Journal of Foot & Ankle Surgery最新文献

{"title":"A retrospective comparative study of arthroscopic versus open tibiotalocalcaneal arthrodesis using a straight retrograde intramedullary nail.","authors":"Ruokun Huang, Yaping Ye, Jun Xiong, Zi Li","doi":"10.1053/j.jfas.2026.09.007","DOIUrl":"10.1053/j.jfas.2026.09.007","url":null,"abstract":"<p><strong>Background: </strong>Tibiotalocalcaneal arthrodesis (TTCA) using a straight retrograde intramedullary nail (RIMN) is an established salvage procedure for severe ankle and hindfoot pathology. Direct comparative evidence between open and arthroscopic TTCA remains limited.</p><p><strong>Purpose: </strong>To compare clinical, radiographic, and perioperative outcomes between open and arthroscopic TTCA performed using a straight RIMN.</p><p><strong>Study design: </strong>Retrospective comparative study.</p><p><strong>Patients and methods: </strong>Fifty-five patients (55 feet) who underwent TTCA between December 2022 and December 2024 were retrospectively reviewed, including 28 treated with open TTCA and 27 with arthroscopic TTCA. No patient underwent bilateral procedures during the study period. Outcomes included operative duration, intraoperative blood loss, length of hospital stay, clinical scores, complications, and CT-confirmed fusion. Solid fusion was defined as ≥75% osseous bridging across the arthrodesis interface on CT.</p><p><strong>Results: </strong>CT-confirmed fusion was observed in 27 of 28 patients in the open group (96.4%; 95% CI, 82.3%-99.4%) and 26 of 27 patients in the arthroscopic group (96.3%; 95% CI, 81.7%-99.3%; p = 0.987). Time to fusion and operative duration did not differ significantly between groups (p = 0.421 and p = 0.308, respectively). Arthroscopic TTCA was associated with lower intraoperative blood loss (p < 0.0001) and shorter hospital stay (p = 0.021). AOFAS, Pain-NRS, SF-36, and UCLA scores improved significantly from baseline in both groups. Two superficial wound infections occurred in the open group; one resolved with conservative treatment and one required surgical debridement.</p><p><strong>Conclusion: </strong>Arthroscopic TTCA with RIMN showed similar observed fusion rates and functional outcomes to the open approach and was associated with lower intraoperative blood loss and shorter hospitalization. Given the retrospective design and temporal imbalance between the groups, these findings should be interpreted cautiously. Arthroscopic TTCA may represent a feasible alternative in selected patients.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramedullary nailing versus internal plate fixation in the repair of open, distal tibial fractures with articular involvement - A retrospective analysis.","authors":"Darrian George-Johnson, Jayne Ward, Thomas Cloake, Antonia Millington","doi":"10.1053/j.jfas.2026.09.009","DOIUrl":"10.1053/j.jfas.2026.09.009","url":null,"abstract":"<p><strong>Background: </strong>Open distal tibial fractures with articular involvement (ODTFAI) are complex injuries, but there is little consensus regarding whether intramedullary nailing (IMN) or internal plate fixation (IPF) is better suited to their repair.</p><p><strong>Purpose: </strong>The aim of this study is to compare IMN against IPF in ODTFAI repair to determine which yields better outcomes.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>A retrospective analysis was conducted, using patient data collected between April 2015 and December 2023, at a major tertiary center. Forty-nine adult patients with open AO/OTA 43-C fractures were included. Twenty-five had been treated with IMN and twenty-four had been treated with IPF. The incidence of complications was the primary outcome. Secondary outcomes included time to weight-bearing and time to radiographic union.</p><p><strong>Results: </strong>Complication rates were significantly higher in the IPF group (IMN = 24 %, IPF = 54 %, p = 0.032). Amputation rates were lower in the IMN group (IMN = 0 %, IPF = 17 %, p = 0.035 respectively). The mean OTA arterial score was higher in the IMN group (IMN = 1.20, IPF = 1.00, p = 0.032). The proportion of cases returning to theater was higher in the IPF group than in the IMN group (IMN = 8 %, IPF = 50 %, p = 0.001).</p><p><strong>Conclusion: </strong>Complications may be more likely when ODTFAI are treated with IPF. Fewer patients experienced a return to theater and failed limb salvage following nail stabilization. IMN could be more suited to the repair of open, articular distal tibial fractures, thus leading to better outcomes for patients.