CME OnDemand: 2025 Advanced Foot and Ankle Course-Symposium 1 & 2

Video Transcription

Video Summary

The AOFAS Advanced Foot and Ankle Virtual Course focused on complex foot and ankle issues, featuring expert talks on amputation advances, failed ankle instability surgery, osteochondral lesions, Lisfranc injuries, and cavovarus deformities in pediatric and adult patients. Dr. Matthew Carty highlighted cutting-edge amputation techniques, such as the Ewing amputation, which emphasize functional limb restoration by integrating advanced residual limb reconstruction, pain mitigation strategies (like targeted muscle reinnervation), sensory restoration, proprioception through agonist-antagonist myoneural interfaces, and improved prosthetic interfaces. These innovations enable improved function and embodiment, allowing some patients to return to athletic activities successfully.<br /><br />Dr. Jeremy Smith addressed the challenges of failed lateral ankle ligament reconstructions, emphasizing the importance of understanding failure causes—surgical, biological, or patient-related—and tailoring revision strategies including arthroscopy, tendoscopy, ligament repair with augmentation, graft reconstructions, alignment corrections, and, as a last resort, fusion or amputation.<br /><br />Dr. Ben Jackson focused on osteochondral lesions of the talus, common but often missed injuries in athletes. He advocated for MRI diagnosis when recovery deviates from typical ankle sprain progression and emphasized microfracture or chondral abrasion as first-line treatments, reserving advanced interventions for failures. Proper rehabilitation and addressing instabilities or alignment issues are crucial for successful outcomes.<br /><br />Dr. Anisha Kodakia and colleagues discussed Lisfranc injuries in athletes, noting that most return to play but residual displacement negatively affects performance. Both fixation and fusion can be effective if the midfoot is restored to stable alignment. Preserving first tarsometatarsal motion may benefit cutting athletes. Flexible fixation techniques and minimally invasive methods were also highlighted.<br /><br />Drs. Tony Riccio, Michelle Christie, Christian Plast, and Jesse Doty presented on cavovarus deformities in children and adults, often linked to neuropathies like Charcot-Marie-Tooth disease. They emphasized thorough clinical and genetic evaluation, respecting soft tissue balance before osteotomy or fusion, and individualized approaches to staged surgeries, tendon transfers, osteotomies, and fusions. Emerging gene therapies and neuromuscular stimulators offer promising future treatments.<br /><br />Overall, the course highlighted multidisciplinary advances, nuanced patient assessment, and evolving surgical and rehabilitative techniques tailored to complex foot and ankle pathologies.

Asset Caption

Symposium 1 – Sports
Moderator: Jeremy T. Smith, MD

Sports After Amputation
Matthew J. Carty, MD

Failed Instability
Jeremy T. Smith, MD

OLTs: Updates and Return to Sport
J. Benjamin Jackson III, MD

Lisfranc in the Athlete
Anish R. Kadakia, MD

Cases and Discussion

Symposium 2 – Cavovarus
Moderator: Jacob R. Zide, MD

Updates in the Neurological Understanding of CMT
Michelle R. Christie, MD

Management of Cavovarus in the Pediatric Patient
Anthony I. Riccio, MD

Management and Revision of Cavovarus in the Adult
Christian Plaass, MD

MIS Reconstruction in Cavovarus Deformity
Jesse F. Doty, MD

Cases and Discussion

Keywords

AOFAS Advanced Foot and Ankle Virtual Course

complex foot and ankle issues

amputation advances

Ewing amputation

targeted muscle reinnervation

agonist-antagonist myoneural interfaces

failed ankle instability surgery

lateral ankle ligament reconstruction failure

arthroscopy and tendoscopy

osteochondral lesions of the talus

Lisfranc injuries in athletes

midfoot alignment restoration

cavovarus deformities

Charcot-Marie-Tooth disease

neuromuscular stimulators