Core Knowledge in Orthopaedics: Foot and Ankle

Osteochondral Lesions of Talus

KEY FACTS The natural history of osteochondral lesions of the talus appears to be fairly benign, especially as it relates to the risk of the development of arthritis. Treatment is thus most appropriately based on the patient's symptoms, a very…

Ankle Instability

KEY FACTS Ankle Instability Ankle sprains are among the most common injuries seen by orthopaedic surgeons. A variety of pathologies can result from an ankle sprain mechanism. These individual pathologies should be actively sought, as the treatment is not the…

Other Tendon Disorders

KEY FACTS Tendon pathology is most commonly related to the degenerative process of tendinosis, as is seen in the Achilles and posterior tibial tendons. While tendonitis is a more common term colloquially, tendinosis is a much more common problem clinically.…

Achilles Tendinosis and Rupture

KEY FACTS Achilles Tendinosis Achilles tendinosis can be noninsertional or insertional, although it is the same pathology, i.e., degenerative tendinopathy. Insertional tendinopathy can be associated with a Haglund deformity, insertional ossification, or both. A heel lift and physical therapy are…

Heel Pain

KEY FACTS Heel pain results in 1 million medical visits per year and comprises 1% of all visits to orthopaedic surgeons. The majority of patients with heel pain will be treated successfully nonoperatively. Heel pain can be plantar (subcalcaneal) or…

Ankle Arthritis

KEY FACTS The most common etiology of ankle arthritis is posttraumatic. The ankle bears the highest load per surface area of any joint in the body, yet has a small surface contact area of only 350 mm². The cartilage in…

Lesser Toe Disorders and Metatarsalgia

KEY FACTS An interdependent system of dynamic, static, and bony restraints is responsible for the maintenance of normal toe alignment and stability. Given the relatively small size of the lesser toes in proportion to the relatively large repetitive stresses they…

Hallux Rigidus and Sesamoid Pathology

KEY FACTS Hallux Rigidus Hallux rigidus is the most common arthritic condition in the foot. Hallux rigidus tends to be bilateral, although it is often not synchronous. The 1st metatarsophalangeal (MTP) joint generally becomes stiffer and more painful as the…

Hallux Valgus

KEY FACTS Hallux Valgus Hallux valgus is defined principally by the intermetatarsal angle; the distal metatarsal articular angle can also weigh on treatment decisions; the hallux valgus angle is the least relevant to treatment. Etiology is likely multifactorial with genetics…

Diabetic Foot

KEY FACTS Diabetes mellitus is a multisystem disease resulting from defects in insulin secretion &/or resistance to insulin action, which culminates in systemic hyperglycemia, which can have negative effects, especially when chronically elevated. The total prevalence of diabetes in the…