Of Compression Maintenance Using A Lag Screw For Hindfoot Arthrodesis. Poster presentation at the American College of Physicians – Arizona Chapter 2019 Annual Meeting Poster Competition, October 19, 2019, Phoenix, AZ.
• Latt, D. L. (2019, Oct). Self-reported injuries and treatments in collegiate dancers. International Association for Dance Medicine & Science Annual Conference. Montreal, Quebec: International Association for Dance Medicine & Science.
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  Paulsen K, Latt LD. Self-reported injuries and treatments in collegiate dancers. Poster presentation at the International Association for Dance Medicine & Science Annual Conference, October 24-27, 2019, Montreal, Quebec, Canada.
• Latt, D. L. (2019, Sept). Hindfoot Bone Viscoelasticity and Stress Relaxation.. AOFAS Annual Meeting, September 12-15, 2019. Chicago, IL: AOFAS.
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  Son M, Johnson B, Latt LD. Hindfoot Bone Viscoelasticity and Stress Relaxation. Poster presentation at the AOFAS Annual Meeting, September 12-15, 2019, Chicago, IL.
• Schmitz, H., Witte, R. S., Gao, L., Latt, D. L., Ingram, C. P., Taljanovic, M., Klewer, J., Szivek, J. A., Klewer, J., Szivek, J. A., Ingram, C. P., Taljanovic, M., Gao, L., Latt, D. L., Schmitz, H., & Witte, R. S. (2016, January). Ultrasound Elasticity Imaging of the Posterior Tibial Tendon using FOCUS Simulation Software. 27th Annual Undergraduate Biology Research Program Conference. Tucson, AZ.

Other Teaching Materials

• Latt, D. L. (2015. Shear Wave Elastography: Basic Physics and Musculoskeletal Applications.. Radiologic Society of North America 100th Scientific Assembly and Annual Meeting, Nov 29-Dec 4 2015.
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  Taljanovic MS, Melville D, Gimber LH, Latt LD, Becker GW, Klauser A. Shear Wave Elastography: Basic Physics and Musculoskeletal Applications. Accepted June 24, 2015 as an Educational Exhibit. Radiologic Society of North America 100th Scientific Assembly and Annual Meeting, November 29 - December 4, 2015. Chicago, IL.

Others

• Latt, D. L. (2015, November). In vivo Ultrasound Elasticity Imaging Differentiates Healthy From Diseased Tendons.. Abstract accepted November 2015.
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  Latt LD, Gao L, Taljanovic MS, Szivek JA, Guerra JD, Klewer JA, Witte RS. In vivo Ultrasound Elasticity Imaging Differentiates Healthy From Diseased Tendons. Abstract accepted Nov 4, 2015. Podium Presentation at the Orthopaedic Research Society 2016 Annual Meeting, March 5-8, 2016. Orlando, FL.