Polymethylmethacrylate (PMMA) Augmentation Enhances the Mechanical Characteristics of Midfoot Beam Constructs in Charcot Neuroarthropathy Cadaver Model.

BACKGROUND: Even with the best conservative care, patients with Charcot neuroarthropathy (CN) of the foot and ankle often ulcerate, increasing their risk of infection, amputation, and death. Surgical fixation has been associated with risk of recurrent ulceration, potentially due to poor bone quality prone to recurrent deformity and ulceration. We propose midfoot beam reconstruction with PMMA augmentation as a novel means of improving fixation. METHODS: A protocol was developed to create characteristic CN midfoot fragmentation both visually and fluoroscopically in each of 12 matched-pair cadaveric feet. Afterward, the pairs were divided into 2 groups: (1) midfoot beam fusion surgery alone, and (2) midfoot beam fusion surgery augmented with PMMA. A solid 7.0-mm beam was placed into the medial column and a solid 5.5-mm beam was placed across the lateral column. In the PMMA group, 8 to 10 mL of PMMA was inserted into the medial column. The hindfoot of each specimen was potted and the metatarsal heads were cyclically loaded for 1800 cycles, followed by load to failure while load and displacement were continually recorded. RESULTS: One specimen in the beam alone group failed before reaching the 1800th cycle and was not included in the failure analysis. The midfoot beam only group demonstrated greater mean displacement during cycle testing compared with the PMMA group, P < .05. The maximum force (N), stiffness (N/mm), and toughness (Nmm) were all significantly greater in the group augmented with PMMA, P < .05. CONCLUSION: In a CN cadaveric model, PMMA augmentation significantly decreased gapping during cyclic loading and nearly doubled the load to failure compared with midfoot beams alone. CLINICAL RELEVANCE: The results of this biomechanical study demonstrate that augmentation of midfoot beams with PMMA increases the strength and stiffness of the fusion construct. This increased mechanical toughness may help reduce the risk of nonunion and infection in patients with neuropathic midfoot collapse.

Measurement of the Induced Magnetic Polarisation of Rotated-Domain Graphene Grown on Co Film with Polarised Neutron Reflectivity.

In this paper, we determine the magnetic moment induced in graphene when grown on a cobalt film using polarised neutron reflectivity (PNR). A magnetic signal in the graphene was detected by X-ray magnetic circular dichroism (XMCD) spectra at the C K-edge. From the XMCD sum rules an estimated magnetic moment of 0.3 µB/C atom, while a more accurate estimation of 0.49 µB/C atom was obtained by carrying out a PNR measurement at 300 K. The results indicate that the higher magnetic moment in Co is counterbalanced by the larger lattice mismatch between the Co-C (1.6%) and the slightly longer bond length, inducing a magnetic moment in graphene that is similar to that reported in Ni/graphene heterostructures.

Determining the Proximity Effect-Induced Magnetic Moment in Graphene by Polarized Neutron Reflectivity and X-ray Magnetic Circular Dichroism.

We report the magnitude of the induced magnetic moment in CVD-grown epitaxial and rotated-domain graphene in proximity with a ferromagnetic Ni film, using polarized neutron reflectivity (PNR) and X-ray magnetic circular dichroism (XMCD). The XMCD spectra at the C K-edge confirm the presence of a magnetic signal in the graphene layer, and the sum rules give a magnetic moment of up to ∼0.47 µB/C atom induced in the graphene layer. For a more precise estimation, we conducted PNR measurements. The PNR results indicate an induced magnetic moment of ∼0.41 µB/C atom at 10 K for epitaxial and rotated-domain graphene. Additional PNR measurements on graphene grown on a nonmagnetic Ni9Mo1 substrate, where no magnetic moment in graphene is measured, suggest that the origin of the induced magnetic moment is due to the opening of the graphene's Dirac cone as a result of the strong C pz-Ni 3d hybridization.

