Foot & ankle specialist最新文献

{"title":"Deltoid All-Inside Repair in SER IV Bimalleolar-Equivalent Ankle Fractures.","authors":"Tiago Soares Baumfeld, Matheus Kuffner, Daniel Soares Baumfeld, Gustavo Araujo Nunes, Alexandre Leme Godoy Dos Santos, Stefan Rammelt","doi":"10.1177/19386400261427776","DOIUrl":"10.1177/19386400261427776","url":null,"abstract":"<p><p>BackgroundAnkle fractures are the second most common fractures of the lower limb. In supination-external rotation (SER) stage 4 injuries, the medial malleolus or the deltoid ligament is disrupted. The stability of the deltoid ligament is essential for the functionality, however, the need for surgical repair remains debated. The aim of this study is to assess deltoid stability in 12 ankle fractures treated with an all-inside repair technique.MethodsA prospective case series of 12 patients (8 men,4 women aged between 25 and 53 years who had a stage 4 LH SER ankle fracture with unstable deltoid ligament injury between September 2023 and February 2024. No patients in this study had an associated posterior malleolus fracture. All patients were treated with deltoid all-inside repair at the time of fracture fixation. Outcomes were measured using the VAS scales, radiographic and magnetic resonance imaging (MRI), and AOFAS scores are reported exclusively in the Supplementary Material for historical comparability, Stability was tested using stress and weight-bearing radiographs, measuring talar tilt (TT) and medial clear space (MCS).ResultsClinically, the patients had good results, with a mean VAS of 1.5 and AOFAS score of 87 at 6 months follow-up. There were no complications observed during the study period. MCS remained stable (P = .125), with means of 3.03 mm (postop), 2.87 mm (weight-bearing), and 3.38 mm (stress). Similarly, TT remained consistent (P = .597), with means of 1.17º (postop), 0.87º (weight-bearing), and 1.14º (stress). These findings confirm preserved joint alignment and ligament integrity postrepair.DiscussionTo the best of our knowledge, All-inside deltoid repair has been described; however, reports specifically within SER IV bimalleolar-equivalent fractures and short-term radiographic stability remain limited. The technique demonstrated favorable short-term functional outcomes and radiographic stability.ConclusionSER IV bimalleolar-equivalent ankle fractures, arthroscopic all-inside deltoid repair maintained radiographic reduction and yielded favorable short-term outcomes.Levels of EvidenceLevel IV, Case Series.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"435-442"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-Stacked One-Third Tubular Plating for Suprasyndesmotic Fibula Fractures: Technique Description and Clinical Case Series.","authors":"Robert Kaspar Wagner, Jacob S Borgida, Alice W Wong, Bryce Jensen, Derek S Stenquist, Thuan V Ly","doi":"10.1177/19386400241298820","DOIUrl":"10.1177/19386400241298820","url":null,"abstract":"<p><p>Fixation for suprasyndesmotic fibula fractures (AO/OTA type 44C, consistent with Weber C) is classically achieved using a single one-third tubular plate. However, these fractures may sometimes require stronger fixation due to the diaphyseal fracture location and the lack of structural support from injured ligaments. To increase stability, 3.5 mm plates can be used, but these plates are bulky and too stiff to contour. As alternative, the authors present the technique and clinical and patient-reported outcomes (PROs) of using stacked one-third tubular plating for suprasyndesmotic fibula fractures to increase stability of fixation. Between 2021 and 2023, 14 patients were treated with stacked one-third tubular plating. All patients healed uneventfully. One patient developed an infection with wound breakdown and exposed hardware after fracture healing. Thirteen patients (93%) responded to PROs. The median Olerud-Molander ankle score was 75 (interquartile range [IQR]: 30-80), the median EQ-5D-5L score was 80 (IQR: 69-81), and the median numeric rating scale (NRS) score was 3 (IQR: 0-5). The use of double-stacked one-third tubular plates is a simple and safe technique that can be used to increase stability of suprasyndesmotic fibula fractures leading to reliable healing rates and satisfactory PROs.