Foot & Ankle Orthopaedics最新文献

{"title":"Does Conventional Radiography Overrepresent Joint Space Narrowing in Hallux Rigidus? A Comparative Study With Weightbearing CT Imaging.","authors":"Ahmed Saleh, Vineel Mallavarapu, Nacime Salomao Barbachan Mansur, Aly M Fayed, Cesar de Cesar Netto","doi":"10.1177/24730114261471159","DOIUrl":"https://doi.org/10.1177/24730114261471159","url":null,"abstract":"<p><strong>Background: </strong>Conventional weightbearing radiographs are the gold standard for grading hallux rigidus (HR), yet clinical symptoms often do not correlate with radiographic severity. This study compared 2-dimensional (2D) weightbearing radiographs with weightbearing computed tomography (WBCT) to evaluate if traditional imaging overrepresents joint degeneration.</p><p><strong>Methods: </strong>A retrospective study of 21 patients (13 males; average age 55.9 years) with HR was conducted. All patients had both weightbearing radiographs and WBCT. Two fellowship-trained orthopaedic surgeons measured the first metatarsophalangeal joint (first MTPJ) space, dorsal osteophyte height, and dorsal narrowing percentage. Inter-rater reliability was assessed using intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>Joint space width was significantly larger on WBCT (1.9 ± 0.44 mm) compared to radiographs (0.92 ± 0.53 mm; <i>P</i> < .001). WBCT also showed significantly less narrowing of the dorsal articular surface (22.78% ± 8.71% vs 46.57% ± 18.8%, <i>P</i> < .001). Inter-rater reliability for joint space narrowing was excellent for WBCT (ICC = 0.91) but moderate for radiographs (ICC = 0.67; <i>P</i> < .001). WBCT was more sensitive in detecting loose bodies and sesamoid changes.</p><p><strong>Conclusion: </strong>WBCT demonstrated consistently larger joint-space measurements and less dorsal joint-space narrowing compared with conventional radiographs, along with substantially higher inter-rater reliability for joint space narrowing. These findings indicate a systematic measurement difference between modalities, with radiographs tending to overrepresent joint-space loss. This discrepancy may help explain why joint-preserving procedures such as cheilectomy can succeed even when radiographs appear advanced.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261471159"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ankle Arthrodesis Associated With Risk of Progression to Subtalar Arthrodesis Compared to Total Ankle Arthroplasty.","authors":"Gloria Coden, Kristian Efremov, Philip Hanna, Colin Wood, Matthew Beckles, Jay Modi, Kurt Hofmann","doi":"10.1177/24730114261469567","DOIUrl":"https://doi.org/10.1177/24730114261469567","url":null,"abstract":"<p><strong>Background: </strong>It is unknown how the increased range of motion and improved gait mechanics provided by total ankle arthroplasty (TAA) affects the progression of subtalar arthritis compared with ankle arthrodesis (AA). We hypothesized that patients treated with TAA would have a lower incidence of postoperative subtalar arthrodesis (SA) compared to AA.</p><p><strong>Methods: </strong>We retrospectively reviewed a matched cohort of 2105 AA and 2105 TAA surgeries performed between January 1, 2016, and December 31, 2022, using a commercial claims database. Patients with a history of preoperative ipsilateral SA were excluded. Patients were matched 1:1 for gender, age, indication for ankle surgery, and obesity at time of ankle surgery. The primary endpoint was the cumulative incidence of subtalar arthrodesis following the index ankle procedure. Univariate and multivariate regression analyses were performed. Significance was set at <i>P</i> <.05.</p><p><strong>Results: </strong>Demographics were similar between cohorts, including age, gender, presence of obesity, and length of follow-up. At the 5-year time point, the cumulative incidence of subtalar arthrodesis was 42 SAs for every 1000 AAs (4.2%, absolute risk [AR] = 1.425%), compared with 14 SAs for every 1000 TAAs (1.4%, <i>P</i> = .018; AR = 0.713%, absolute risk reduction [ARR] = 0.71%, CI = 0.09%-1.33%). A univariate analysis demonstrated that AA was associated with increased risk of SA (OR = 2.01, CI = 1.08-3.76), whereas factors such as age, gender, laterality, obesity, and diagnosis did not significantly affect SA risk (all <i>P</i> > .05). In a multivariate analysis, AA remained associated with increased risk of requiring SA (OR = 1.90, CI = 1.01-3.56).