Accuracy of Pain Tolerance Self-assessment Versus Objective Pressure Sensitivity.

INTRODUCTION: Effective treatment of postoperative pain after elective surgery remains elusive, and the experience of pain can be variable for patients. The patient's intrinsic pain tolerance may contribute to this variability. We sought to identify whether there was a correlation between subjective report of intrinsic pain tolerance and objective measurement of pressure dolorimetry (PD). We also sought to identify whether a correlation existed between PD and Patient Reported Outcome Measurement Information System (PROMIS) scores of pain intensity, physical function, and mood. PD is a validated, objective method to assess pain tolerance. Markers of general mental and physical health are correlated with pain sensitization and may also be linked to pain tolerance. METHODS: PROMIS scores, dolorimetry measurements, and survey data were collected on 40 consecutive orthopaedic foot and ankle surgery patients at the initial clinic visit. Patients were included if they had normal sensation on the plantar foot and no prior surgery or plantar heel source of pain. RESULTS: Objective dolorimetry data reflecting 5/10 pain for the patients were 24 N/cm 2 (±8.9). Patients estimated their pain threshold as 7.3/10 (±2.1). No correlation was found between objective and subjective pain threshold identified. A moderate negative correlation of R = -0.44 was observed regarding PROMIS-M with dolorimetry data ( P < -0.05). PROMIS-M score >60 had a significant decrease in pain threshold to 15.9 ± 8.5 N/cm 2 compared with 25.7 ± 8.9 N/cm 2 for those who were less depressed with a PROMIS<60 ( P < 0.05). CONCLUSION: Subjective pain tolerance is not correlated with the patient's own objective pain threshold or markers of mental health and should not be used to assist clinical decision making. PROMIS-M is inversely correlated with objective pain. Higher PROMIS-M scores are associated with a lower objective pain threshold. LEVEL OF EVIDENCE: Level II-Lesser Quality Randomized Controlled Trial or Prospective Comparative Study.

Biophysical studies of lipid nanodomains using different physical characterization techniques.

For the past 50 years, evidence for the existence of functional lipid domains has been steadily accumulating. Although the notion of functional lipid domains, also known as "lipid rafts," is now widely accepted, this was not always the case. This ambiguity surrounding lipid domains could be partly attributed to the fact that they are highly dynamic, nanoscopic structures. Since most commonly used techniques are sensitive to microscale structural features, it is therefore, not surprising that it took some time to reach a consensus regarding their existence. In this review article, we will discuss studies that have used techniques that are inherently sensitive to nanoscopic structural features (i.e., neutron scatting, nuclear magnetic resonance, and Förster resonance energy transfer). We will also mention techniques that may be of use in the future (i.e., cryoelectron microscopy, droplet interface bilayers, inelastic x-ray scattering, and neutron reflectometry), which can further our understanding of the different and unique physicochemical properties of nanoscopic lipid domains.

Emergent Magnetic States and Tunable Exchange Bias at 3d Nitride Heterointerfaces.

Interfacial magnetism stimulates the discovery of giant magnetoresistance (MR) and spin-orbital coupling across the heterointerfaces, facilitating the intimate correlation between spin transport and complex magnetic structures. Over decades, functional heterointerfaces composed of nitrides have seldom been explored due to the difficulty in synthesizing high-quality nitride films with correct compositions. Here, the fabrication of single-crystalline ferromagnetic Fe3 N thin films with precisely controlled thicknesses is reported. As film thickness decreases, the magnetization dramatically deteriorates, and the electronic state changes from metallic to insulating. Strikingly, the high-temperature ferromagnetism is maintained in a Fe3 N layer with a thickness down to 2 u.c. (≈8 Å). The MR exhibits a strong in-plane anisotropy; meanwhile, the anomalous Hall resistivity reverses its sign when the Fe3 N layer thickness exceeds 5 u.c. Furthermore, a sizable exchange bias is observed at the interfaces between a ferromagnetic Fe3 N and an antiferromagnetic CrN. The exchange bias field and saturation moment strongly depend on the controllable bending curvature using the cylinder diameter engineering technique, implying the tunable magnetic states under lattice deformation. This work provides a guideline for exploring functional nitride films and applying their interfacial phenomena for innovative perspectives toward practical applications.

