AANA25 Foot & Ankle Access Pass *Non-CME*-CONCURRENT SESSION 3H: Sports Ankle Update

Video Transcription

Video Summary

This transcript captures a closing session from an orthopedic foot-and-ankle meeting focused on 2025 management trends and athlete recovery.<br /><br />Eric Ferkel reviews evaluation and arthroscopic management of osteochondral lesions of the talus (OLT): exam plus X‑ray, MRI, often CT, then diagnostic arthroscopy. He emphasizes safe portal placement (protecting the superficial peroneal nerve), debridement of synovitis/impingement, and tailoring treatment to lesion size, containment, cysts, edema, and chronicity. For smaller lesions, bone marrow stimulation aims to form fibrocartilage; newer “nanofracture”/small-needle techniques may reduce bone compaction and improve marrow access versus awls/K-wires. Outcomes data show functional improvement, with biologic augmentation (BMAC/PRP, extracellular matrix scaffolds) supported by consensus statements and improved imaging (MOCART) scores. For larger/hemitalar defects, bulk talar osteochondral allograft can yield high survivorship and patient satisfaction; a case illustrates graft prep, fixation, and good 1‑year outcome.<br /><br />A VCU medical student presents a systematic review on “return to sport” (RTS) after foot/ankle surgery: across 151 studies, 54% lacked an explicit RTS definition and many used inconsistent binary or time-based endpoints, limiting comparability and patient counseling. Standardized staged definitions (training, clearance, competition) are recommended.<br /><br />Guillermo (Buenos Aires) reports that anterior ankle impingement does best long-term when arthroscopic spur resection is paired with etiology-based procedures (instability repair, hindfoot varus correction), showing improved AOFAS scores and no recurrence in a small retrospective series.<br /><br />Dr. Gainey summarizes syndesmotic injuries: prioritize stable vs unstable, use MRI clues (e.g., deltoid + PITFL tears, fluid tracking), consider arthroscopy/stress testing, ensure accurate reduction, and often repair deltoid/associated lateral ligaments.<br /><br />Ian Elliott discusses Lisfranc injuries in high-level athletes, favoring ORIF (often with medial column stabilization) for many indirect athletic patterns, reserving fusion for joint destruction; flexible fixation is an emerging area.<br /><br />Richard Ferkel closes with “future tech”: AI (still needs validation), wearables/GPS systems for workload and asymmetry, markerless motion analysis (DARI), and 3D-printed custom braces for performance and rehab. The panel debates fusion vs fixation in athletes and strategies to reduce reinjury and optimize wound healing.

Asset Caption

Meta Tag

Concept Talar Osteochondral Lesion

Concept Syndesmotic Ankle Injury

Concept Lisfranc Injury

Concept Return to Sport

Concept Imaging Workup

Keywords

osteochondral lesion of the talus (OLT)

ankle arthroscopy

bone marrow stimulation

nanofracture technique

biologic augmentation (BMAC/PRP)

talar osteochondral allograft

return to sport (RTS) definitions

anterior ankle impingement

syndesmotic injury management

Lisfranc injury ORIF in athletes

wearables and markerless motion analysis in rehab

Talar Osteochondral Lesion

Syndesmotic Ankle Injury

Lisfranc Injury

Return to Sport

Imaging Workup