</p><p><strong>Conclusion: </strong>In this study, we found a significantly higher incidence of subtalar arthrodesis following AA compared with TAA. Surgeons may consider the risk of progression to SA when deciding between TAA and AA for patients with advanced ankle arthritis, particularly in preoperative counseling for patients without existing subtalar arthritis, as TAA may offer an opportunity to mitigate this risk.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261469567"},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of Achilles Insertional Repair Techniques: Minimally Invasive Compared to Open Repair.","authors":"Jorge I Acevedo, Sofia Rivera, Kelsey A Crawford, Lauren Barnes, David E Jaffe, John Chao, Dominic S Carreira","doi":"10.1177/24730114261466664","DOIUrl":"https://doi.org/10.1177/24730114261466664","url":null,"abstract":"<p><strong>Background: </strong>Insertional Achilles tendinopathy (IAT) is a common yet challenging condition that often resists conservative treatment. Traditional open surgical repair carries risk of complications including delayed wound healing and infection. This study compares the outcomes of a minimally invasive surgical (MIS) technique using arthroscopic-assisted double-row repair vs open repair.</p><p><strong>Methods: </strong>Fifty-six patients with IAT underwent surgical intervention between June 2021 and September 2024 (32 MIS, 24 open). Patient-reported outcomes (PROs) were assessed pre- and post-operatively with a minimum 1-year follow-up. Six patients were excluded from analysis for comparability between groups. Statistical analysis used 2-tailed <i>t</i> tests with a Bonferroni adjustment (α = 0.05/3 = 0.0167). The proportion of each cohort reaching the minimal clinically important difference (MCID) was compared via χ² analysis, and complications were correlated to body mass index (BMI) and age using logistic regression analyses. Sensitivity analyses using multiple linear regressions, adjusted for follow-up time, were performed on the full cohort (α = 0.05).</p><p><strong>Results: </strong>The MIS group had significantly worse preoperative scores compared with the open group. But at a mean follow-up of 2.2 years for the MIS group and 2.0 years for the open group, the MIS group demonstrated significantly greater improvements in Patient-Reported Outcomes Measurement Information System physical function and visual analog scale scores (<i>P</i> < .001 for both) and a significantly greater proportion of patients at MCID (<i>P</i> < .05 for both). Foot and Ankle Ability Measure activities of daily living subscale showed similar findings without significance detected. All PROs retained significance on sensitivity analysis. Complication rates were 0% in the MIS group and 5.0% in the open group with no correlation to BMI or age.</p><p><strong>Conclusion: </strong>Despite limitations necessitating further studies, our results begin to suggest superior functional outcomes following MIS repair for IAT compared to traditional open repair, supporting MIS as a potentially safer and more effective alternative for appropriate patients.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261466664"},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic vs Percutaneous Minimally Invasive Debridement and Reinsertion for the Treatment of Insertional Achilles Tendinosis: A Retrospective Analysis of Patient-Reported Outcomes.","authors":"Sofia Rivera, Jorge I Acevedo, Eric H Durudogan, Kevin D Martin, Anish R Kadakia","doi":"10.1177/24730114261469545","DOIUrl":"https://doi.org/10.1177/24730114261469545","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgery (MIS) for insertional Achilles tendinopathy (IAT) has been adopted to reduce soft tissue trauma, accelerate recovery, and minimize complications associated with open procedures. Both percutaneous and arthroscopic repairs have demonstrated favorable outcomes, but direct comparison is limited. This study compares complication rates and patient-reported outcomes (PROs) between the two techniques. We hypothesized that both approaches would achieve postoperative scores comparable to population means.