http://liverpoolfootandankle.com/

Liverpool Foot and Ankle, 57 Greenbank Road, Liverpool (2025)

23/10/2025

📄 New Research Spotlight: “Open Excision vs. Percutaneous Intermetatarsal Ligament Release for Morton’s Neuroma – Is Width Important?” (Foot & Ankle Surgery, 2025) AOFAS Journals

Morton’s neuroma remains one of the most common causes of forefoot pain — yet surgical treatment can vary.

This new multicentre study by Emanuel Cortesão de Seiça João Seixas Alexei Buruian Daniel Peixoto João Vide (Foot & Ankle Surgery, 2025) provides valuable insight into how neuroma width can possibly guide treatment choice.

🔍 Key findings:
• 46 patients (58 feet) were reviewed, comparing open excision and percutaneous intermetatarsal ligament release (PILR).
• Both techniques improved pain and function, but open excision achieved significantly better outcomes for neuromas >7.4 mm in width.
• For smaller neuromas (

23/10/2025

🌍 International faculty for Mason at CIOS 🇮🇳

We are proud that our very own Professor Lyndon Mason has been invited as International Faculty at the 5th Biennial Cochin International Orthopaedic Summit (CIOS 2025) in Kochi, Kerala, India 🇮🇳.

Held at the Grand Hyatt, Kochi, this prestigious global meeting — celebrating its 10th year — brings together leading orthopaedic surgeons from across the world to explore the theme “Dilemmas in Orthopaedics.”

Prof Mason will be sharing his internationally recognised work on complex ankle fractures and posterior malleolar management — research that continues to shape surgical practice worldwide.

CIOS 2025 features expert-led cadaveric workshops, global keynote sessions, and collaborative discussions uniting specialists from over 20 countries.

Congratulations Prof Mason on this latest international faculty position, showcasing Liverpool’s continued impact on orthopaedic education, innovation, and research excellence.

📍 Cochin International Orthopaedic Summit 2025
📅 25–26 October 2025 | Grand Hyatt, Kochi, India
🌐 www.ciosonline.com

12/10/2025

🇸🇪 International Invitation for Professor Lyndon Mason

We’re proud to share that our very own Professor Lyndon Mason, has been invited to deliver the Academic Friday Session at Uppsala University Hospital, Sweden, on October 17th.

This invitation follows Professor Mason’s recent PhD from the University of Liverpool, focused on posterior malleolar fractures — a body of work that has transformed understanding and management of these complex injuries worldwide.

At Uppsala, Professor Mason will present on the Posterior Malleolus, discussing the evolution of treatment from biomechanics and fracture morphology to surgical approaches and outcome optimisation.

It’s a privilege to see his research being recognised by the prestigious Department of Orthopaedics at Uppsala University, a leading centre of orthopaedic excellence.

We wish Professor Mason every success in his upcoming lecture and thank Professor Olof Wolf and his team for the kind invitation.

🕗 Friday 17th October 2025 | 08:00–08:30 (Sweden) / 07:00–07:30 (UK)

04/10/2025

⚽️ Grassroots football matters! ⚽️

Liverpool Foot & Ankle Clinic is proud to sponsor West Kirby United U12s — Nebula & Celeste 🌟

Supporting local grassroots teams is about more than football — it’s about teamwork, resilience, and community. We’re thrilled to help these young players grow, stay active, and chase their goals (on and off the pitch!) 💪⚽️

Here’s to a fantastic season ahead for Nebula and Celeste — play hard, have fun, and keep shining bright ⭐️⭐️

04/10/2025

👏 Well done to our who has been invited as the guest speaker at the West of Scotland Foot & Ankle Society (WOSFAS) meeting in Glasgow on Monday 6th October.

Hosted at and supported by , the meeting will also welcome the European Foot & Ankle Society Fellows for a joint evening of education and collaboration.

Professor Mason will present his pioneering research on posterior malleolar fractures, which has helped reshape treatment and surgical approaches both nationally and internationally 🌍

20/09/2025

🔎 Article of Interest: Fixation Merhods and Post-Operative Protocols in First MTP Joint Fusion

Hallux rigidus remains the most common form of foot arthritis, and first MTP joint arthrodesis is widely accepted as the gold standard treatment for advanced cases. Despite this, questions persist regarding:

1️⃣ Which fixation method gives the most reliable outcomes?
2️⃣ What weight-bearing regime is safest and most effective post-operatively?

