Foot & ankle specialist最新文献

{"title":"Tourniquet Use Does Not Affect Soft Tissue Outcomes Following Rotational Ankle Fracture Repair.","authors":"Justin F Xie, Abhishek Ganta, Nirmal Tejwani, Sanjit R Konda, Kenneth A Egol","doi":"10.1177/19386400261456932","DOIUrl":"https://doi.org/10.1177/19386400261456932","url":null,"abstract":"<p><p>IntroductionTourniquet use for ankle fracture fixation surgery is a common but not universally accepted practice due to concerns regarding soft tissue complications. Although prior literature has demonstrated increased short-term postoperative pain, tourniquet use's association with other complications remains under-investigated.MethodsA retrospective cohort study was performed of adult patients undergoing open reduction and internal fixation of a closed rotational ankle fracture (OTA Type 44) between 2012 and 2024 at an urban academic health system. Patients were stratified by tourniquet use. Demographic information, injury characteristics, and operative variables were collected. The primary outcome was the development of postoperative complications-wound dehiscence, fracture-related infection, superficial wound infection, delayed wound healing, peripheral nerve injury, venous thromboembolism, and nonunion. Secondary outcomes were operative time and estimated blood loss. Multivariable logistic regression was used to evaluate the association between tourniquet use and postoperative complications.ResultsA total of 617 patients met the inclusion criteria, including 446 who had a tourniquet inflated during surgery and 171 who did not. No significant differences in baseline patient demographics or comorbidity were observed. After multivariable logistic regression, tourniquet use was not associated with higher odds of any wound complication, fracture-related infection, delayed wound healing, or peripheral nerve injury. Among patients in the tourniquet cohort, 4 developed venous thromboembolism and 7 developed a fracture nonunion. No such complications were observed among patients treated without a tourniquet. Tourniquet use was associated with a modest decrease in estimated blood loss (47.3 ± 44.2 vs 33.9 ± 36.0 mL, P < .001) with no significant increase in operative time.ConclusionTourniquet use during operative fixation of closed rotational ankle fractures was not associated with increased soft tissue or bony complications. The findings support the safety of continued tourniquet use per surgeon preference, provided that appropriate patient selection is employed.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261456932"},"PeriodicalIF":2.1,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388459","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":"Concentrated Bone Marrow Aspirate in the Management of Foot and Ankle Pathologies.","authors":"Alexander Tham, Jared Rubin, James J Butler, Samuel R Montgomery, Nathaniel P Mercer, Bradley A Lezak, Edward Mojica, Lefko Charalambous, John G Kennedy","doi":"10.1177/19386400261458581","DOIUrl":"10.1177/19386400261458581","url":null,"abstract":"<p><p>Concentrated bone marrow aspirate (cBMA) is an autologous biologic increasingly used in orthopaedic surgery for its regenerative potential. It contains mesenchymal stem cells (MSCs), growth factors, and cytokines that contribute to tissue repair and immunomodulation. Mesenchymal stem cells primarily exert their effects through paracrine signaling and macrophage reprogramming, promoting a shift from a pro-inflammatory (M1) to a reparative (M2) phenotype. Emerging evidence also suggests a role for mitochondrial transfer in this process. In foot and ankle surgery, cBMA has been investigated in the management of osteochondral lesions of the talus, fracture healing, and tendon disorders. Early clinical studies suggest potential improvements in functional outcomes, healing rates, and revision rates; however, the available evidence remains heterogeneous and is largely limited to small, non-randomized studies. Variability in cBMA preparation and reporting further limits comparability across studies. As such, while cBMA represents a promising adjunct in foot and ankle surgery, its clinical role is not yet fully defined. Future research should focus on prospective, controlled studies with standardized methodologies and explore emerging cell-free approaches, including MSC-derived extracellular vesicles, to optimize regenerative strategies.