</p><p><strong>Methods: </strong>This retrospective nonrandomized cohort study included patients undergoing percutaneous or arthroscopic IAT repair with minimum 1-year follow-up. PROs including Foot and Ankle Ability Measure Activities of Daily Living subscale (FAAM ADL), Patient-Reported Outcomes Measurement Information System for Physical Function (PROMIS PF), and visual analog scale (VAS) scores were analyzed using Bonferroni adjusted significance thresholds (α = 0.05/3 = 0.0167). Minimal clinically important difference (MCID) achievement was compared using χ² tests and sensitivity analyses were performed to account for baseline differences (α = 0.05).</p><p><strong>Results: </strong>Fifty patients (25 arthroscopic, 25 percutaneous) were included. The arthroscopic group had significantly longer follow-up (<i>P</i> < .001), and a significantly higher prevalence of diabetes (<i>P</i> < .01). There were no complications. All PROs improved significantly from baseline (<i>P</i> < .001 or <i>P</i> < .01). Postoperative VAS scores were significantly lower in the percutaneous group (0.3 ± 0.5 vs 1.6 ± 1.7, <i>P</i> < .01), averaging 2.2 points lower after adjustment (β = -2.22, 95% CI -3.33 to -1.12; <i>P</i> < .001). Postoperative FAAM ADL scores were higher in the percutaneous group (92.4 ± 15.5 vs 82.5 ± 15.5), although this did not meet the pre-specified significance threshold (<i>P</i> = .03; α = 0.0167); after adjustment, scores averaged 13 points higher in the percutaneous group (β = 12.99, 95% CI 1.29-24.69, <i>P</i> < .05).</p><p><strong>Conclusion: </strong>Both percutaneous and arthroscopic MIS approaches were associated with significant improvements in pain and function postoperatively. The percutaneous approach was associated with significantly lower postoperative pain scores after adjustment, and may also be associated with higher FAAM ADL scores, although this finding did not meet the pre-specified significance threshold and requires confirmation in larger prospective studies.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261469545"},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of surgical costs associated with isolated distal fibula fractures.","authors":"Michael Amick, Tim Wardrop, Taylor Mendenhall, Chong Zhang, Angela P Presson, Devon Nixon","doi":"10.1177/24730114261466669","DOIUrl":"https://doi.org/10.1177/24730114261466669","url":null,"abstract":"<p><strong>Background: </strong>Operative fixation of distal fibula fractures is a common surgical procedure within orthopaedics. Understanding the variables that influence cost for surgical management of such injuries is increasingly important. In this study, we aimed to evaluate the cost differences in isolated distal fibula fixation.</p><p><strong>Methods: </strong>In total, 394 patients were identified who underwent isolated distal fibula fracture fixation between 2018 and 2025 based on <i>Current Procedural Terminology</i> (<i>CPT</i>) coding (27792). Patient demographics, fixation strategy, implant type, and surgical setting were analyzed. Multivariable generalized linear models with inverse Gaussian distribution were used to estimate adjusted cost ratios. Cost data were obtained using the Value-Drive Outcomes (VDO) tool, an instrument at our institution that aggregates itemized costs for each surgical encounter. Costs are reported as relative cost ratios rather than raw dollar amounts.</p><p><strong>Results: </strong>Of the 394 surgeries, 244 were performed at a specialty surgery center (SSC) and 150 were completed at an academic medical center (AMC). Total direct costs were higher for fibula fracture surgery performed at an AMC vs an SSC, resulting in a 42% increase in total direct costs for AMC procedures (cost ratio 1.42, 95% CI 1.32-1.52). Further, AMC facility costs were 84% higher than SSC (cost ratio 1.84; 95% CI 1.75-1.94), with the difference driven primarily by non-OR facility costs whereas OR facility costs were comparable between sites. Implant choice for fibula fixation did not appear to meaningfully influence cost. Surgeon specialty type did not differ in facility cost after controlling for surgery setting (facility cost ratio 1.00, 95% CI 0.95-1.06; <i>P</i> = .97).</p><p><strong>Conclusion: </strong>Distal fibular fracture fixation is significantly more costly when performed at an academic medical center than at a specialty surgery center, largely due to differences in non-OR facility costs. When medically appropriate, operative management of fibula fractures in an outpatient setting may lead to significant cost reductions.