Room-temperature valence transition in a strain-tuned perovskite oxide.

Cobalt oxides have long been understood to display intriguing phenomena known as spin-state crossovers, where the cobalt ion spin changes vs. temperature, pressure, etc. A very different situation was recently uncovered in praseodymium-containing cobalt oxides, where a first-order coupled spin-state/structural/metal-insulator transition occurs, driven by a remarkable praseodymium valence transition. Such valence transitions, particularly when triggering spin-state and metal-insulator transitions, offer highly appealing functionality, but have thus far been confined to cryogenic temperatures in bulk materials (e.g., 90 K in Pr1-xCaxCoO3). Here, we show that in thin films of the complex perovskite (Pr1-yYy)1-xCaxCoO3-δ, heteroepitaxial strain tuning enables stabilization of valence-driven spin-state/structural/metal-insulator transitions to at least 291 K, i.e., around room temperature. The technological implications of this result are accompanied by fundamental prospects, as complete strain control of the electronic ground state is demonstrated, from ferromagnetic metal under tension to nonmagnetic insulator under compression, thereby exposing a potential novel quantum critical point.

Induced Ferromagnetism in Epitaxial Uranium Dioxide Thin Films.

Actinide materials have various applications that range from nuclear energy to quantum computing. Most current efforts have focused on bulk actinide materials. Tuning functional properties by using strain engineering in epitaxial thin films is largely lacking. Using uranium dioxide (UO2 ) as a model system, in this work, the authors explore strain engineering in actinide epitaxial thin films and investigate the origin of induced ferromagnetism in an antiferromagnet UO2 . It is found that UO2+ x thin films are hypostoichiometric (x<0) with in-plane tensile strain, while they are hyperstoichiometric (x>0) with in-plane compressive strain. Different from strain engineering in non-actinide oxide thin films, the epitaxial strain in UO2 is accommodated by point defects such as vacancies and interstitials due to the low formation energy. Both epitaxial strain and strain relaxation induced point defects such as oxygen/uranium vacancies and oxygen/uranium interstitials can distort magnetic structure and result in magnetic moments. This work reveals the correlation among strain, point defects and ferromagnetism in strain engineered UO2+ x thin films and the results offer new opportunities to understand the influence of coupled order parameters on the emergent properties of many other actinide thin films.

Atomically engineered cobaltite layers for robust ferromagnetism.

Emergent phenomena at heterointerfaces are directly associated with the bonding geometry of adjacent layers. Effective control of accessible parameters, such as the bond length and bonding angles, offers an elegant method to tailor competing energies of the electronic and magnetic ground states. In this study, we construct unit-thick syntactic layers of cobaltites within a strongly tilted octahedral matrix via atomically precise synthesis. The octahedral tilt patterns of adjacent layers propagate into cobaltites, leading to a continuation of octahedral tilting while maintaining substantial misfit tensile strain. These effects induce severe rumpling within an atomic plane of neighboring layers, further triggering the electronic reconstruction between the splitting orbitals. First-principles calculations reveal that the cobalt ions transit to a higher spin state level upon octahedral tilting, resulting in robust ferromagnetism in ultrathin cobaltites. This work demonstrates a design methodology for fine-tuning the lattice and spin degrees of freedom in correlated quantum heterostructures by exploiting epitaxial geometric engineering.

Reversible Hydrogen-Induced Phase Transformations in La0.7Sr0.3MnO3 Thin Films Characterized by In Situ Neutron Reflectometry.