<b>Levels of Evidence</b>: <i>Level IV Retrospective Case Series</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"390-399"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution Patterns of Tumors and Tumor-Like Lesions of the Forefoot and Midfoot: A 12.5-Year Study at a University Hospital.","authors":"Christian Scheele, Norbert Harrasser, Simone Beischl, Dietmar Dammerer, Ulrich Lenze, Carolin Knebel, Florian Lenze","doi":"10.1177/19386400241283418","DOIUrl":"10.1177/19386400241283418","url":null,"abstract":"<p><p>Background<i>Masses in the forefoot and midfoot are common reasons for medical presentation and can be caused by various pathological conditions. The challenge in clinical practice is to distinguish the multitude of trivialities from the few malignant entities and to arrive at a reliable clinical diagnosis in a reasonable amount of time with a moderate use of diagnostic tools.</i>Material and Methods<i>In a retrospective analysis, tumors, tumor-like lesions, and pseudotumors distal to the Chopart joint presented to our multidisciplinary university tumor board between January 2010 und June 2023 were analyzed concerning entity, location, age, and sex.</i>Results<i>Of the 167 cases included, 18 were osseous and 149 were soft tissue lesions. Overall, the metatarsal region was most frequently affected, accounting for 42.5% of all cases. Osseous lesions showed a preference for the phalanges and soft-tissue lesions occurring more frequently in the metatarsal region. In total, 88.0% of all cases were benign. All 20 malignant cases derived from soft tissue, occurred in all sections of the forefoot and midfoot and comprised 13 entities. Most lesions affected middle-aged patients, but cases occurred in almost every age group.</i>Conclusion<i>In the examined patient population of a German university hospital, most cases were benign soft tissue lesions with a substantial share of pseudotumors and tumor-like lesions. However, the malignancy rate of 12.0% highlights the importance of differential diagnostic considerations. In cases of uncertain results, it is crucial to refer individuals with unclear masses to a specialized center for musculoskeletal tumor care early on in their treatment process.</i>Levels of Evidence:<i>III</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"355-361"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482309","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":"Radiographic and Patient-Reported Outcomes for First Tarsometatarsal Arthrodesis Using an Intramedullary Nail for Hallux Valgus Deformity: A Consecutive Case Series.","authors":"Connor C Ott, Ayush D Shah, Kayla J Seiffert, Rebecca Stone McGaver, Paul M Cammack, Scott M Holthusen, Jeffrey D Seybold, John C Tanner, William M Engasser","doi":"10.1177/19386400241301822","DOIUrl":"10.1177/19386400241301822","url":null,"abstract":"<p><p>BackgroundFirst tarsometatarsal (TMT) arthrodesis is one of the most common procedures performed each year for the correction of hallux valgus deformity, and nonunion rates for first TMT arthrodesis are commonly reported to be between 4% and 15%. The purpose of this study was to evaluate the effectiveness of an intramedullary nail system in patients requiring first TMT arthrodesis.MethodsAn ambispective, multisurgeon, consecutive case series was conducted, in which retrospective and prospective collection of patient-reported outcome measure (PROM) and radiologic data were conducted. Patients who underwent first TMT arthrodesis from July 2019 to July 2022 for hallux valgus deformity with an intramedullary nail system and had adequate records for a minimum of 3 months postoperation (±4 weeks) were included.ResultsSeventy patients were included in the final analysis, with a median prospective PROM follow-up of 1.6 years. There was an overall union rate of 91.4% (64/70 patients). Nine patients required secondary procedures: 4 hardware removals and 5 nonunion revisions. Collected PROMs and radiologic data showed significant improved from preoperative to prospective follow-up (P < .01).ConclusionFirst TMT arthrodesis using an intramedullary