Diabetic foot osteomyelitis (DFO) is a severe complication of diabetes mellitus and a leading cause of non-traumatic lower extremity amputation. Treatment remains clinically challenging with high recurrence rates despite standard antibiotic therapy and surgical debridement. This narrative review synthesizes current evidence on novel operative and nonoperative therapies for DFO, focusing on emerging biomaterials, local antibiotic delivery systems, innovative surgical techniques, and adjunctive topical agents. Studies examining bioabsorbable and nonabsorbable antibiotic carriers, such as calcium sulfate beads, collagen sponges, and bioactive glass, demonstrate promising infection resolution rates and a potential to reduce the surgical burden, though most are limited by small cohorts and observational designs. Similarly, alternative surgical approaches (i.e., cancelloplasty, conservative bone excision, and tibial cortex distraction) have shown early success in limb preservation. Nonoperative strategies, including adjunct antimicrobials, antimicrobial peptides, and topical oxygen, offer additional options, particularly for patients unfit for surgery. While initial outcomes are encouraging, the supporting evidence is heterogeneous and primarily limited to case series and small, noncomparative trials. Overall, these novel therapies show potential as adjuncts to established DFO management, but further prospective research is indicated to define their long-term efficacy, safety, and role in clinical practice.

As tissue engineering and regenerative medicine (TERM) continues to revolutionize medicine and surgery, there is also growing interest in applying these advancements to foot and ankle surgery. The purpose of this article is to provide a comprehensive review of the types of gel scaffolds and templates, their applications in foot and ankle surgery, the challenges with current utilization, and the future directions of TERM in foot and ankle surgery. With multiple compelling scaffold prospects across the numerous natural, synthetic, and hybrid polymers currently utilized in TERM, promising results have been described in the treatment of osteoarthritis (OA) and osteochondral lesions (OCLs). However, concerns with material biocompatibility, structural integrity, feasibility during surgery, and degradation still exist and limit the extent of utilization. As researchers continue to develop enhanced polymers and formulations that address current issues, there are many opportunities to increase applications across foot and ankle surgery.

Background/Objectives: Triplane ankle fractures represent a complex fracture type in pediatric patients. These fractures can prove challenging due to the involvement of multiple fracture planes and variations in segment fragmentation. With increasing literature pertaining to the treatment of triplane fractures and the limitations of previous systematic reviews, the aim of this review is to summarize recent data on the diagnosis, treatment, and complications of pediatric triplane ankle fractures. Methods: This systematic review was conducted following PRISMA guidelines and searched five major databases up to July 2024. The inclusion criteria focused on observational studies and randomized controlled trials in pediatric triplane fractures. Case reports, cadaveric studies, and systematic reviews were excluded. Articles were screened and graded using the MINORS tool for quality assessment. Data were extracted on demographics, fracture types, treatment approaches, and outcomes. Results: A total of 34 studies met the inclusion criteria. The use of CT scans in combination with radiographs was common, and two-part fractures were the most frequently observed type. Surgical treatment, particularly open reduction with internal fixation, was preferred, while conservative surgical treatment remains under-reported. Complications were minimal, with limb length discrepancy being the most common. Conclusions: This review highlights the increased use of CT for diagnosing triplane fractures and the preference of certain surgical interventions. Conservative treatment approaches, though less studied, may offer alternatives in moderate cases. This review emphasizes the need for further research on conservative treatment outcomes, longer follow-ups, and randomized controlled trials to refine treatment strategies for this complex fracture pattern.

Background: Flatfoot deformity is associated with altered lower extremity biomechanics and functional impairment during gait. However, evidence describing spatio-temporal gait alterations remains heterogeneous and has not been consistently synthesized across studies. Methods: A systematic review was conducted in accordance with PRISMA guidelines. MEDLINE (via PubMed) and Scopus were searched through 24 March 2025 for studies evaluating gait characteristics in individuals with flatfoot or progressive collapsing foot deformity. Studies reporting spatio-temporal parameters in both flatfoot and healthy control cohorts were included in quantitative synthesis. Random-effects meta-analyses were performed to evaluate gait velocity, stance duration, stride length, and cadence. Results: Fifteen studies met inclusion criteria, of which five provided sufficient data for meta-analysis. Compared with healthy controls, individuals with flatfoot demonstrated longer stance duration and shorter stride length. No differences were observed in gait velocity or cadence. Substantial heterogeneity was present across all pooled outcomes (I² > 80%), reflecting variability in study populations, disease characteristics, and gait analysis methodologies. Conclusions: Flatfoot is associated with consistent spatio-temporal gait adaptations characterized by longer stance duration and reduced stride length. Despite heterogeneity among included studies, these findings suggest consistent spatio-temporal gait adaptations that may serve as clinically relevant markers of altered gait mechanics and functional impairment. Further studies with standardized protocols are needed to refine the role of gait analysis in the assessment and management of flatfoot.

Background: Total shoulder arthroplasty (TSA) is the preferred treatment for glenohumeral arthritis refractory to nonoperative measures. However, some surgeons have argued for a role for hemiarthroplasty (HA) in the setting of a smooth glenoid that articulates appropriately with the humeral head. The purpose of this study is to evaluate long-term revision rates and short-term postoperative complications in patients undergoing either HA or TSA for glenohumeral arthritis. Methods: A retrospective review of patients who underwent HA and TSA was conducted using a commercially available national database. Demographics, postoperative complications, risk factors, revision rates, and costs were analyzed using 2 sample t-tests, chi-squared tests, and multivariate logistic regressions. Results: Patients were stratified by operation: (1) HA (n = 1615) or 2) TSA (n = 7845). Patients undergoing primary TSA had higher rates of prior ipsilateral rotator cuff repair and corticosteroid injections. At 2 years, patients who underwent HA, 3.0% of patients had revision surgery, compared to 1.6% of patients who underwent TSA ( P = .002); at 5 years, 3.7% of the HA cohort ( P < .0001) had revision surgery, compared to 1.9% of patients who underwent TSA. Conclusions: Patients undergoing TSA or RTSA for glenohumeral arthritis had higher preoperative co-morbidities but had no difference in short-term complication rates with a lower risk of revision surgery at both 2-year and 5-year follow-up when compared to HA. Increasing age, female sex, hyperlipidemia, postoperative infection, shoulder instability, and thromboembolism all independently increased odds for revision shoulder arthroplasty for glenohumeral arthritis. Level of evidence: Level: III.