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261466669"},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde Osteochondral Autograft Transplantation for Osteochondral Lesions of the Distal Tibial Plafond: Technique Tips and Early Clinical Experience.","authors":"Jaeyoung Kim, Cordelia Burn, Jonathan Gamarra, Mark C Drakos","doi":"10.1177/24730114261469186","DOIUrl":"10.1177/24730114261469186","url":null,"abstract":"","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261469186"},"PeriodicalIF":0.0,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Internal Brace Augmentation Alone vs Broström Repair With Internal Brace for Chronic Lateral Ankle Instability.","authors":"Clayton Maschhoff, Vu Bui, Stephen Gauta, Andrew Rosenbaum","doi":"10.1177/24730114261469184","DOIUrl":"10.1177/24730114261469184","url":null,"abstract":"<p><strong>Background: </strong>The Broström procedure and its modifications remain the gold standard for surgical treatment of chronic lateral ankle instability (CLAI). Internal brace augmentation has gained popularity because of its enhanced mechanical stability and potential to facilitate earlier rehabilitation. However, the effectiveness of internal brace augmentation without formal ligament repair remains unclear. This study compared 1-year postoperative outcomes between standalone internal brace augmentation and modified Broström repair with internal brace augmentation.</p><p><strong>Methods: </strong>We retrospectively reviewed all lateral ankle stabilization procedures performed at a single academic center between January 2017 and December 2020. Patients were grouped by surgical technique: (1) Internal Brace Alone, defined as suture-tape augmentation without formal ligament repair (ST), and (2) Broström + Internal Brace. Outcomes assessed at a minimum follow-up of 1 year included satisfaction, persistent pain, recurrent instability, and revision surgery.</p><p><strong>Results: </strong>A total of 80 patients met inclusion criteria, including 58 (72.5%) in the ST cohort and 22 (27.5%) in the combined cohort. Baseline demographic and comorbidity profiles were similar between groups (all <i>P</i> > .05). At a minimum follow-up of 12 months, both cohorts demonstrated high satisfaction rates, with no significant difference between the ST and combined groups (87.5% vs 90.9%, <i>P</i> = .67). Persistent ankle pain was reported in 32.7% of ST patients vs 22.7% of combined-group patients (<i>P</i> = .38). Recurrent instability occurred in 6.9% and 4.5% of patients, respectively (<i>P</i> = .70). Revision surgery was required in 12.1% of ST patients compared with 4.5% of combined-group patients (<i>P</i> = .32).</p><p><strong>Conclusion: </strong>With the sample size available, no statistically significant differences in measured 1-year outcomes could be detected between standalone internal brace augmentation and modified Broström repair with internal brace augmentation. These findings should be considered preliminary and require confirmation in adequately powered prospective studies.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261469184"},"PeriodicalIF":0.0,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Prevention and Treatment of Ankle Osteoarthritis: A Translational Clinical Roadmap from the 2026 AOFAS/Arthritis Foundation Ankle Arthritis Think Tank.","authors":"Jonathon D Backus, Lew C Schon, William R Ledoux, Mitchell C Coleman, Kelsey H Collins, Scott J Ellis, Amy L Lenz, Cesar de Cesar Netto, Constantine A Demetracopoulos, Nancy E Lane, Jason M Wilken, Annunziato Amendola, Anish R Kadakia, Erik A Wikstrom, Kenneth J Hunt, Bopha Chrea, Judith F Baumhauer, Todd O McKinley, Michelle McLeod, Donald D Anderson","doi":"10.1177/24730114261464607","DOIUrl":"https://doi.org/10.1177/24730114261464607","url":null,"abstract":"<p><p>Ankle osteoarthritis (OA) is predominantly post-traumatic in origin. It differs in important ways biologically, mechanically, and clinically from hip and knee OA. Despite recognition of its long-term burden, treatment strategies for ankle OA remain largely reactive and centered on end-stage reconstruction. The Arthritis Foundation and the American Orthopaedic Foot & Ankle Society (AOFAS) co-sponsored an Ankle Arthritis Think Tank to address this deficiency in Napa, CA, on January 22, 2026. The focus was to solve patient frustration of limited treatment options and relatively poor outcomes when comparing to hip and knee osteoarthritis. The 2026 meeting brought together a multidisciplinary group of scientists and clinicians to present our current related state of knowledge and to define translational research priorities capable of advancing prevention and treatment of ankle OA within the next decade. Four structured sessions addressed topics relating to ankle OA: (1) Biologic and Biomechanical Pathogenesis, (2) Diagnostic and Management Challenges, (3) Therapeutic Strategies, and (4) Research Methodology. A moderated closing discussion focused on identifying actionable and fundable research pathways. Session presentations and discussion are synthesized here into a unified review.