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of osteotomy gap implant selection on prognosis following medial opening wedge supramalleolar osteotomy: A retrospective cohort study.","authors":"Xuewen Wang, Yonghui Zang, Baozhou Zhang, Zeyu Zhang, Liangpeng Lai, Xiaofeng Gong, Hui Du, Xing Li, Yong Wu","doi":"10.1053/j.jfas.2026.09.012","DOIUrl":"10.1053/j.jfas.2026.09.012","url":null,"abstract":"<p><strong>Background: </strong>Optimal management of the osteotomy gap during medial opening wedge supramalleolar osteotomy (MOWSMO) for varus ankle osteoarthritis remains uncertain.</p><p><strong>Purpose: </strong>To compare union and clinical outcomes among four gap-management strategies and examine whether gap height was associated with early union.</p><p><strong>Study design: </strong>Retrospective cohort study; Level of Evidence, III.</p><p><strong>Methods: </strong>We reviewed 125 patients undergoing MOWSMO and grouped them by gap management: void retention (n = 15), metal cage (n = 35), structural allograft (n = 56), or autograft (n = 19). Clinical and radiographic outcomes, complications, satisfaction, and union at 3, 6, and 12 months were compared. Logistic regression evaluated gap height and 3-month union, adjusted for age and body mass index.</p><p><strong>Results: </strong>Clinical scores improved in all groups (p < 0.001), without between-group differences at final follow-up (AOFAS, p = 0.127; FFI, p = 0.239; NRS, p = 0.405). At 3 months, union was observed in 1/15 (7%) void, 17/35 (49%) cage, 37/56 (66%) allograft, and 13/19 (68%) autograft cases (p < 0.001); 12-month union did not differ (p = 0.140). Greater gap height was associated with lower odds of 3-month union (odds ratio, 0.808; 95% confidence interval, 0.670-0.974; p = 0.025). Complication and satisfaction rates were similar among groups.</p><p><strong>Conclusions: </strong>Void retention showed slower early radiographic healing but similar 12-month union and final outcomes. The small void group and nonrandom allocation preclude a noninferiority conclusion. Larger prospective studies are needed.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neglected Seymour fractures of the hallux in children: Fixation versus no fixation, and transarticular versus extra-articular technique.","authors":"İbrahim Halil Demir, Nevzat Gonder, Beytullah Unat, Ramazan Erol, Ilkan Kisi, Oğuz Kaya, İdris Perktaş","doi":"10.1053/j.jfas.2026.09.014","DOIUrl":"10.1053/j.jfas.2026.09.014","url":null,"abstract":"<p><strong>Background: </strong>Open Seymour fractures of the hallux, distinct from closed physeal injuries, lack a clear optimal stabilization strategy when presentation is delayed.</p><p><strong>Purpose: </strong>To compare reduction maintenance and recovery of interphalangeal (IP) motion after three operative strategies for neglected, open hallux Seymour fractures.</p><p><strong>Study design: </strong>Retrospective comparative cohort study.</p><p><strong>Methods: </strong>Forty-four children presenting more than 48 hours after injury underwent irrigation, debridement, and nail bed repair, with transarticular fixation (TFx, n = 16), extra-articular crossed-wire fixation (EFx, n = 17), or no skeletal fixation (NoFx, n = 11). Minimum follow-up was 12 months. Categorical outcomes were compared with exact tests; continuous outcomes with Kruskal-Wallis tests and adjusted pairwise comparisons.</p><p><strong>Results: </strong>Loss of reduction occurred in 5/11 NoFx patients versus 0/33 fixed patients (p < 0.001). Median time to full IP motion was 77 days in TFx versus 56 days in both EFx and NoFx (TFx vs EFx, p = 0.002 after adjustment). Physeal alteration occurred in 3/16 TFx, 3/17 EFx, and 7/11 NoFx patients (overall p = 0.027), though pairwise comparisons were not significant. All 5 patients with loss of reduction had physeal alteration, versus 8/39 without (exploratory p = 0.001). Osteomyelitis occurred in 12/44 patients and correlated with longer treatment delay.</p><p><strong>Conclusions: </strong>Fixation was associated with maintained reduction in this neglected, open-injury cohort. Extra-articular fixation showed earlier recovery of full IP motion than transarticular fixation, with no loss of reduction in either fixed group. These findings support joint-sparing fixation when feasible but do not establish causal superiority or identify which fractures may safely remain unfixed.