We report on the mechanism for hydrogen-induced topotactic phase transitions in perovskite (PV) oxides using La0.7Sr0.3MnO3 as a prototypical example. Hydrogenation starts with lattice expansion confirmed by X-ray diffraction (XRD). The strain- and oxygen-vacancy-mediated electron-phonon coupling in turn produces electronic structure changes that manifest through the appearance of a metal insulator transition accompanied by a sharp increase in resistivity. The ordering of initially randomly distributed oxygen vacancies produces a PV to brownmillerite phase (La0.7Sr0.3MnO2.5) transition. This phase transformation proceeds by the intercalation of oxygen vacancy planes confirmed by in situ XRD and neutron reflectometry (NR) measurements. Despite the prevailing picture that hydrogenation occurs by reaction with lattice oxygen, NR results are not consistent with deuterium (hydrogen) presence in the La0.7Sr0.3MnO3 lattice at steady state. The film can reach a highly oxygen-deficient La0.7Sr0.3MnO2.1 metastable state that is reversible to the as-grown composition simply by annealing in air. Theoretical calculations confirm that hydrogenation-induced oxygen vacancy formation is energetically favorable in La0.7Sr0.3MnO3. The hydrogenation-driven changes of the oxygen sublattice periodicity and the electrical and magnetic properties similar to interface effects induced by oxygen-deficient cap layers persist despite hydrogen not being present in the lattice.

Designing Magnetism in High Entropy Oxides.

In magnetic systems, spin and exchange disorder can provide access to quantum criticality, frustration, and spin dynamics, but broad tunability of these responses and a deeper understanding of strong limit disorder are lacking. Here, it is demonstrated that high entropy oxides present a previously unexplored route to designing materials in which the presence of strong local compositional disorder may be exploited to generate tunable magnetic behaviors-from macroscopically ordered states to frustration-driven dynamic spin interactions. Single-crystal La(Cr0.2 Mn0.2 Fe0.2 Co0.2 Ni0.2 )O3 films are used as a model system hosting a magnetic sublattice with a high degree of microstate disorder in the form of site-to-site spin and exchange type inhomogeneity. A classical Heisenberg model simplified to represent the highest probability microstates well describes how compositionally disordered systems can paradoxically host magnetic uniformity and demonstrates a path toward continuous control over ordering types and critical temperatures. Model-predicted materials are synthesized and found to possess an incipient quantum critical point when magnetic ordering types are designed to be in direct competition, this leads to highly controllable exchange bias behaviors previously accessible only in intentionally designed bilayer heterojunctions.

Room-Temperature Ferromagnetism at an Oxide-Nitride Interface.

Heterointerfaces have led to the discovery of novel electronic and magnetic states because of their strongly entangled electronic degrees of freedom. Single-phase chromium compounds always exhibit antiferromagnetism following the prediction of the Goodenough-Kanamori rules. So far, exchange coupling between chromium ions via heteroanions has not been explored and the associated quantum states are unknown. Here, we report the successful epitaxial synthesis and characterization of chromium oxide (Cr_{2}O_{3})-chromium nitride (CrN) superlattices. Room-temperature ferromagnetic spin ordering is achieved at the interfaces between these two antiferromagnets, and the magnitude of the effect decays with increasing layer thickness. First-principles calculations indicate that robust ferromagnetic spin interaction between Cr^{3+} ions via anion-hybridization across the interface yields the lowest total energy. This work opens the door to fundamental understanding of the unexpected and exceptional properties of oxide-nitride interfaces and provides access to hidden phases at low-dimensional quantum heterostructures.

Additively Manufactured NdFeB Polyphenylene Sulfide Halbach Magnets to Generate Variable Magnetic Fields for Neutron Reflectometry.