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261464607"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary vs Revision and Salvage First Metatarsophalangeal Joint Arthrodesis: A National Database Study of Utilization, Complications, and Cost Analysis.","authors":"Jacob W McDevitt, Eric H Durudogan, Frederic J Washburn, Milap S Patel, Anish R Kadakia, Muhammad Y Mutawakkil","doi":"10.1177/24730114261466656","DOIUrl":"https://doi.org/10.1177/24730114261466656","url":null,"abstract":"<p><strong>Background: </strong>First metatarsophalangeal joint (MTPJ) arthrodesis is the gold standard for end-stage hallux rigidus and a salvage option for failed hallux valgus correction. Although complication rates for primary and revision fusion have been reported separately, no large-scale study has directly compared outcomes between these cohorts.</p><p><strong>Methods: </strong>Primary and revision first MTPJ arthrodesis cases were identified using the PearlDiver Mariner national administrative claims database. The revision and salvage cohort was defined as first MTPJ arthrodesis performed ipsilateral to any prior hallux procedure, including hallux valgus correction, cheilectomy, arthroplasty, or prior fusion, and is not limited to revision of a failed prior first MTPJ arthrodesis specifically. Cases involving trauma, infection, malignancy, or fewer than 2 years of follow-up were excluded. After 1:1 propensity score matching on demographics and comorbidities, 2099 patients remained in each cohort. Thirty-day complications, 2-year reoperations and failure-related diagnoses, postoperative opioid use, and cumulative health care expenditures were compared between cohorts.</p><p><strong>Results: </strong>Early postoperative complication rates were low and comparable between groups (revision 3.7% vs primary 3.1%, <i>P</i> = .30), with no significant differences in infectious, medical, or surgical complications. At 2 years, revision arthrodesis was associated with significantly higher rates of any reoperation (12.6% vs 8.2%, <i>P</i> < .001), repeat fusion (7.2% vs 4.4%, <i>P</i> < .001), hardware removal (5.4% vs 2.1%, risk ratio 2.51, <i>P</i> < .001), nonunion diagnoses (9.9% vs 4.1%, <i>P</i> < .001), infection-related diagnoses (10.1% vs 6.6%, <i>P</i> < .001), and wound complications (6.7% vs 4.2%, <i>P</i> < .001). Postoperative opioid fill rates were higher in the revision cohort at all evaluated time points, including within 30 days (38.7% vs 34.4%, <i>P</i> = .003) and at 1 year (56.7% vs 51.5%, <i>P</i> = .001).</p><p><strong>Conclusion: </strong>Revision first MTPJ arthrodesis is associated with similar short-term perioperative risk but significantly greater long-term failure burden compared with primary fusion. These findings emphasize the importance of durable primary correction and suggest that salvage cases may warrant heightened attention to patient optimization. Although fixation strategy and biologic augmentation were not directly evaluated in this study, these represent plausible clinical considerations for mitigating reoperation risk and downstream resource use that merit prospective investigation.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261466656"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Sagittal Talar Alignment With Subtalar Arthroereisis Prior to Total Ankle Replacement in PCFD Class E: A Technical Tip.","authors":"Julieta Brué, Enrico Pozzessere, Francesco Di Lauro, Lolita Micicoi, Cesar de Cesar Netto","doi":"10.1177/24730114261469157","DOIUrl":"10.1177/24730114261469157","url":null,"abstract":"<p><p>Visual AbstractThis is a visual representation of the abstract.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261469157"},"PeriodicalIF":0.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13462485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}