nail system result in nonunion rates and PROMs comparable to other techniques currently being used.Levels of Evidence:<i>Level IV: Retrospective Case Series</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"406-415"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonunion and Calcaneocuboid Subluxation Are Minimal After Evans Osteotomy Without Fixation.","authors":"Solangel Rodriguez-Materon, Megan Miles, Nigel Hsu, Brian Gallagher, Gregory Guyton","doi":"10.1177/19386400241298799","DOIUrl":"10.1177/19386400241298799","url":null,"abstract":"<p><p>BackgroundFixation of the Evans osteotomy for flatfoot correction has been advocated without supporting data to facilitate union and avoid calcaneocuboid subluxation. We examined these issues in the largest reported series of Evans procedures to date.MethodsA total of 118 cases from a consecutive series of 137 patients who underwent Evans osteotomy without fixation by a single surgeon were available for review. Average follow-up was 62.5 weeks. Bony union and radiographic measurements including calcaneocuboid subluxation were evaluated.ResultsUnion occurred in 117/118 cases (99.2%). Calcaneocuboid subluxation increased minimally compared to preoperative values (1.5 ± 2.3 mm). The mean wedge size was 7.1 ± 1.4 mm. All radiographic measurements of the longitudinal arch improved.ConclusionThe Evans osteotomy without fixation demonstrated near-universal union and minimal calcaneocuboid subluxation. The frequent use of additional osteotomies in our series might have allowed the use of smaller wedges and contributed to our favorable results.Level of Evidence:4.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"400-405"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repairing the Deltoid Ligament in Ankle Fractures: Is it time for a Paradigm Shift?","authors":"Joy Van den Berg, Diederick Penning, Sebastian Baumbach, Tim Schepers","doi":"10.1177/19386400241307817","DOIUrl":"10.1177/19386400241307817","url":null,"abstract":"<p><p>BackgroundIt remains unclear whether repairing the deltoid ligament (DL) is beneficial in acute ankle fractures. The aim of this review is to critically review the developments in deltoid ligament repair (DLR) in ankle fractures over the course of 44 years.MethodAn electronic search was conducted on the PubMed and Embase database including comparative studies evaluating the effect of performing DLR in adults suffering from a closed acute ankle fracture with suspected rupture of the DL.ResultsA total of 27 studies were retrieved, of which only one was a randomized study. A total of 1327 patients were reviewed (663 undergoing DLR and 664 receiving non-DLR treatment for an acute ankle fracture). Although earlier studies concluded that DLR holds little necessity in ankle fracture treatment if the anatomy of the ankle is restored, more recent studies support DLR due to more favorable clinical and radiographic outcomes.DiscussionAll studies agree that restoration of the ankle anatomy to its pre-fracture state is necessary to achieve the best clinical outcome. However, there is still controversy in whether to standardize DLR in ankle fracture treatment. The literature shows a clear shift toward more frequent restoration of the DL, and in light of improved surgical techniques and implants, there is a need for more rigorous studies to provide a clear indication for DLR in acute ankle fracture treatment.Level of Evidence:<i>III</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"416-425"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959597","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":"Minimally Invasive First Metatarsophalangeal Joint Arthrodesis With a Low-Profile Hybrid Locking Plate and a Beveled Compression Screw: A Surgical Technique.","authors":"Joseph R Duff, Austin G Alecxih, Charles C White, Jesse F Doty","doi":"10.1177/19386400251331648","DOIUrl":"10.1177/19386400251331648","url":null,"abstract":"<p><p>Arthrodesis of the first metatarsophalangeal joint (MTPJ) is a valuable intervention for a variety of hallux pathologies and is still considered the gold standard treatment for advanced hallux rigidus, one of the most commonly encountered pathologies of the forefoot. With the advent and expansion of minimally invasive surgery (MIS) techniques, MIS First MTPJ arthrodesis offers a new approach to treat hallux conditions with the potential to limit complications and further enhance patient satisfaction. We describe a technique that affords the benefits of MIS surgery without compromising the biomechanical superiority of a dorsal hybrid low-profile plate with a beveled, partially threaded compression screw.