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing dynamics of ankle fracture care across emergency, inpatient, and ambulatory settings.","authors":"Faheem Pottayil, Chrishaun Alexander, Daniel Aka, David Aka, Kevin Y Heo, Grace C Ford, Joshua A Parry, Jaimo Ahn, Thomas J Moore","doi":"10.1053/j.jfas.2026.09.013","DOIUrl":"10.1053/j.jfas.2026.09.013","url":null,"abstract":"<p><strong>Background: </strong>Ankle fracture care is increasingly delivered outside inpatient settings, but whether this transition is uniform across patient, fracture, payer, and geographic groups remains unclear.</p><p><strong>Purpose: </strong>To evaluate national trends in ankle fracture care across emergency department, inpatient, and ambulatory surgery settings from 2016 to 2022 and identify factors associated with inpatient admission after emergency department presentation.</p><p><strong>Study design: </strong>Retrospective serial cross-sectional study.</p><p><strong>Methods: </strong>Healthcare Cost and Utilization Project data from the Nationwide Emergency Department Sample, National Inpatient Sample, and Nationwide Ambulatory Surgery Sample were used to estimate annual ankle fracture volumes. Fractures were classified as unimalleolar, bimalleolar, or trimalleolar. Cochran-Armitage tests assessed temporal trends, and survey-weighted multivariable logistic regression evaluated 2022 admission factors.</p><p><strong>Results: </strong>Emergency department visits increased 12.0% (219,601 to 246,042), ambulatory surgery encounters increased 33.6% (75,571 to 101,000), and inpatient admissions decreased 1.7% (82,065 to 80,635). In 2022, admission odds were higher for patients aged 65 years or older, bimalleolar and trimalleolar fractures, Medicare coverage, and nonmetropolitan location (all p < 0.001). The nonmetropolitan association varied by fracture subtype (p = 0.023) and attenuated after the coronavirus disease 2019 pandemic (odds ratio, 0.89; p = 0.006).</p><p><strong>Conclusions: </strong>National ankle fracture care shifted toward ambulatory surgery without a parallel increase in inpatient admissions. Admission remained associated with fracture complexity, age, payer, and geography.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of closure materials on outcomes following transmetatarsal amputation: A retrospective review.","authors":"Alec Wroblewski, Justin Waller, Joni K Evans, Cody Blazek, John Bonvillian, Paula Gangopadhyay","doi":"10.1053/j.jfas.2026.09.011","DOIUrl":"10.1053/j.jfas.2026.09.011","url":null,"abstract":"<p><strong>Background: </strong>Transmetatarsal amputation (TMA) is an important limb-salvage procedure for foot infection and ischemia but is associated with variable healing rates and postoperative complications. While patient-specific risk factors have been well described, the impact of closure material on wound and infection outcomes remains poorly defined.</p><p><strong>Purpose: </strong>To evaluate whether external closure material influences postoperative wound complications or infection following TMA.</p><p><strong>Study design: </strong>Level 3 retrospective comparative study.</p><p><strong>Methods: </strong>A retrospective review was conducted of 108 patients who underwent primary TMA between 2013 and 2022 across four hospitals. Associations between closure materials and postoperative wound complications or infection were evaluated. Patient characteristics, including diabetes and vascular status, as well as secondary outcomes such as pain, proximal amputation, and contralateral amputation, were analyzed. Fisher's exact test and logistic regression were used for statistical analysis.</p><p><strong>Results: </strong>Wound complications occurred in 70 patients (65%), and postoperative infection in 10 patients (9%). No statistically significant differences in wound risk were observed among closure materials (nylon p = 0.061, staples p = 0.165, polypropylene p = 0.990). Infection rates similarly did not differ by closure material (nylon p = 0.058, staples p = 0.990, polypropylene p = 0.990). Multivariable regression confirmed no external closure material-specific association with wound or infection outcomes. Wound and infection occurrence were not significantly associated with secondary postoperative outcomes.</p><p><strong>Conclusions: </strong>No significant association between external closure material and postoperative wound or infection outcomes was detected in this cohort. Larger studies are needed to evaluate the influence of closure material on postoperative outcomes.