A new systematic review published in Foot & Ankle Surgery explores these very questions:

“An evidenced based review of the efficacy of fixation type and post-operative weight-bearing status on metatarsophalangeal joint fusion for treatment of hallux rigidus”
👉 https://lnkd.in/ejcstRks

📊 Key findings:
• Fixation: Fair evidence supports the use of screws, plates, or plate + compression screw. Insufficient evidence exists for staples and newer devices.
• Weight-bearing: Both immediate weight-bearing and non-weight-bearing show comparable clinical outcomes.
• Evidence gap: Further high-quality Level I and II studies are needed to refine recommendations.

💡 This review reinforces that there is flexibility in both fixation choice and rehabilitation, but also highlights the lack of consensus in our field.

❓ Discussion point:
In your practice:
• What fixation method do you prefer for first MTPJ arthrodesis?
• Do you allow immediate weight-bearing post-operatively, or do you still recommend a period of protection?

I’d be very interested to hear how colleagues are approaching this in their own units.

14/09/2025

🔎 New RCT on Minimally Invasive vs Open Surgery for Hallux Valgus

Escudero et al. have just published a randomized controlled trial comparing MITO (minimally invasive transverse distal metatarsal osteotomy with percutaneous Akin) vs open chevron Akin (OC) surgery for mild–moderate hallux valgus in the American Orthopaedic Foot & Ankle Society journal FAI.

📊 Key findings:
• 40 patients, 40 feet randomized
• No difference in surgical time, PROMs, AOFAS, or radiographic results at 1 year
• Early wound healing favored MITO at 6 weeks (PWAT score)
• Complication rate: 15% in both groups
• At 1 year, outcomes were equivalent across both techniques

💡 Takeaway:
This small RCT suggests that minimally invasive techniques may offer short-term soft tissue benefits in wound healing, but at 1 year, both MIS and open osteotomies achieve comparable functional and radiographic outcomes. Larger, multicentre trials will be important to confirm these findings and guide practice.

📖 paper https://lnkd.in/e-2SsDiX

24/08/2025

🔍 MIS vs Open in Calcaneal Fractures – What does the latest Level 1 evidence tell us? 👣

A new systematic review and meta-analysis of RCTs in Foot and Ankle Surgery ( Purdie et al., santosh baliga 2025) compares the extensile lateral approach (ELA) with minimally invasive surgical techniques (MIS)—namely the sinus tarsi and percutaneous approaches—for displaced intra-articular calcaneal fractures (DIACFs).

💡 Key findings across 14 RCTs (n = 1367):

✅ Wound Complications
MIS significantly reduces wound complications vs ELA (RR 6.48, GRADE: High)

✅ Functional Outcomes
Higher AOFAS and Maryland Foot Scores at both 6 and 12 months for MIS (especially early recovery)

✅ Radiographic Outcomes
No significant difference in Bohler’s or Gissane’s angles—MIS achieves comparable anatomical reduction

📊 Both sinus tarsi and percutaneous approaches showed consistent benefits over ELA in subgroup analyses.

🧠 For clinicians, this study reinforces the shift towards MIS for DIACFs, especially where wound risks and return to function are paramount.

🎓 For educators and trainees, it’s a great article to spark critical appraisal discussions on surgical technique selection, bias in meta-analysis, and how functional outcomes evolve over time.

🔁 Are you still using ELA routinely for Sanders II/III? Has MIS changed your algorithm?

📚 https://lnkd.in/e5kcbprx

16/08/2025

🦶💡 Is 3D printing changing the game in ankle surgery?

This new review highlights the growing role of 3D printing in complex ankle reconstruction — not just in theatre, but also in how we prepare and teach.

🔹 Total talus replacement (TTR) is emerging as a viable alternative to fusion or conventional arthroplasty — especially in cases of AVN, trauma, or tumour.
🔹 Custom implants and patient-specific instrumentation in TAA and arthrodesis are improving fit, alignment, and union.
🔹 Supramalleolar osteotomy with PSI leads to shorter op times, less blood loss, and reduced radiation.
🔹 Beyond surgery — 3D models are proving invaluable for education and simulation, giving trainees and surgeons the opportunity to visualise, rehearse, and refine complex procedures preoperatively.

