Background/Objectives: Hyaluronic acid (HA) is a natural substance in the human body with anti-inflammatory and healing properties that help repair bone by supporting cell growth, blood vessel formation, and tissue structure. A common complication after minimally invasive surgery is delayed bone healing in osteotomies. HA may offer a useful treatment to support faster recovery. Methods: This systematic review followed PRISMA guidelines and was pre-registered in PROSPERO (ID: CRD420250654929). Searches were conducted in PubMed, EbscoHost, Web of Science, and Scopus up to 25 January 2025. Studies from the last five years on HA and bone healing were included. The main outcomes were faster bone repair and improved regeneration. Study quality was assessed using the OCEBM, ROBINS-I, and GRADE tools. Results: Out of 96 studies, 9 met the inclusion criteria. HA, especially when combined with other materials or stem cells, helped bone repair by supporting new bone formation. Materials like 3D-printed scaffolds, hydrogels, and meshes showed good results in bone healing. However, differences in the study design made direct comparison difficult. Conclusions: Hyaluronic acid shows promise for bone repair, especially in combination with other materials. More standardized clinical trials are needed to confirm its effectiveness and define how best to use it in minimally invasive surgeries.

Background and Objectives: Minimally invasive distal metatarsal osteotomy (DMMO) has established itself as an effective surgical technique for the treatment of metatarsalgia, notable for its reduced postoperative pain and faster recovery. However, doubts remain regarding the frequency and nature of postoperative complications. The objective of this systematic review and meta-analysis was to evaluate the incidence of the most frequent complications associated with the DMMO technique, including prolonged edema, delayed bone healing, transfer metatarsalgia, floating toe, and persistent pain. Materials and Methods: A systematic review was conducted following the PRISMA 2020 guidelines, with the protocol registered in the PROSPERO database (CRD420251067666). Searches were conducted in the PubMed, Scopus, and Web of Science databases, including clinical studies published between 2010 and 2025. The inclusion criteria covered studies in adults treated with DMMO and reporting postoperative complications. The methodological quality assessment was performed using Joanna Briggs Institute (JBI) tools according to the design of each study. Random-effects models were used for the meta-analyses, assessing heterogeneity using the I² statistic. Results: Fifteen studies with a total sample of more than 493 patients were included. Prolonged edema was the most common complication (30.91%), followed by delayed bone healing (14.9%), transfer metatarsalgia (12.73%), floating toe (10.45%), and persistent pain (8.5%). Less frequent complications included nonunion, infections, necrosis, and bone misalignments. The combined incidence of floating toe was 40% (I² = 0%), while prolonged edema showed considerable heterogeneity (I² = 88.3%). The overall quality of the evidence was considered moderate to low, mainly due to the predominance of observational studies. Conclusions: The DMMO technique represents a minimally invasive surgical option with generally favorable results. However, some complications, such as prolonged edema and floating toe, have a significant incidence. The methodological variability between studies highlights the need for standardized protocols and higher-quality prospective studies to establish the safety profile of this technique more accurately.

Background/Objectives: Chronic plantar fasciopathy is a degenerative pathology that elicits persistent heel pain, significantly impacting quality of life. When conservative treatments fail to yield satisfactory outcomes, radiofrequency microtenotomy utilizing the Topaz technique presents a minimally invasive alternative with regenerative potential. This study aims to evaluate its efficacy in pain reduction, functional improvement, and complication rate compared to other treatments. Methods: A systematic review was conducted in accordance with the PRISMA guidelines and registered in PROSPERO (CRD4202525648314). PubMed, EBSCOhost, Web of Science, and Scopus (2014–2024) were comprehensively searched to identify studies on the Topaz technique for refractory chronic plantar fasciopathy. Clinical trials, cohort studies, and case series were included, and a meta-analysis was performed using a random-effects model to assess pain, the Visual Analog Scale (VAS), American Orthopaedic Foot & Ankle Society function(AOFAS), and complications. Results: Fifteen studies encompassing 1576 patients were analyzed. The meta-analysis demonstrated a significant reduction in pain of 5.90 points on the VAS scale (95% CI: 5.03 to 6.77, p < 0.001) and a functional improvement of 0.28 points on the AOFAS scale (95% CI: 0.27 to 0.28, p < 0.001). The complication rate was low (3.00%), with high patient satisfaction (90%) and rapid recovery. Conclusions: The findings suggest that the Topaz technique is a safe and effective option for chronic plantar fasciopathy, demonstrating significant improvements and minimal complications.

Background/Objectives: Hallux valgus is a common foot deformity that requires surgical correction to restore proper alignment. Precision in the osteotomies performed during these surgeries is critical to avoid complications and improve outcomes. However, variability in surgeon experience can negatively affect precision. In this context, advances in 3D printing have enabled the development of customized surgical guides, which may enhance precision and reduce variability among surgeons with different levels of expertise. This study aims to evaluate the effectiveness of a 3D-printed surgical guide in minimally invasive hallux valgus correction, focusing on the accuracy of osteotomies performed by novice surgeons, experienced surgeons, and theoretically trained consultants. Methods: An ex vivo study was performed with 30 cadaveric feet, divided into three groups according to the level of experience of the surgeons: 3D guide group, Master’s students, professionals. All surgeons performed Akin and Reverdin-Isham osteotomies, but the experimental group (the 3D guide group) utilized a customized 3D-printed surgical guide for enhanced precision during these procedures. Radiographic measurements of osteotomy angles and alignment were taken after the interventions, and compared with the planned values. Statistical analyses were conducted to evaluate the variability in the precision of the cuts. Results: The use of the 3D-printed surgical guide significantly reduced angular variability in the experienced group, achieving higher levels of accuracy than experienced surgeons. Effect sizes, which ranged from small to large, indicated a greater impact on angle measurements (η² = 0.46, p < 0.001); no significant differences were found between the groups in other evaluated parameters. Conclusions: The incorporation of 3D-printed surgical guides in hallux valgus surgery significantly improves osteotomy accuracy, particularly in less experienced surgeons. This suggests that these guides can help standardize procedures, reduce the learning curve, and lower intraoperative complications.