<b>Level of Evidence:</b> Therapeutic, Level V: Technique article.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"426-434"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous Thromboembolism in Outpatient Elective Foot and Ankle Procedure Patients: Who Is at Risk?","authors":"Kevin Y Heo, Anthony Karzon, Wesley Manz, Rishin J Kadakia, Jason T Bariteau, Michelle M Coleman","doi":"10.1177/19386400241286593","DOIUrl":"10.1177/19386400241286593","url":null,"abstract":"<p><p>Background<i>Venous thromboembolism (VTE) is a rare but potentially serious complication following elective foot and ankle (F&A) procedures. The absence of guidelines for thromboprophylaxis in elective procedures underscores the importance of identifying patients at risk. This study aimed to identify key risk factors of VTE in patients who underwent elective foot and ankle (F&A) operations.</i>Methods<i>Data was collected from the IBM MarketScan Database (2009-2019) for patients <u>></u>18 years old without prior VTE who underwent elective F&A procedures. Patients were divided into 3 groups based on region of operation (forefoot, mid/hindfoot, lower leg/ankle). VTE incidence (including deep vein thrombosis and/or pulmonary embolism) was recorded 30 and 90 days postprocedure. Risk factors for VTE were identified through multivariate logistic regression.</i>Results<i>Among the 301 256 patients who underwent elective F&A procedures, the overall 90-day incidence of VTE was 0.95%. The findings revealed that 31.9% of VTE incidents occurred within the first 2 weeks after operation, and 29.2% still occurred after 6 weeks. Analysis of the anatomical region of operation demonstrated that the lowest rate of 90-day VTE was amongst patients undergoing forefoot procedures (0.70%). There was a higher risk for VTE in patients undergoing midfoot/hindfoot procedures (1.22%, OR = 1.81) and lower leg/ankle procedures (1.76%, OR = 2.31). Additional risk factors for VTE included thrombophilia (4.02%, OR = 3.37), male sex (1.30%, OR = 1.47), increasing age (1.02% age 65+, OR = 1.41), and a high Charlson Comorbidity Index (1.12%, OR < 0.82 for scores <5).</i>Conclusion<i>This study identifies the incidence and timing for VTE after elective F&A procedures. Furthermore, this study defines the risk factors associated with increased odds of VTE after elective F&A procedures. These findings are helpful in educating patients about a continued risk for VTE throughout the 90-day postoperative period and beyond. These results can also be utilized to stratify patients who need thromboprophylaxis based on the individual risk level.</i>Level of Evidence:<i>Level III: Retrospective cohort study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"341-354"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Fibrocartilage Preservation in Retromalleolar Groove Deepening for Peroneal Tendon Instability.","authors":"Henri L B Ullmann, Tamara Munoz, Wei Shao Tung, Gregory Waryasz, Christopher W DiGiovanni, Lorena Bejarano-Pineda","doi":"10.1177/19386400261471644","DOIUrl":"https://doi.org/10.1177/19386400261471644","url":null,"abstract":"<p><p>BackgroundSurgery is often indicated for peroneal tendon dislocation as conservative treatment carries a high recurrence rate. Direct retromalleolar groove deepening removes the fibrocartilage layer, whereas fibrocartilage-preserving techniques are more complex and their clinical benefit is uncertain. This study compared outcomes between these approaches for peroneal tendon instability.MethodsWe retrospectively reviewed 54 patients (21 direct, 33 fibrocartilage-preserving) who underwent retromalleolar groove deepening with ≥6 months follow-up. Outcomes were residual symptoms, recurrent instability, revision