Halbach arrays are the most efficient closed structures for generating directed magnetic fields and gradients, and are widely used in various electric machines. We utilized fused deposition modeling-based Big Area Additive Manufacturing technology to print customized, compensated concentric Halbach array rings, using polyphenylene sulfide-bonded NdFeB permanent magnets for polarized neutron reflectometry. The Halbach rings could generate a 0 ≤ B ≤ 0.30 T field, while preserving 90% polarization of an axial neutron beam. Polarized neutron beams are used to study a wide range of structural and magnetic phenomena spanning physics, chemistry, and biology. In this study, we demonstrate the effectiveness of additive manufacturing for producing prototype Halbach arrays, characterize their magnetic properties, and generated magnetic fields, and discuss the conservation of neutron beam polarization as a function of magnetic field.

Ferroelectric Self-Polarization Controlled Magnetic Stratification and Magnetic Coupling in Ultrathin La0.67Sr0.33MnO3 Films.

Multiferroic oxide heterostructures consisting of ferromagnetic and ferroelectric components hold the promise for nonvolatile magnetic control via ferroelectric polarization, advantageous for the low-dissipation spintronics. Modern understanding of the magnetoelectric coupling in these systems involves structural, orbital, and magnetic reconstructions at interfaces. Previous works have long proposed polarization-dependent interfacial magnetic structures; however, direct evidence is still missing, which requires advanced characterization tools with near-atomic-scale spatial resolutions. Here, extensive polarized neutron reflectometry (PNR) studies have determined the magnetic depth profiles of PbZr0.2Ti0.8O3/La0.67Sr0.33MnO3 (PZT/LSMO) bilayers with opposite self-polarizations. When the LSMO is 2-3 nm thick, the bilayers show two magnetic transitions on cooling. However, temperature-dependent magnetization is different below the lower-temperature transition for opposite polarizations. PNR finds that the LSMO splits into two magnetic sublayers, but the inter-sublayer magnetic couplings are of opposite signs for the two polarizations. Near-edge X-ray absorption spectroscopy further shows contrasts in both the Mn valences and the Mn-O bond anisotropy between the two polarizations. This work completes the puzzle for the magnetoelectric coupling model at the PZT/LSMO interface, showing a synergic interplay among multiple degrees of freedom toward emergent functionalities at complex oxide interfaces.

Antiferromagnetism of Double Molybdate LiFe(MoO4)2.

The magnetic properties of the spin-5/2 double molybdate LiFe(MoO4)2 have been characterized by heat capacity, magnetic susceptibility, and neutron powder diffraction techniques. Unlike the multiferroic system LiFe(WO4)2 which exhibits two successive magnetic transitions, LiFe(MoO4)2 undergoes only one antiferromagnetic transition at TN ∼ 23.8 K. Its antiferromagnetic magnetic structure with the commensurate propagation vector k = (0, 0.5, 0) has been determined. Density functional theory calculations confirm the antiferromagnetic ground state and provide a numerical estimate of the relevant exchange coupling constants.

Analysis of Orthopaedic Job Availability in the United States Based on Subspecialty.

BACKGROUND: The number of orthopaedic residency graduates pursuing additional subspecialty training has increased along with the percentage of advertised jobs requiring fellowship. As such, the implications of fellowship training on job availability and marketability may impact their choice of subspecialty. The purpose of this study was to evaluate job availability in the United States for general orthopaedics and orthopaedic subspecialties. METHODS: Job advertisements in 2019 were reviewed from the career center databases of the Journal of Bone and Joint Surgery, American Academy of Orthopaedic Surgeons, as well as of individual subspecialty societies. Job listings were cross referenced to identify unique jobs within the United States, which were categorized by the orthopaedic training required, practice type, and location. To assess job availability, a ratio of fellows to job listings was calculated based on the number of matched candidates for nine subspecialty fellowships and the number of residency graduates entering general practice in 2019. RESULTS: A total of 466 unique job listings were identified with 114 generalist and 352 subspecialist positions. The subspecialties with the lowest number of fellows per advertised job were foot and ankle (1.1), adult reconstruction (2.0), and trauma (2.1). The subspecialties with the highest number of fellows per advertised job were sports medicine (6.3), shoulder and elbow (5.8), and oncology (5.7). Job availability for general orthopaedics was higher than for any subspecialty. The highest percentage of positions advertised were hospital employed jobs compared with private practice and academic positions. CONCLUSIONS: Job availability for fellowship graduates varies notably based on orthopaedic subspecialty. At this time, generalists and subspecialists trained in foot and ankle, adult reconstruction, and trauma seem to be in greatest demand. The reason for the differences in demand is likely multifactorial. Our findings should be considered by orthopaedic residents pursuing fellowship training in addition to weighing both personal interest and financial considerations in their subspecialty choice.

