New research in foot and ankle surgery is presented in the latest JBJS Specialty Update, What’s New in Foot and Ankle Surgery. Here, we highlight the 5 most noteworthy studies, as selected by coauthor Bradley Petrisor, MSc, MD, FRCSC.
Total Ankle Arthroplasty
Total ankle arthroplasty (TAA) was compared with ankle arthrodesis (AA) for the treatment of end-stage ankle arthritis in a systematic review of 9 studies encompassing 3,460 TAAs and 3,983 AAs. TAA was associated with lower rates of complication (13.1% vs. 31.4%), implant removal (8.5% vs. 20%), and nonunion (1.6% vs. 7.2%). Patient-reported outcomes were similar between TAA and AA1.
Minimum 10-year functional outcomes of TAA vs. AA for ankle arthritis were evaluated in a follow-up report published in JBJS. Outcomes were reported for 211 patients from a multicenter cohort in which the treatment was tailored to the condition of the patient. The TAA and AA groups demonstrated similar long-term functional outcomes; however, the AA group was more likely to avoid additional surgery2.
Trauma
Different fixation constructs used in open reduction and internal fixation of Lisfranc injuries were investigated in a systematic review of 36 studies. The studies comprised retrospective cohorts, meta-analyses, reviews, and a prospective study and included both low- and high-energy trauma cases. The reviewers noticed a move away from traditional fixation (e.g., Kirschner wires and transarticular screws) toward articular bridge plating and flexible constructs3.
A meta-analysis evaluated the outcomes of syndesmotic injuries of the ankle treated with suture-button fixation vs. transsyndemostic screws across 7 Level I clinical trials (490 patients). The suture-button group demonstrated better functional outcomes and lower rates of implant failure, implant removal, and malreduction4.
Artificial Intelligence
Researchers assessed the readability of AI-generated text regarding foot and ankle procedures and compared it with that of patient information leaflets produced by The British Orthopaedic Foot and Ankle Society. The AI-generated content had worse readability (i.e., exceeded recommended health literacy levels) and, for 2 of the 3 evaluated procedures, also had lower accuracy5.
What’s New in Foot and Ankle Surgery is freely available at JBJS.org.
What’s New by Subspecialty
Each month, JBJS publishes a review of the most pertinent studies from the orthopaedic literature in a select subspecialty. To read the reports, visit the What’s New by Subspecialty collection at JBJS.org.
Recent OrthoBuzz posts include: What’s New in Biologics, What’s New in Hand and Wrist Surgery, and What’s New in Machine Learning and Generative AI.
References
- Encinas R, Kiriluk SH, Hardman J, Jackson JB 3rd, Gonzalez T. Clinical outcomes and safety profile for total ankle arthroplasty and ankle arthrodesis for symptomatic ankle arthritis: a systematic review. J Am Acad Orthop Surg. 2025 Sep 24.
- Glazebrook M, Balasubramaniam U, Walls A, Younger ASE, Penner M, Wing K, Dryden PJ, Daniels TR. Outcomes of total ankle replacement versus ankle arthrodesis for the treatment of end-stage ankle arthritis: a concise follow-up, at a minimum of 10 years, of a previous report. J Bone Joint Surg Am. 2025 Mar 19;107(6):552-7.
- Talia AJ, Roshan-Zamir S, Shepherd DW. Outcomes in open reduction and internal fixation of tarsometatarsal (Lisfranc) injuries: a contemporary review of fixation constructs. Foot Ankle Orthop. 2025 Jul 28;10(3):24730114251352519.
- Migliorini F, Maffulli N, Cocconi F, Schäfer L, Bell A, Katusic D, Vaishya R. Better outcomes using suture button compared to screw fixation in talofibular syndesmotic injuries of the ankle: a Level I evidence-based meta-analysis. Arch Orthop Trauma Surg. 2024 Jun;144(6):2641-53.
- Jaques A, Abdelghafour K, Perkins O, Nuttall H, Haidar O, Johal K. A study of orthopedic patient leaflets and readability of AI-generated text in foot and ankle surgery (SOLE-AI). 2024 Dec 16;16(12):e75826.