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic role of examination under anaesthesia and MRI in chronic symptomatic lateral ankle ligament instability.","authors":"Aysha Rajeev, Saurav Krishnan, Kailash Devalia","doi":"10.1053/j.jfas.2026.08.020","DOIUrl":"10.1053/j.jfas.2026.08.020","url":null,"abstract":"<p><strong>Background: </strong>Chronic lateral ankle instability commonly develops following traumatic rupture or pathological laxity of the lateral ankle ligament complex. Although magnetic resonance imaging (MRI) is effective in identifying complete ligament tears, it may be less reliable in detecting functional ligament incompetence due to elongation or laxity.</p><p><strong>Purpose of the study: </strong>This study evaluates whether examination under anesthesia (EUA) provides superior diagnostic accuracy compared to MRI in patients with chronic lateral ankle instability.</p><p><strong>Study design: </strong>A prospective case analysis was performed on 49 symptomatic patients who underwent lateral ligament reconstruction. All patients underwent preoperative MRI and EUA.</p><p><strong>Methods: </strong>EUA was conducted under general anaesthesia using image-intensifier-guided anterior drawer and talar tilt stress tests. MRI scans were independently assessed by two experienced musculoskeletal radiologists. MRI findings were compared with both EUA and intraoperative findings.</p><p><strong>Results: </strong>EUA demonstrated ankle instability in 48 out of 49 patients, with positive anterior drawer and talar tilt tests. When compared with intraoperative findings, MRI demonstrated a sensitivity of 59.2%. In comparison, the EUA showed a sensitivity of 98%. Intraoperative findings included complete ligament rupture in 17 patients (34.7%), ligament laxity in 18 (36.7%), elongated lateral ligament complex in 13 (26.5%), and partial rupture in 1 patient (2.0%).</p><p><strong>Conclusions: </strong>EUA, in conjunction with clinical symptoms, appears more reliable than MRI in diagnosing chronic lateral ankle instability and should be considered a key diagnostic tool in its management.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Component Sizing on Total Ankle Arthroplasty Survivorship.","authors":"Anthony Schwab, Helene Cook, Roland Ramdass, Jason Nowak, Garret Strand","doi":"10.1053/j.jfas.2026.09.005","DOIUrl":"10.1053/j.jfas.2026.09.005","url":null,"abstract":"<p><strong>Background: </strong>Component sizing and alignment are critical to total ankle arthroplasty (TAA) longevity, yet the relationship between talar downsizing, polyethylene thickness, and revision risk remains unclear.</p><p><strong>Purpose: </strong>This retrospective cohort study evaluated whether talar downsizing improves survivorship and examined secondary associations between polyethylene thickness, coronal alignment, and revision.</p><p><strong>Study design: </strong>Level III Retrospective Study METHODS: A retrospective cohort study with 173 TAA procedures was performed. Variables included talar downsizing status, tibial and talar component sizes, initial polyethylene thickness, and comorbidities. Primary outcomes were revision or polyethylene exchange. Logistic regression assessed the relationship between downsizing, polyethylene size, and revision risk; correlation analysis examined polyethylene size versus preoperative tibiotalar angle.</p><p><strong>Results: </strong>Talar downsizing was performed in 115 of 173 ankles (66.5%). Patients with a downsized talar component showed a lower, though nonsignificant, likelihood of revision (OR 0.66; p = 0.36). Smaller polyethylene components (≤7 mm, n = 12) were associated with significantly higher reoperation rates than components ≥8 mm (33.3% vs 19.3%; OR = 3.05; p = 0.04) Mean preoperative coronal alignment was 0.98° valgus ± 8.9° (95% CI -0.35 to 2.31), with no correlation between polyethylene (PE) thickness and deformity (r = -0.01; p = 0.90). Hindfoot fusion was not statistically significantly associated with revision risk (p = 0.07). Implant survivorship was 86.9% at a mean clinical follow-up duration of 4.1 ± 2.2 years (range, 1.0-9.3 years).</p><p><strong>Conclusion: </strong>Talar component downsizing was not significantly associated with revision risk in this cohort. While downsizing may offer potential biomechanical benefits related to edge-loading and alignment, further investigation is needed to determine whether these factors translate to improved clinical outcomes.