The insurance side of AI   Centers for Medicare and Medicaid Services (CMS) does not require insurers to disclose how they make authorization decisions or how predictive technologies factor into the process. A 2025  survey  found that most insurers are now using AI, with 68% using it for prior authorization reviews. The battle lines are drawn when decisions to deny care are made without human oversight. In this same survey, only 12% of insurers said they used or were consider

by Vince Vacketta, DPM   PNBs have become a popular tool for managing pain after orthopedic surgery, but a new look at nearly 23,000 patients at Massachusetts General Hospital suggests the story is more nuanced.   This single-center retrospective  study  compared patients who received single-injection PNBs with those who did not. In the recovery room, the benefits were clear: patients with PNBs reported lower peak pain scores and required fewer opioids. But once the block wor

Ligament augmentation in lateral ankle reconstructions got a big boost with the publication of a Level 1  paper  showing superior two- and five-year outcomes when using a ligament augment. Since then, the market has expanded with offerings from  Stryker  ( Artelon ), Arthrex  (Internal Brace),  Conmed  (BioRez), and  Medline  (ForceWeb). Augment use in ortho foot and ankle In an online  survey  of American Orthopaedic Foot & Ankle Society (AOFAS), 85.7% reported using ligamen

Metal hypersensitivity affects 10-15% of foot and ankle patients, usually presenting with an eczematous-type rash overlying metallic implants and representing a type IV delayed hypersensitivity reaction.  Relevance of jewelry allergy A history of jewelry or contact allergy is an important clue. Research shows that 60% of patients with prosthesis-related hypersensitivity (PRH) patients had a known contact allergy – 25.7% to metals and 34.6% to other substances. In a patch test

The peroneus longus (PL) tendon is often used an autograft source with the belief that donor-site morbidity is minimal. However, this new  study  challenges that belief and causes us to pause before sacrificing the PL tendon. Study design The study is a retrospective review of 35 patients (mean age 43) who underwent PL autograft harvest between 2021–2023, with an average 22.5-month follow-up. Pre- and postoperative assessments included SANE, AOFAS, FAOS, CAIT scores, and ankl

by Vince Vacketta, DPM Two recent studies shed light on early weightbearing and mobilization following ankle fracture ORIF:  Study 1  – Hybrid cast and brace vs. traditional cast This study compared a hybrid approach (short cast followed by a functional brace) with the traditional six-week cast, evaluating function, pain, complications over two years. It found that rigid, long-duration immobilization is not necessarily superior. More flexible or functional approaches can matc

PCFD involves progressive ligamentous and bone changes. While osseous deformities are well described, ligament orientation is the focus...