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: Traumatic anterior shoulder instability (ASI) is common among young, active patients, with a progression to glenohumeral osteoarthritis (OA) in up to 55% of patients. Surgical stabilization procedures are routinely offered to patients; however, the long-term risk of the development and severity of OA after these interventions remains unclear because of the overlap with injury mechanics. Purpose: To evaluate the incidence and severity of radiographic OA after surgical treatment for traumatic ASI. Study Design: Systematic review; Level of evidence, 4. Methods: This PROSPERO-registered systematic review and meta-analysis was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search was performed on February 12, 2025, in MEDLINE via PubMed, CINAHL, Embase, CENTRAL and SPORTDiscus, covering publications from 2004 to 2025. Data extracted included the rate of progression to OA (graded in accordance with the Samilson-Prieto or Buscayret classification), incidence of recurrent dislocations, and Rowe score at final follow-up. Cohort characteristics were summarized with weighted means, and data were presented as pooled proportion estimates with 95% confidence intervals (CIs), calculated via meta-analysis of binomial (OA progression, recurrent dislocation) and continuous (Rowe score) variables. Results: A total of 34 studies with a minimum 5-year follow-up comprising 2375 patients and 2403 shoulders were included, and 1962 of these shoulders had follow-up radiographs at a mean follow-up time of 139.0 months. The overall pooled rate of progression to radiographically diagnosed OA was 40.7% (95% CI, 32.6%-49.2%); rates of progression to grade ≥II and grade III OA were estimated to be 10.5% (95% CI, 6.9%-15.6%) and 2.3% (95% CI, 1.1%-4.7%), respectively. The pooled rate of OA at final follow-up based on a surgical intervention was 47.2% (95% CI, 32.0%-63.0%) for arthroscopic Bankart repair, 46.8% (95% CI, 36.6%-57.2%) for open Bankart repair, and 30.3% (95% CI, 20.0%-43.0%) for the Latarjet procedure. The overall pooled rate of recurrent instability was 10.4% (95% CI, 7.7%-13.9%), and the overall pooled Rowe score at final follow-up was 88.2 (95% CI, 86.1-90.3). Conclusion: The progression to radiographic OA occurred in a significant number of patients after surgical treatment for traumatic ASI at long-term follow-up. Although radiographic OA was common, severe degeneration was relatively rare, and functional outcomes remained favorable. These findings provide clinicians with pooled long-term data that can support evidence-based patient counseling, inform surgical planning, and guide future interventional trials.

Background: Rotator cuff tears occur with increased prevalence and worse outcomes in patients with diabetes mellitus. Glucagon-like peptide-1 receptor agonists (GLP-1RA) have demonstrated efficacy in improving glycemic control and reducing body weight, and early studies have examined their perioperative use in total shoulder arthroplasty. Purpose: To investigate the association between GLP-1RA use and postoperative outcomes following arthroscopic rotator cuff repair (RCR). Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective cohort study utilizing the TriNetX database identified patients undergoing arthroscopic RCR from 2000 to 2024. Patients prescribed GLP-1RA within 6 months preoperatively were compared with a propensity-matched cohort without GLP-1RA exposure. Primary outcomes included 90-day postoperative medical complications and 2-year surgical outcomes. Outcomes between cohorts were compared using odds ratios (ORs) with 95% CIs. Results: After propensity score matching, 3066 patients were included in each cohort. The GLP-1RA cohort had a significantly lower risk of hospital readmission within 90 days (2.7% vs 3.6%; OR, 0.741; 95% CI, 0.555-0.989; P = .04) and reduced likelihood of subsequent RCR within 2 years (4.5% vs. 5.7%; OR, 0.768; 95% CI, 0.611-0.966; P = .02). No significant differences were observed in surgical-site infection, pneumonia, thromboembolic events, or emergency department visits within 90 days postoperatively. Likewise, no differences were found in other surgical outcomes, including shoulder arthroplasty, lysis of adhesions, or adhesive capsulitis at the 2-year follow-up. Conclusion: Preoperative GLP-1RA use for patients undergoing arthroscopic RCR was associated with a decreased risk of both hospital readmission at 90 days and subsequent RCR at 2 years postoperatively. There was no difference in the risk of shoulder arthroplasty, adhesive capsulitis, lysis of adhesions, or 90-day medical complications between groups. These findings suggest that GLP-1RA use appears safe in the perioperative period for patients undergoing arthroscopic RCR, providing reassurance for clinicians managing patients already prescribed these medications.