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261458581"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364285","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":"Functional Outcomes of Displaced Intra-Articular Calcaneal Fractures: A Randomized Superiority Trial of Essex-Lopresti Versus 3-Point Distraction Technique by Forgon and Zadravecz.","authors":"Sushil Mankar, Abhijit Kawalkar, Rahul Sakhare, Razi Zaidi","doi":"10.1177/19386400261456921","DOIUrl":"10.1177/19386400261456921","url":null,"abstract":"<p><p>IntroductionOpen reduction and internal fixation with plating is the most common surgical method of treatment for displaced intra-articular calcaneal fractures, but it has a high infection rate, which leads to chronic osteomyelitis, causing permanent disability; also, the postoperative complications are higher than those of percutaneous techniques. Thus, percutaneous fixation techniques using various indirect reduction methods provide an alternative to addressing these issues. Our study aimed to compare the functional outcomes of displaced intra-articular calcaneal fractures treated with percutaneous fixation using the Essex-Lopresti technique and 3-point distraction technique described by Forgon and Zadravecz.Materials and methodsA prospective randomized superiority study of displaced intra-articular calcaneal fractures was conducted between July 2015 and June 2020. Patients were randomized into 2 groups; group A was operated using the Essex-Lopresti technique, and in group B, a 3-point distracter was used to aid reduction. Functional assessment was done using calcaneal fracture scoring system of Kerr et al and Maryland foot scoring system.ResultsThere were 43 patients with 46 displaced intra-articular calcaneal fractures, with 27 males and 11 females. The mean duration of follow-up was 28 months. There were 20 patients with 23 calcaneal fractures in group A and 18 patients with 18 calcaneal fractures in group B. No statistically significant difference was found in functional outcomes of both techniques, but the operating time was significantly longer in group B patients.ConclusionBoth the Essex-Lopresti technique and use of a 3-point distractor coupled with percutaneous cancellous screw fixation of displaced intra-articular calcaneal fractures provide good functional outcomes with minimal complications. There is no statistically significant difference in the functional outcomes, but outcome scores were better in the 3-point distractor group.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261456921"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354981","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":"Multicenter Treatment of Ankle Fractures: Does Arthroscopic Examination Make a Difference?","authors":"Jorge I Acevedo, Sofia Rivera, Kelsey A Crawford, Joseph D Queen, Thomas G Harris, Dominic S Carreira","doi":"10.1177/19386400261451599","DOIUrl":"https://doi.org/10.1177/19386400261451599","url":null,"abstract":"<p><p>BackgroundThe role of arthroscopy in the management of ankle fractures is controversial. This study aims to evaluate the prevalence of intra-articular pathologies detected during arthroscopically assisted reduction and internal fixation (ARIF) of ankle fractures, stratified by fracture classification, for indirect comparison to current literature. We also present short- to mid-term patient-reported outcomes (PROs) for a subset of the participant cohort.MethodsWe retrospectively analyzed the intra-articular findings of 134 patients who underwent ARIF of ankle fractures. A statistical analysis was performed to assess for significant differences in the proportions of affected patients across fracture types for each intra-articular pathology. PROs included Visual Analog Scale (VAS) ratings and Foot and Ankle Ability Measure scores for Activities of Daily Living (FAAM ADL).ResultsIntra-articular pathologies were noted in 92.5% of patients including sources of anterior impingement such as synovitis (52.2%), soft tissue (29.9%), and loose bodies (33.6%), as well as syndesmotic injury (47.0%), deltoid injury (26.1%), and osteochondral defects (29.1%) (Figure 1). Deltoid injury was more frequently detected in Weber C fractures than in any other fracture type. Syndesmotic injury occurred significantly more frequently in Weber C fractures than in Weber A (P < .01) and Weber B fractures (P < .001) (Table 1, Figure 2). PROs obtained for a subset of patients at the final follow-up reflected low VAS scores (mean = 1.78, n = 49) and high FAAM ADL scores (mean = 71.1, n = 14).ConclusionArthroscopy during ankle fracture surgery is valuable in the detection of intra-articular pathologies that may require treatment to ensure positive patient outcomes. Furthermore, fracture type may be correlated with higher incidence of certain intra-articular pathologies. While future direct comparison is necessary between open reduction and internal fixation (ORIF) and ARIF, our study proposes that ARIF detects issues that may otherwise remain undetected during ORIF and suggests that concomitant arthroscopy is beneficial for ankle fracture fixation.Level of Evidence:<i>Level IV-Case series</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261451599"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355013","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":"A Break-Even Cost-effectiveness Analysis for Venous Thromboembolism Prophylaxis in Achilles Tendon Repair Surgery.","authors":"Kush Mody, Avani A Chopra, David Ahn, Iyad S Ali, Michael C Aynardi, Sheldon Lin","doi":"10.1177/19386400261452500","DOIUrl":"https://doi.org/10.1177/19386400261452500","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a potentially life-threatening complication following orthopaedic surgery. While prophylaxis is well-established in joint arthroplasty, its role after Achilles tendon repair remains controversial. Despite being a soft-tissue procedure, prolonged postoperative immobilization increases VTE risk, with some studies reporting symptomatic rates as high as 7%. However, no prior studies have assessed whether pharmacologic VTE prophylaxis breaks-even in this population.