🧠 As both a clinical tool and an educational platform, 3D printing is bridging the gap between planning and performance.

🔗 Full article: https://lnkd.in/eZEQfwaJ

📣 Are you using 3D models in your practice or training? Do you see them becoming routine in ankle surgery?

09/08/2025

❓ What are the safe zones for minimally invasive midfoot surgery? ❓

MIS midfoot fusion and osteotomy may have the possible benefits of faster recovery, smaller scars, and less soft-tissue disruption — but without direct visualisation, critical neurovascular structures and tendons are at risk.

A new cadaveric study has created fluoroscopic heatmaps mapping the dorsal neurovascular bundle, superficial peroneal nerve, and key tendons on standard AP and oblique views.

The findings:
🔹 Red zones = highest injury risk
🔹 Blue zones = less common but possible trajectories
🔹 No-colour areas = completely safe for burr or screw placement
🔹 AP vs oblique views reveal different optimal access points for the medial and lateral columns

This “radiological safety atlas” bridges the gap between open anatomy and MIS fluoroscopic navigation — aiming to reduce iatrogenic injury and improve surgical confidence. Well done to the authors. 👏

📄 Karaismailoglu B, Peiffer M, Raduan F, Hollander JJ, Knebel A, Kwon JY, Soheil Ashkani-Esfahani, MD, MPH , . Radiological safety atlas of minimally invasive midfoot fusion: A cadaver study. Foot Ankle Surg. 2025;31:448–453.
🔗 https://lnkd.in/eJ6KTehN

08/08/2025

🔍 Broström Repair – With or Without Suture Tape Augmentation?

Lateral ankle instability is a common challenge. The augmented Broström repair, using high-strength suture tape, offers greater initial biomechanical stability in cadaver studies — but does that translate into better patient outcomes in the long term?

This 5-year median follow-up study in compared:
• Broström repair alone (BR)
• Broström repair with suture tape augmentation (BR-ST)

📊 Key findings:
• No significant difference in FAAM ADL, FAAM sport, SF-12 PCS, Tegner score, or patient satisfaction between BR and BR-ST.
• Slightly higher SF-12 mental component scores in the BR-ST group (possibly reflecting greater confidence in the repair).
• Low revision rates in both groups (1 revision for recurrent instability in BR-ST).
• Earlier recovery in the BR-ST group often occurred because surgeons felt more confident in the repair and therefore advised a faster return to activity.

💡 Takeaway: While augmentation may allow for accelerated rehab and weight-bearing due to surgeon confidence, long-term functional outcomes appear similar. The choice may ultimately depend on patient profile, tissue quality, and surgeon preference.

Is it worth the expense?

📄 Full paper: https://journals.sagepub.com/doi/10.1177/10711007231176806

What’s your current go-to for chronic lateral ankle instability — standard Broström, augmentation, or anatomic reconstruction?

28/07/2025

🔬 Can Early Functional Rehab Prevent Heterotopic Ossification After Achilles Rupture?

In this thought-provoking study from , Magnusson et al. explored whether early weightbearing and ankle mobilization could reduce heterotopic ossification (HO) following surgical repair of Achilles tendon ruptures.

👣 Key findings from the 69-patient cohort:
• HO occurred in 19% of patients—but crucially, it had no negative impact on functional outcomes (ATRS, VISA-A, ROM, tendon strain).
• In fact, those with HO showed a trend towards better heel-raise performance at 1 year.
• HO developed within the first 6 weeks post-op, irrespective of the rehab protocol.
• Early functional rehab (mobilization and weightbearing) did not prevent HO.

📌 Takeaway: Heterotopic ossification is more common than we might expect after Achilles surgery—yet may not impair recovery. And despite animal data suggesting loading can influence HO, this clinical study found no protective effect from early motion.

🧠 Did you know that surgical repair of Achilles tendon ruptures can lead to heterotopic calcification?
❓Has anyone seen this in practice—or used specific methods to prevent HO in tendon repairs?
🧐Does HO occur after conservative treatment of Achilles tendon ruptures?

Let’s start a conversation.

📰 https://lnkd.in/enBd74yB

Liverpool Foot and Ankle

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