October 2025

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Cover Story


lerEXPO Conversation: Congestive Lower Extremity Failure (CLEF)

Healthcare professionals are continually striving to improve patient outcomes through enhanced understanding and precise diagnosis. Yet, a significant pathological continuum, chronic venous insufficiency (CVI) and chronic venous disease (CVD), remains grossly underrecognized and misunderstood by many across the healthcare spectrum. This gap in knowledge often leads to delayed or incorrect diagnoses, suboptimal patient care, and unnecessary suffering for millions worldwide.

By John Chuback, MD

Features


Management of Charcot Soft Tissue Complications

Charcot neuroarthropathy is a complex condition that often leads to considerable challenges due to its complex nature. One primary concern is the management of soft tissue complications, including chronic wounds and surgical dehiscence, which are prevalent among Charcot patients. These complications can significantly impact limb functionality and...

By Kelsey Millonig, DPM, MPH, FACFAS, DABPM, DABFAS

Lower Extremity Injuries Caused by Falls Treated at Hospital Emergency Departments

Falls are a major public health concern, causing millions of injuries in the United States (US) each year. A portion of injuries caused by falls are likely to involve the lower extremity. The objective of this study was to describe lower extremity injuries caused by falls treated at US hospital emergency departments (EDs).

By Mathias B. Forrester, BS

CAGA 101: The 12 Dirty Truths of Foot Mechanics

We all know we will not live forever, but perhaps a good goal would be to not outlive your health. We also know that there are elements of our health we can control and those we can’t. Aging is a simple fact, though we often don’t consider it at the functional microscopic level. We can’t do much about the ending, but we have much to say and...

By Jay Segel, DPM; Sally Crawford, MS

3D Scanning vs. Plaster Casting–Evolving Techniques in Orthotic Capture

Over the last few decades, clinicians have debated the merits of traditional plaster casting versus modern 3D scanning in orthotic capture. Amid continuing discourse, 1 principle holds: the clinician’s grasp of anatomical data and its impact on device design is critical to success.  Equally as vital is the orthotic lab’s role in translating clinical intent into design.

By Dr. Dean Hartley (Podiatrist & Adjunct Engineering Fellow–University of Queensland)

ShortTakes From the Literature


A Novel Reconstructive Approach for Plantar Charcot Midfoot Ulcer

Chronic plantar ulcers in Charcot neuropathic osteoarthropathy (CNO) present a significant challenge in limb salvage due to biomechanical instability, poor tissue quality, and high mechanical stress at weight-bearing sites. Traditional surgical techniques, such as exostectomy and tendo-Achilles lengthening (TAL), effectively...

Anatomy of Plantaris Tendon and Management of Midportion Achilles Tendinopath

Midportion Achilles tendinopathy (Mid-AT) is a complex condition that may be exacerbated by anatomical variations of the plantaris tendon. Recent anatomical studies, particularly the classification proposed by Olewnik et al., have enhanced the understanding of plantaris-Achilles interactions and their clinical implications.

Why I Want Bunion Surgery—The Patient’s Perspective

Hallux valgus is the most common pathology afflicting the hallux. Surgery is generally offered to symptomatic patients who fail conservative treatment. The aim of this study is to evaluate patient-reported reasons for undergoing hallux valgus corrective surgery in a preoperative and postoperative cohort.

Study Compares Clinical and MRI Findings for Midfoot Pain

Midfoot pain is common but poorly understood, with radiographs often indicating no anomalies. This study aimed to describe bone, joint and soft tissue changes and to explore associations between MRI-detected abnormalities and clinical symptoms (pain and disability) in a group of adults with midfoot pain, but who were radiographically negative for osteoarthritis.

Diagnostic Advancements in Early Detection of Diabetic Neuropathy

Diabetic neuropathy (DN) is a widespread complication of diabetes, affecting nearly 50% of individuals with the condition. It commonly begins with the gradual loss of sensation in the lower extremities, particularly in the feet. If left undetected and untreated, this loss of sensation can lead to serious consequences, such as...

