2025 AOFAS Annual Meeting-Paper Session 4A

Video Transcription

Video Summary

The conference featured diverse foot and ankle surgery research presentations emphasizing minimally invasive techniques, ankle arthroscopy, osteochondral lesion management, and complications in total ankle replacements. Dr. Lou Schoen discussed a large series of transfibular total ankle replacements with excellent 5- to 7-year outcomes, highlighting improvements in pain, function, and deformity correction with low revision rates. Dr. Wolfram Grun presented a 10-year RCT on Lisfranc injuries, showing no clinical or radiographic advantage of bridge plating over primary arthrodesis, recommending arthrodesis as preferred. Dr. Martin Gregersen addressed diagnosing deep deltoid ligament injury in Weber B ankle fractures, finding weight-bearing radiographs to be highly sensitive and specific compared to arthroscopy. Raveena Joshi revealed that subtalar arthritis is common after pilon fractures, indicating acute hindfoot nailing may not compromise the joint as previously thought. Dr. Sam Adams demonstrated that angulated, divergent screw placement enhances compression and contact area in fixations, suggesting revised hardware strategies for improved stability. Steven Hadley’s retrospective review supported deltoid ligament repair in ankle fracture surgery, showing reduced radiographic complications and modestly improved PROMIS functional scores. Dr. James Lackman outlined management options for infected total ankle replacements, underscoring challenges in diagnosis and the limited success of single-stage revisions. Dr. Konstantin Dimetricopoulos highlighted prophylactic fixation techniques to reduce medial malleolar fractures post-total ankle replacement, stressing early deformity correction with rigid fixation. Carl Schweitzer focused on revision total ankle arthroplasty strategies, emphasizing preservation of bone stock and staged approaches for complex cases. Dr. Sam Black presented the utility and pitfalls of 3D printing for salvage implants. Ariana Giannakas advocated for wide-awake needle arthroscopy transitioning from OR to office settings for diagnostic and minimally invasive interventions. Eric Ferkel reviewed tibial plafond osteochondral lesions management, emphasizing bone treatment alongside cartilage repair. Greg Juarez discussed innovative tenoscopy techniques for peroneal, posterior tibial, FHL, and Achilles tendons. Tom Lewis introduced the filament union sign after MIS bunion surgery, a thin bony bridge with uncertain clinical significance affecting ~3% of patients. Yeogwon Yoon associated inadequate post-op sesamoid position with hallux valgus recurrence after MIS osteotomy. Jennifer Hong showed MIS foot and ankle arthrodesis accelerates union time independent of synthetic bone graft use. Ettore Vulcano reported decreased extensor hallucis longus tendon injury risk with wedge burrs versus Shannon burrs during MIS cheilectomy. Overall, the session highlighted advances in minimally invasive techniques, nuanced understanding of biomechanics, imaging, and outcomes, while calling for further research on long-term effects and optimization of surgical strategies.

Keywords

minimally invasive foot and ankle surgery

ankle arthroscopy

osteochondral lesion management

total ankle replacements

transfibular total ankle replacement outcomes

Lisfranc injury treatment

deep deltoid ligament injury diagnosis

subtalar arthritis after pilon fractures

angulated divergent screw fixation

deltoid ligament repair in ankle fractures

infected total ankle replacement management

prophylactic fixation medial malleolar fractures

revision total ankle arthroplasty strategies

3D printing salvage implants

wide-awake needle arthroscopy