Effect of Ulnar Collateral Ligament Reconstruction on Pitch Accuracy, Velocity, and Movement in Major League Baseball Pitchers.

BACKGROUND: Ulnar collateral ligament (UCL) reconstruction is frequently performed on Major League Baseball (MLB) pitchers. Previous studies have investigated the effects of UCL reconstruction on fastball and curveball velocity, but no study to date has evaluated its effect on fastball accuracy or curveball movement among MLB pitchers. PURPOSE/HYPOTHESIS: The primary purpose of this study was to determine the effects of UCL reconstruction on fastball accuracy, fastball velocity, and curveball movement in MLB pitchers. Our hypothesis was that MLB pitchers who underwent UCL reconstruction would return to their presurgery fastball velocity, fastball accuracy, and curveball movement. The secondary purpose of this study was to determine which factors, if any, were predictive of poor performance after UCL reconstruction. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: MLB pitchers who underwent UCL reconstruction surgery between 2011 and 2012 were identified. Performance data including fastball velocity, fastball accuracy, and curveball movement were evaluated 1 year preoperatively and up to 3 years of play postoperatively. A repeated-measures analysis of variance with a Tukey-Kramer post hoc test was used to determine statistically significant changes in performance over time. Characteristic factors and presurgery performance statistics were compared between poor performers (>20% decrease in fastball accuracy) and non-poor performers. RESULTS: We identified 56 pitchers with a total of 230,995 individual pitches for this study. After exclusion for lack of return to play (n = 14) and revision surgery (n = 3), 39 pitchers were included in the final analysis. The mean presurgery fastball pitch-to-target distance was 32.9 cm. There was a statistically significant decrease in fastball accuracy after reconstruction, which was present up to 3 years postoperatively (P = .007). The mean presurgery fastball velocity of 91.82 mph did not significantly change after surgery (P = .194). The mean presurgery curveball movement of 34.49 cm vertically and 5.89 cm horizontally also did not change significantly (P = .937 and .161, respectively). CONCLUSION: Fastball accuracy among MLB pitchers significantly decreased after UCL reconstruction for up to 3 years postoperatively. There were no statistically significant differences in characteristic factors or presurgery performance statistics between poor and non--poor performers.

Study of the magnetic interface and its effect in Fe/NiFe bilayers of alternating order.

We present a comprehensive study on the magnetization reversal in the Fe/NiFe bilayer system by alternating the order of the magnetic layers. All the samples show growth-induced uniaxial magnetic anisotropy due to the oblique angle deposition technique. Strong interfacial exchange coupling between the Fe and NiFe layers leads to single-phase hysteresis loops in the bilayer system. The strength of coupling being dependent on the interface changes upon alternating the order of magnetic layers. The magnetic parameters such as coercivity H C, and anisotropy field H K become almost doubled when a NiFe layer is grown over the Fe layers. This enhancement in the magnetic parameters is primarily dependent on the increase of the thickness and magnetic moment of the Fe-NiFe interfacial layer as revealed from the polarized neutron reflectivity (PNR) data of the bilayer samples. The difference in the thickness and magnetization of the Fe-NiFe interfacial layer indicates the modification of the microstructure by alternating the order of the magnetic layers of the bilayers. The interfacial magnetic moment increased by almost 18% when the NiFe layer was grown over the Fe layer. In spite of the different values of anisotropy fields and modified interfacial exchange coupling, the Gilbert damping constant values of the ferromagnetic bilayers remain similar to the single NiFe layer.