</p><p><strong>Methods: </strong>A literature review and the TriNetX Research Network were used to identify symptomatic VTE rates within 30 days of primary Achilles tendon repair without pharmacologic prophylaxis. The cost of treating a symptomatic VTE was estimated from published data and adjusted to 2025 US dollars. Retail drug pricing was obtained from an online pharmacy database. A break-even analysis was conducted to determine the absolute risk reduction (ARR) and number needed to treat (NNT) required for aspirin (81 mg and 325 mg), warfarin (5 mg), enoxaparin (40 mg), and rivaroxaban (20 mg) to be cost-effective. A sub-analysis compared postoperative bleeding and transfusion rates in patients who received chemoprophylaxis versus those who did not.</p><p><strong>Results: </strong>Among 8935 patients undergoing Achilles tendon repair without chemoprophylaxis, 47 developed a symptomatic VTE (0.526%). Aspirin and warfarin broke-even across all VTE rates, with NNTs ranging from 9217 to 10 547. Warfarin still broke-even when including international normalized ratio (INR) monitoring costs. Enoxaparin and rivaroxaban only broke-even at the highest VTE rate (7.2%), with NNTs of 131 and 390, respectively, and required higher VTE treatment costs to be justified.</p><p><strong>Conclusion: </strong>In this study, we found that aspirin 81 mg, aspirin 325 mg, and warfarin break-even for VTE chemoprophylaxis following Achilles tendon repair. Enoxaparin and rivaroxaban failed to break-even. Chemoprophylaxis decisions should be individualized, weighing patient risk and economic considerations.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261452500"},"PeriodicalIF":2.1,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347626","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":"Evaluating ChatGPT's Ability to Provide Patient Care Information in Foot and Ankle Surgery: A Comparative Analysis.","authors":"Allison J Lewis, Zinoubia Hasasna, Alexandra Krez, Geoffrey Phillips, Adam D Bitterman","doi":"10.1177/19386400261456922","DOIUrl":"https://doi.org/10.1177/19386400261456922","url":null,"abstract":"<p><strong>Background: </strong>Patients increasingly use the Internet and artificial intelligence (AI) platforms ChatGPT for medical information, raising concerns about the accuracy and clinical depth of AI-generated content. This study evaluated the reliability and clinical utility of ChatGPT (GPT-3.5 and GPT-4.0) for common foot and ankle conditions compared with patient education materials from the American Orthopaedic Foot & Ankle Society (AOFAS) FootCareMD.</p><p><strong>Methods: </strong>Between January 20 and 26, 2025, standardized prompts were used to query GPT-3.5 and GPT-4.0 across 15 common foot and ankle conditions. ChatGPT responses were compared with AOFAS FootCareMD content based on the number of symptoms, risk factors, and treatment options provided. Two fellowship-trained foot and ankle orthopaedic surgeons independently evaluated response accuracy, categorizing outputs as <50%, 50% to 74%, 75% to 99%, or 100% accurate. Paired t-tests were used for statistical comparisons, and inter-rater reliability was assessed using Cohen's weighted kappa.</p><p><strong>Results: </strong>GPT-4.0 generated significantly more symptoms than AOFAS content (P = .015). In contrast, GPT-3.5 listed significantly fewer treatment options than both AOFAS and GPT-4.0 (P = .042). When addressing surgical management, both ChatGPT versions frequently provided vague or incomplete information. GPT-3.5 referenced surgery without procedural detail in 53% of responses, while GPT-4.0 lacked detailed surgical explanations or omitted them entirely in 80% of responses. Overall accuracy ratings were high, with 77% of responses judged as 75% to 99% accurate and only 3.4% rated below 50% accuracy. However, inter-rater agreement between surgeons was poor (κ = -0.02), for responses labeled as 100% accurate, highlighting subjectivity in grading AI-generated medical content.</p><p><strong>Conclusion: </strong>ChatGPT effectively provides general information on foot and ankle conditions, regarding causes and symptoms, and GPT-4.0 offers more comprehensive treatment discussions than GPT-3.5. Nevertheless, its limited depth and specificity regarding surgical options restrict its clinical usefulness. Until further improvements are made, AI-generated content should serve as a supplement rather than a replacement for expert-reviewed patient education resources.</p><p><strong>Level of evidence: </strong><i>Level III Case Control Study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261456922"},"PeriodicalIF":2.