First MTP Joint-Preserving Surgery for Forefoot Deformity in Patients with RA

Arthrodesis of the first metatarsophalangeal (MTP) joint has been the gold standard for surgical treatment, particularly in cases of advanced joint destruction. This procedure is favored for its effectiveness in alleviating pain and improving function, despite sacrificing joint mobility. This study compares the clinical outcomes of first MTP joint...

Diabetic Foot Infection in Relation to Bacteraemia and Endocarditis

Diabetic foot infections (DFIs) are one of the most important components causes for foot related hospitalization, surgery and lower extremity amputation. In addition to foot specific complications, DFIs are also associated with an increased risk of systemic complications such as acute kidney injury, central line infections, bacteraemia and endocarditis.

The Ground Truth: Foot & Ankle Unlocked

The Ground Truth: Foot & Ankle Unlocked is a bold, monthly exploration of foot and ankle anatomy, biomechanics, and clinical pathology–where foundational science meets modern medicine.

The Ground Truth isn’t just clinical, anatomy-driven–it’s education elevated, surgery informed, and innovation inspired. For podiatrists, orthopedic specialists, educators, and students alike, this is where lower extremity excellence begins–one structure, one pathology, one breakthrough at a time.


Melted Boundaries: Regenerative Orthobiologics in Lower Extremity Medicine–The Rise of Orthokine® (Autologous Conditioned Serum) and Enhanced PRP Therapy for Joint Pain

Orthokine® is the proprietary name for a German-developed autologous conditioned serum (ACS) therapy now advanced in musculoskeletal medicine for joint pain. In scientific literature and clinical contexts, Orthokine is used interchangeably with the generic designation autologous conditioned serum (ACS), with...

By Dr. Hooman Mir, DPM, MSci, FAPWCA
UTRGV, School of Podiatric Medicine
Department of Podiatric Medicine, Surgery & Biomechanics

Industry News & Updates


Smart Insole Tracks How You Walk, Run, Stand

A new smart insole system that uses machine learning to learn and classify 8 different types of motion states, including static ones like sitting and standing to more dynamic movements such as running and squatting, monitors how people walk in real time could help users improve posture and provide early warnings for...

Data-Driven Designs to Improve Prosthetic Legs

Researchers have developed a new, data-driven way of fitting prosthetic legs, which could lead to better fitting prostheses, in less time and at a lower cost. The technology has been developed by Radii Devices and the University of Southampton, UK. The study shows that transtibial prosthetic limbs designed using the...

Evaluating FAST Walk System for Neuromodulation-Assisted Gait Recovery in Chronic Stroke

In an effort to address the ongoing challenge of gait impairment after stroke, researchers have developed an innovative rehabilitation approach known as FAST walk, an innovative, electromyography (EMG)-triggered system that synchronizes transcutaneous spinal cord stimulation with hip extensor stimulation.

Zimmerman Shoes Acquires Markell Shoe Company

Zimmerman Shoes, Orwigsburg, Pennsylvania, the United States’ oldest manufacturer of children’s shoes, has acquired Markell Shoe Company, Yonkers, New York, an orthopedic and corrective footwear manufacturer. The acquistion enhances Zimmerman Shoes’ product portfolio and...

AI-Assisted Model Helps Improve Prediction of Worsening Knee OA

An artificial intelligence (AI)-assisted model that combines a patient’s MRI and biochemical and clinical information shows preliminary promise in improving predictions of whether their knee osteoarthritis (OA) may soon worsen. Ting Wang of Chongqing Medical University, China, and...

The Last Word


More Muscle = Better Metabolic Health?

Havers T, Held S, Schönfelder M, Geisler S, Wackerhage H. Effects of Skeletal Muscle Hypertrophy on Fat Mass and Glucose Homeostasis in Humans and Animals: A Narrative Review with Systematic Literature Search. Sports Med.

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