Although prior ankle or subtalar arthrodesis is thought to affect outcomes at adjacent joints, previous studies have not distinguished between successful and failed prior fusions. This study examines whether prior successful vs failed ipsilateral arthrodesis influences nonunion risk in subsequent ankle or subtalar fusion. The primary objective of this study is to examine nonunion rates after subtalar and ankle arthrodesis in patients with and without prior ipsilateral arthrodesis, and vice versa.

In conclusion, our analysis of the TriNetX Research Network database suggests that when the primary ankle or subtalar arthrodesis is successful, performing a subsequent adjacent fusion does not significantly increase the risk of nonunion compared with an isolated fusion. However, failed prior arthrodesis substantially increases nonunion risk, highlighting the importance of distinguishing between successful and failed prior procedures in clinical decision-making.

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Patient-specific instrumentation (PSI) was developed to improve accuracy and efficiency in implant placement for total ankle arthroplasty (TAA). This study represents the first to measure the accuracy of PSI regarding implant alignment and implant size in the INBONE II total ankle system (Stryker). A secondary goal was to compare radiographic and clinical outcomes between the PSI and that of a matched group of implants performed with standard instrumentation.

In conclusion, this study of stemmed TAA implants, surgeons achieved alignment generally consistent with PSI predictions. PSI adequately predicted implant size. For most cases, PSI achieved similar alignment and correction of deformity compared with standard instrumentation. PSI did not improve radiographic alignment compared with traditional instrumentation and was associated with longer operative times, possibly reflecting the primary surgeon's early experience with the technique. Each surgeon should select PSI or the standard jig based on their experience and preference.

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There is increasing interest in the role of pronation as part of the deformity correction in hallux valgus (HV) especially with the advent of weightbearing computed tomography (WBCT) and percutaneous surgical techniques. This study aimed to assess the coronal rotation of the first metatarsal before and after percutaneous distal transverse osteotomy (Metaphyseal Extra-Articular Transverse and Akin Osteotomy [META]) using WBCT and to correlate these findings with clinical outcome scores.

In conclusion, percutaneous distal transverse osteotomy for hallux valgus deformity can significantly correct coronal plane pronation and improve patient-reported outcomes, although correction of pronation was not significantly correlated with clinical improvement.

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Bone marrow stimulation (BMS) is the most frequently performed surgical procedure for osteochondral lesions of the talus (OLTs). After the surgical intervention, one of the first goals of rehabilitation is to resume weightbearing. This study aims to compare clinical and radiologic outcomes between immediate weightbearing and delayed weightbearing, which represent unrestricted weightbearing and weightbearing starting at 6 weeks postoperatively.

In conclusion, this matched cohort study found no statistically significant difference in clinical or radiologic outcomes at 12 months between immediate and delayed weightbearing following arthroscopic BMS for talar osteochondral lesions. Although early weightbearing may be feasible and well tolerated, the small sample size and wide CIs limit the strength of conclusions. These findings should be considered hypothesis-generating and underscore the need for larger, prospective trials.

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Total ankle arthroplasty (TAA) is a common method of treatment for end-stage ankle arthritis (ESAA). The utilization of Patient-Reported Outcomes Measurement Information System (PROMIS) allows for standardized assessment of patient-driven outcomes, but few studies have been published on outcomes of TAA using PROMIS. The purpose of this study was to describe the recovery trajectory of patients undergoing TAA for ESAA for up to 1 year after surgery using PROMIS scores for physical function (PF), pain interference (PI), and depression (DP).

In conclusion, this study demonstrates that patients who underwent primary TAA have improvements in PROMIS scores at several different time points up to 1 year after surgery. Patients can expect an improvement in pain and function from baseline within 3 months from surgery. Most improvements occur within the first 6 months. More than half of the patients will achieve a PF and PI score within 1 SD of the national average by 6 months, but it can take up to a year for most patients to reach this. Understanding the trajectory of patient recovery at different time points after primary TAA can help set patient expectations and guide intervention.

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Displaced intraarticular calcaneal fractures (DIACFs) are associated with high rates of posttraumatic arthritis. Traditional management with open subtalar arthrodesis often results in high revision rates and complications. Acute open arthrodesis has shown success in Sanders III and IV calcaneus fractures, with favorable return-to-work and radiographic fusion outcomes. This study evaluates the radiographic results of calcaneus percutaneous reduction and posterior arthroscopic subtalar arthrodesis (C-PASTA) for acute Sanders III and IV fractures.

In conclusion, C-PASTA demonstrates excellent fusion rates, significant restoration of calcaneal alignment, and minimal complications. These findings suggest that C-PASTA is a viable, minimally invasive technique for acute Sanders III and IV fractures.

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The results of the Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) procedure for lateral osteochondral lesions of the talus (OLTs) are unknown. Therefore, the present prospective study aims to assess the numeric rating scale (NRS) of pain during walking at 2-year follow-up. Secondarily, the aim is to assess other clinical, radiologic, and safety outcomes.

In conclusion, in the first 7 prospectively followed patients who underwent the TOPIC procedure for large osteochondral lesions of the lateral talar dome, an improvement of the NRS of pain during walking from median 5 preoperatively to 1 at 2-year follow-up was observed.

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Medial gutter impingement may compromise the results of an otherwise well-fixed total ankle arthroplasty (TAA), but no previous study has assessed predisposing factors. This case-control study sought to investigate potential risk factors and the role of talar component downsizing in decreasing medial impingement. In conclusion, talar component downsizing correlated with an 82% reduction in the probability of medial gutter impingement. Postoperative varus alignment, an elevated joint line level, and medially translated and internally rotated talar component were more prevalent in patients reoperated for medial impingement. Click here to read the article.

Nonunion following naviculocuneiform (NC) joint arthrodesis is a well-recognized complication. Most studies reporting nonunion rates involve a limited number of cases or focus on a single disease entity. Moreover, there is variation between studies with regard to the number of articular facets included in the arthrodesis as well as the fixation construct used, with no clear evidence indicating how these factors influence union. This study, using the largest cohort to date, aims to investigate the nonunion rate following NC joint arthrodesis and to identify demographic and surgical factors associated with nonunion. In conclusion, this study demonstrates a significant rate of nonunion following NC joint arthrodesis, exceeding that previously reported. We found that the rate of nonunion significantly increased in arthrodeses involving only the medial NC facet as compared to those including multiple NC facets. Click here to read the article.

Ankle and hindfoot fusion in the presence of large bony defects represents a challenging problem. The purpose of this study was to evaluate outcomes of patients who underwent ankle-hindfoot fusions with impaction bone grafting (IBG) with morselized femoral head allograft to fill large bony void defects. In conclusion, impaction of morselized femoral head allograft can fill large bony voids around the ankle or hindfoot during fusion, with rapid graft incorporation and no graft collapse despite early loading. This technique offers satisfactory and comparable union outcomes without limb shortening or expensive custom 3D-printed metal cages. Click here to read the article.