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341300","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":"Patient-Reported Outcomes, Patient Satisfaction, and Return to Play After Surgical Treatment of Syndesmosis Injuries in Competitive Athletes.","authors":"Jeffrey R Ruland, Margaret G Mercante, Wendy M Novicoff, M Truitt Cooper, Joseph S Park","doi":"10.1177/19386400261456902","DOIUrl":"https://doi.org/10.1177/19386400261456902","url":null,"abstract":"<p><p>BackgroundFew studies have investigated return to play after surgical stabilization of syndesmotic injuries without fracture with minimal data on patient-reported outcome measures. The purpose of this study was to evaluate patient-reported outcomes, patient satisfaction, and return to play after surgical repair of syndesmosis injuries in competitive athletes.MethodsA retrospective review of competitive athletes who underwent surgery for an unstable syndesmosis was performed. Patients were excluded if they were not competitive athletes or had the presence of a concomitant fracture. Patient-reported outcome measures were collected via telephone questionnaires. These included the Foot and Ankle Ability Measure (FAAM) Sports Subscale as well as 7 other questions regarding subjective assessment of function, patient satisfaction, and return to play.ResultsA total of 29 ankles in 28 competitive athletes were included. Twenty-four of 28 (86%) patients were male, and 4 of 28 (14%) patients were female. Average age at surgery was 20.7 ± 2.4 (15-24). Twenty-five of 28 (89.3%) athletes completed the post-operative telephone questionnaire with a mean follow-up of 41 months (minimum 9 months). In total, 100% of patients returned to athletic activity. Nineteen of 20 patients (95%) eligible to do so returned to competition, with 16 of 25 (64%) patients reporting a return to pre-injury level of function. The average FAAM-sports score was 29.6 (max 32) ± 3.5. Twenty-four of 25 patients reported post-operative function as normal or nearly normal. Twenty-four of 25 patients reported that they were either very satisfied or satisfied. Patient-reported time of return to unrestricted play was 19.9 ± 9.8 weeks. Injury grade, repair technique, acuity of injury, and concomitant injuries were not associated with prolonged return to play or decreased FAAM scores.ConclusionA high percentage of competitive athletes undergoing surgical treatment of syndesmosis injury were able to return to their previous level of competition, with nearly all achieving good-to-excellent outcome scores and satisfaction. Severity of injury, concomitant injury, or repair technique was not found to have an effect on outcomes.Level of EvidenceIV, single-arm retrospective case series.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261456902"},"PeriodicalIF":2.1,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304190","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":"Anatomic Feasibility of 4-Legged Staples for Naviculocuneiform Arthrodesis.","authors":"Steven R Cooperman, Lauren M Christie, Travis M Langan, Patrick E Bull, Mark A Prissel","doi":"10.1177/19386400261456898","DOIUrl":"https://doi.org/10.1177/19386400261456898","url":null,"abstract":"<p><strong>Background: </strong>Naviculocuneiform (NC) arthrodesis is indicated for multiple pathologies, including degenerative and traumatic arthritis, progressive collapsing foot deformity, and medial column instability. Despite its broad application, no consensus exists regarding the optimal fixation construct. Shape-memory dynamic compression staples offer potential advantages in midfoot fusion compared to static fixation.</p><p><strong>Purpose: </strong>To evaluate the feasibility of using 4-legged dynamic compression staples for NC arthrodesis and to characterize NC joint anatomy to guide implant selection and orientation.</p><p><strong>Study design: </strong><i>Level IV cadaveric study</i>.</p><p><strong>Methods: </strong>Twenty fresh-frozen cadaveric lower limbs (10 pairs) were dissected to expose the NC joint. Measurements of the medial and intermediate cuneiform and navicular facets were recorded. Four-legged staples (26 and 30 mm) were inserted, and adjacent joints were examined for proximal or distal penetrance. Statistical analysis was performed using Mann-Whitney U tests with significance set at P ≤ .05.</p><p><strong>Results: </strong>Staple fixation across the medial cuneiform-navicular articulation was safe in all 40 applications without talonavicular or tarsometatarsal breakthrough. In contrast, the intermediate segment demonstrated a significantly shorter length (35.83 ± 3.24 mm vs 46.40 ± 4.15 mm; P = .0002) and higher rates of talonavicular breakthrough at 20% for 26 mm staples and 60% for 30 mm staples. Longer intermediate segments correlated with reduced breakthrough (P = .0190).</p><p><strong>Conclusion: </strong>To our knowledge, this is the first study to quantify NC articulation lengths. Four-legged staples up to 30 mm in length were shown to be feasible for use in both dorsal-to-plantar or medial-to-lateral orientations at the medial cuneiform articulation. Due to breakthrough with the 4-legged staples, 2-legged staples (16-20 mm bridge) and staple legs ≤20 mm are advised for the intermediate segment to minimize iatrogenic injury risk.