The last five years have seen notable advancements in foot and ankle surgery as a result of technical innovations and more consistent reporting of results. Much progress has been made in improving patient-reported outcome measures, in the development of basic research in this area, and in the development of personalized approaches which optimize outcomes for specific groups of patients. This review focuses on five main areas of development within foot and ankle surgery: ankle arthroplasty, osteomyelitis and the diabetic foot, sports injuries, minimally invasive surgery, and orthobiologics. The aim of this annotation is to discuss the progress made in these fields during recent years and propose avenues for further development. Cite this article: Bone Joint J 2025;107-B(3):283–290

Procedures performed at the incorrect anatomical site are commonly perceived as being relatively rare. However, they can be a devastating event for patients and doctors. Evidence from the United Kingdom and North America suggests that wrong-site, wrong-procedure and wrong-patient events occur more commonly than we think. Furthermore, their incidence may be increasing as NHS Trusts increase the volume and complexity of procedures undertaken in order to cope with increasing demands on the system. In previous studies from North America orthopaedic surgery has been found to be the worst-offending specialty.

In this paper we review the existing literature on wrong-site surgery and analyse data from the National Patient Safety Agency and NHS Litigation Authority on 292 cases of wrong-site surgery in England and Wales. Orthopaedic surgery accounted for 87 (29.8%) of these cases. In the year 2006 to 2007, the rate of wrong-site surgery in England and Wales was highest in orthopaedic surgery, in which the estimated rate was 1:105 712 cases.