surgery, and return to activity. Analyses were descriptive, reporting effect sizes with 95% confidence intervals.ResultsNo statistically significant differences were detected between direct and fibrocartilage-preserving techniques in residual symptoms (52.4% vs 63.6%, P = .75), recurrent instability (4.8% vs 6.1%, P = .64), revision surgery (4.8% vs 3.0%, P = .55), or return to preoperative activity among those active pre-injury (40.0% vs 44.4%, P = 1.00).ConclusionIn this retrospective cohort, direct groove deepening achieved outcomes comparable to fibrocartilage-preserving techniques while offering a simpler procedure. High residual symptom rates in both groups suggest that factors beyond fibrocartilage integrity may be relevant for outcome.Level of Evidence:<i>Level III</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261471644"},"PeriodicalIF":2.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteochondral Lesions of the Tibial Plafond (OLTPs): Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle.","authors":"Jared Rubin, Alexander Tham, James J Butler, Paloma Gauthier, Davis Hedbany, John G Kennedy, Jorge P Batista, Stephen Bayer, Gregory C Berlet, Roberto Buda, James D F Calder, Jari Dahmen, Martin S Davey, Christopher W DiGiovanni, Pieter D'Hooghe, Richard D Ferkel, Arianna L Gianakos, Eric Giza, Mark Glazebrook, Laszlo Hangody, Daniel Haverkamp, Beat Hintermann, MaCalus V Hogan, Kenneth J Hunt, Eoghan T Hurley, M Shazil Jamal, Jón Karlsson, Stephen R Kearns, Gino M M J Kerkhoffs, Kaj T A Lambers, Jin Woo Lee, Graham McCollum, Nathaniel P Mercer, Christopher D Murawski, James A Nunley, Jochen Paul, Christopher Pearce, Helder Pereira, Marcelo P Prado, Steven M Raikin, Ian Savage-Elliott, Lew C Schon, James W Stone, Sjoerd A S Stufkens, Martin Sullivan, Masato Takao, Hajo Thermann, David B Thordarson, Victor Valderrabano, Christian J A van Bergen, C Niek van Dijk, Francesca Vannini, Raymond J Walls, Markus Walther, Youichi Yasui, Hua Yinghui, Alastair S E Younger","doi":"10.1177/19386400261471631","DOIUrl":"https://doi.org/10.1177/19386400261471631","url":null,"abstract":"<p><p>BackgroundOsteochondral lesions of the tibial plafond (OLTPs) are considerably less common than osteochondral lesions of the talus (OLT), and the terminology, prognostic factors, and treatment strategies for these lesions remain poorly characterized.MethodsExperts participated in a structured Delphi-based consensus process during the International Consensus Meeting on Cartilage Repair of the Ankle (ICCRA) meeting held in 2019. Blinded surveys, structured questionnaires, literature review, and in-person discussions were used to develop and refine statements. Consensus strength was defined as consensus (51-74%), strong consensus (75-99%), or unanimous (100%).ResultsA total of 11 consensus statements were developed addressing terminology, prognostic factors, and management of OLTP, all of which achieved strong consensus. Unanimous agreement was reached on the terminology \"osteochondral lesion of the tibial plafond.\" Key prognostic factors included lesion characteristics, cystic changes, kissing lesions, and hindfoot alignment. Nonoperative treatment may be considered in asymptomatic or nondisplaced lesions, whereas surgical treatment may be indicated for symptomatic or progressive lesions. Bone marrow stimulation was recommended for small, non-cystic lesions; osteochondral transplantation was supported for larger or cystic lesions. Associated pathology such as kissing lesions and malalignment should be addressed concurrently, and salvage procedures may be considered in advanced cases.ConclusionThese international consensus statements establish practical guidance for the assessment and management of OLTP by integrating current evidence with expert opinion. By outlining key prognostic considerations and treatment pathways, these recommendations aim to reduce variability in clinical practice and provide a foundation for future investigation in this challenging pathology.Level of Evidence:<i>V, expert consensus</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261471631"},"PeriodicalIF":2.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}