<b>Level of Evidence:</b> <i>Level IV Cadaveric Study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261456898"},"PeriodicalIF":2.1,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304201","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":"Platelet-Rich Plasma for Lateral Ankle Ligament Injuries: A Systematic Review of Current Evidence and Limitations.","authors":"Jared Rubin, Ryan Rutherford, Alexander Tham, James J Butler, Edward S Mojica, Cameron Pow, Haider Ali Lakadawala, John G Kennedy","doi":"10.1177/19386400261458588","DOIUrl":"https://doi.org/10.1177/19386400261458588","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this systematic review is to evaluate the clinical outcomes, complication rates, and failure rates following platelet-rich plasma (PRP) injections for lateral ankle ligament injuries.</p><p><strong>Methods: </strong>During June 2025, a systematic review of the PubMed, EMBASE, and Cochrane Library databases was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines to identify comparative clinical studies evaluating PRP for lateral ankle ligament injuries. Data extracted included patient demographics, clinical outcomes, complications, failures, and secondary procedure rates.</p><p><strong>Results: </strong>Five studies were included involving a total of 126 patients (126 ankles) who received PRP injections and 48 patients (48 ankles) who were in the control cohort, with a mean follow-up of 7.1 ± 4.3 months. Across studies, no consistent differences were found in clinical outcome scores between PRP and control cohorts at short-term follow-up. Significant heterogeneity in PRP preparation and administration protocols precluded a pooled meta-analysis from being performed. Platelet-rich plasma injections were associated with low complication (3.4%) and failure (5.1%) rates, and no secondary procedures were reported. Overall, the certainty of the available evidence was low, representing a limited and heterogeneous evidence base.</p><p><strong>Conclusion: </strong>Based on limited short-term data, the available studies do not demonstrate a clear or consistent difference in clinical outcomes between PRP-treated patients and controls. However, the evidence base is scarce, highly heterogeneous, and of low certainty. Substantial variability in PRP preparation and administration, small sample sizes, and short follow-up preclude reliable quantitative synthesis and comparative conclusions. Consequently, the current literature is insufficient to determine whether PRP provides any clinical advantage over standard care for lateral ankle ligament injuries. Further well-designed, adequately powered prospective studies with standardized PRP protocols and longer follow-up are warranted.</p><p><strong>Level of evidence: </strong><i>V</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261458588"},"PeriodicalIF":2.1,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304156","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":"Multi-staged Versus Single-staged Reconstruction for Progressive Collapsing Foot Deformity (PCFD): A Retrospective Cohort Study of Complications and Cost.","authors":"Alice Wei Ting Wang, John Steyn, Madeleine Willegger, Joachim Ortmayr, Sebastian Drago, Oliver Gagne, Lindsay Anderson, Alastair Younger, Andrea Veljkovic","doi":"10.1177/19386400261451025","DOIUrl":"https://doi.org/10.1177/19386400261451025","url":null,"abstract":"<p><p>BackgroundSurgical reconstruction of progressive collapsing foot deformity (PCFD) is generally performed using a single-staged (SS) approach. However, a multi-staged (MS) approach may be used and has not been previously described or evaluated. Questions: 1. Are there any differences in complication rates and subsequent operation rates between SS and MS PCFD reconstruction? 2. How do the costs of SS PCFD reconstruction compare to MS PCFD reconstruction?MethodsA retrospective cohort study of SS and MS PCFD reconstruction was performed, with treatment allocation determined by the treating surgeon. Rates of major complications, subsequent operations, and costs of operating time and hospital admissions were compared.ResultsSeventy-four feet with SS and 63 feet with MS reconstruction were included. Higher major complication rates were noted in SS (16%) compared with MS reconstruction (2%) (<i>P</i> = .02), with no significant difference in subsequent operation rate (<i>P</i> = .05). Total operating room and hospital admission costs were higher in SS ($20 868) compared with MS ($14 900) (<i>P</i> = .01).ConclusionsThis study reports outcomes of MS approach for PCFD reconstruction. In this cohort, MS reconstruction was associated with lower wound complication risks and costs compared with a traditional SS approach. Future studies evaluating patient-reported outcomes are warranted to further optimize surgical management of PCFD.Level of Evidence3.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"19386400261451025"},"PeriodicalIF":2.1,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273925","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}