Distal Chevron Osteotomy Increases Anatomic Intermetatarsal Angle in Hallux Valgus.

BACKGROUND: Distal chevron metatarsal osteotomy (DCO) is a common technique to address hallux valgus (HV), which involves coronal translation of the capital fragment resulting in a nonanatomic first metatarsal. The purpose of this study was to evaluate the radiographic effect of the DCO on the anatomic vs the mechanical axis of the first metatarsal. Our hypothesis was that patients undergoing DCO would have improvement in the mechanical metatarsal axis but worsening of the anatomic axis. METHODS: This was a retrospective case series of consecutive patients who underwent DCO for HV. The primary outcomes were the change in anatomic first-second intermetatarsal angle (a1-2IMA) vs mechanical first-second intermetatarsal angle (m1-2IMA). Secondary outcomes included the change in hallux valgus angle (HVA) and medial sesamoid position. RESULTS: 40 feet were analyzed with a mean follow-up of 21.2 weeks. The a1-2IMA increased significantly (mean, 4.1 degrees) whereas the m1-2IMA decreased significantly (mean, 4.6 degrees) following DCO. There was a significant improvement in HVA (mean, 12.5 degrees). Medial sesamoid position was improved in 21 feet (52.5%). Patients with no improvement in sesamoid position were found to have a larger increase in a1-2IMA (mean, 4.7 vs 3.5 degrees, P = .03) and less improvement in m1-2IMA (mean, 3.8 vs 5.2 degrees, P = .02) compared to patients with improvement in sesamoid position. CONCLUSION: Distal chevron osteotomy for HV was associated with worsening of the anatomic axis of the first metatarsal despite improvements in the mechanical metatarsal axis, HVA, and medial sesamoid position. Greater worsening of the anatomic axis was associated with less improvement of sesamoid position. Our findings may suggest the presence of intermetatarsal instability, which could limit the power of DCO in HV correction for more severe deformities and provide a mechanism for HV recurrence. LEVEL OF EVIDENCE: Level IV, retrospective case series.

Knot of Henry Variation and the Effect on Plantar Flexion Strength.

BACKGROUND: The flexor hallucis longus (FHL) and flexor digitorum longus (FDL) tendons are commonly used for tendon transfer in reconstructive foot and ankle procedures. Some patients experience great toe weakness and loss of push-off strength. The objective of this biomechanical study was to quantify plantarflexion force after FHL and FDL harvest and correlate it to variations in tendon crossover patterns at the knot of Henry to determine if specific patterns have an increased tendency toward forefoot weakness. METHODS: Simulated loads through the Achilles, FHL, and FDL were applied to cadaveric specimens while plantarflexion force was measured using a pressure mapping system. Force was recorded with the FDL and FHL unloaded to simulate tendon transfer. Afterward, specimens were dissected to classify the tendinous slips between the FHL and FDL based on a previously determined system. Functional and anatomical relationships between the classification type and loading patterns were analyzed. RESULTS: There were no statistical differences between the tendon crossover patterns in forefoot force reduction after FHL or FDL harvest. Average decrease in great toe and total forefoot pressure after FHL harvest was 31% and 22%, respectively. Average decrease in lesser toe and total forefoot push-off force after FDL harvest was 23% and 9%, respectively. CONCLUSION: This study quantified loss of plantarflexion force after simulated FHL and FDL harvest and correlated these losses to variations in anatomic crossover patterns at the knot of Henry. Variations at the knot of Henry do not contribute to differences in forefoot weakness. CLINICAL RELEVANCE: The decrease in forefoot pressure seen here would help explain the clinical scenario where a patient does note a loss of great toe strength after FHL transfer.