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of delayed reduction on soft tissue compromise and clinical outcomes in displaced ankle fractures.","authors":"Matthew G Blaszczyk, Jacklyn P Zvonar, Grant Grotelueschen, Ryan L McMillen, Jenna Li","doi":"10.1053/j.jfas.2026.09.003","DOIUrl":"10.1053/j.jfas.2026.09.003","url":null,"abstract":"<p><strong>Background: </strong>Ankle fractures are a common traumatic injury, often resulting in displaced anatomic alignment. Delayed treatment can prevent adequate soft tissue resuscitation, causing significant complications.</p><p><strong>Purpose: </strong>We evaluated time to reduction impact on soft tissue compromise and post-operative outcomes, including rate of complications, re-operation, and length of hospital stay.</p><p><strong>Study design: </strong>We retrospectively reviewed individuals with displaced ankle fractures that underwent closed reduction in the emergency department or in the operating room from January 1, 2022 through December 31, 2025.</p><p><strong>Patients and methods: </strong>Multivariable logistic regression was performed to analyze time to reduction impact on key outcomes. We also evaluated associations with age, body mass index, gender, social history (smoking), and comorbidities (diabetes, renal disease, peripheral vascular disease).</p><p><strong>Results: </strong>Our study included 147 patients. Delayed time to ankle reduction was associated with increased odds of pre-operative soft tissue compromise (odds ratio 1.601, 95% confidence interval 1.101-2.407, p = 0.017) but not independently associated with post-operative complications, re-operation, or hospital length of stay. Peripheral vascular disease and renal disease demonstrated stronger associations with adverse post-operative outcomes (p = 0.027 and p = 0.014). Soft tissue compromise and advancing age noted to be associated with longer hospital stays (both p < 0.001).</p><p><strong>Conclusion: </strong>Delayed time to ankle reduction increased the odds of pre-operative soft tissue compromise but was not independently predictive of post-operative complications, re-operation, or length of stay. These findings demonstrate the importance of prioritizing timely reduction for these displaced ankle traumas to optimize preservation of the soft tissue envelope.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placental-derived injectable products for chronic plantar fasciitis: A systematic review and meta-analysis.","authors":"Ihsan Oesman, Kelvin Kohar, Indira Saraswati Sanjaya","doi":"10.1053/j.jfas.2026.09.006","DOIUrl":"10.1053/j.jfas.2026.09.006","url":null,"abstract":"<p><strong>Background: </strong>Plantar fasciitis may persist despite prolonged conservative treatment, and placental-derived injectable orthobiologics have emerged as potential regenerative therapies. However, their clinical efficacy and safety remain uncertain.</p><p><strong>Purpose: </strong>To systematically evaluate the current evidence on placental-derived injectable products for chronic plantar fasciitis.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>Literature search was conducted through PubMed, Science Direct, Google Scholar, Cochrane, and ProQuest following PRISMA 2020. The primary outcome was pain reduction. Pain outcomes were harmonized to a 0-10 scale and pooled using mean difference (MD). Functional outcomes and adverse events were synthesized narratively. Certainty of evidence was evaluated using GRADE.</p><p><strong>Results: </strong>Six studies involving 324 adults with plantar fasciitis were included. Among placebo-controlled randomized trials, placental-derived injections were associated with greater pain reduction than control (MD 3.37 points; 95% CI, 1.13-5.60; p = 0.003; I² = 92%). Non-randomized comparative studies also favored placental-derived treatment (MD 1.91 points; 95% CI, 0.80-3.03; I² = 9%; p < 0.001). The exploratory cross-design estimate was MD 2.77 points (95% CI, 1.29-4.25; I² = 85%). Functional outcomes generally improved, although heterogeneous instruments precluded quantitative pooling. No serious treatment-related adverse events were reported. Certainty of evidence was low to very low.</p><p><strong>Conclusions: </strong>Placental-derived injectable products may be associated with pain improvement in chronic plantar fasciitis; however, the certainty of evidence remains limited by small sample sizes, substantial heterogeneity, and variation in product formulation and treatment protocols. Further standardized randomized trials are required before routine clinical use can be recommended.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}