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Foot & Ankle International

Foot & Ankle International

Published in Association with American Orthopaedic Foot & Ankle Society

eISSN: 19447876 | ISSN: 10711007 | Current volume: 45 | Current issue: 6 Frequency: Monthly

Established in 1980, Foot & Ankle International (FAI) is the flagship journal of the American Orthopaedic Foot & Ankle Society (AOFAS), published monthly to lead the discourse in foot and ankle scholarship. FAI is committed to advancing medical knowledge in this field, focusing on a wide array of patient ages and conditions. The journal specializes in reconstructive procedures, trauma care, and sports-related injuries, consistently exploring the latest scientific advancements. Known for its stringent peer-review process, FAI publishes clinically-oriented research articles that address various therapeutic approaches in foot and ankle pathology as well as clinically relevant basic science investigations. The journal further augments its scholarly articles with expert commentaries, meta-analyses, systematic and contemporary reviews, engaging podcasts, and detailed surgical videos relevant to key peer-reviewed articles. This comprehensive blend of content cements FAI's status as a primary resource for innovation and expertise in foot and ankle care.

This journal is a member of the Committee on Publication Ethics (COPE). Please click on Submission Guidelines for instructions.

Foot & Ankle International, the official publication of the American Orthopaedic Foot & Ankle Society® (AOFAS®), is a monthly medical journal that emphasizes surgical and medical management as well as basic clinical research related to foot and ankle problems. In circulation since 1980, FAI offers peer-reviewed articles emphasizing surgical and medical management as well as basic clinical research related to foot and ankle problems. The journal focuses on the following areas of foot and ankle interests: surgery, trauma, anesthesia / pain management, arthritis, deformity, diabetes, infection, neuromuscular problems, orthotics and prosthetics, pediatric and adolescent problems, sports, and tumor and oncology rehabilitation.

Editor in Chief
Charles L. Saltzman, MD Salt Lake City, UT, United States
Associate Editors
John T. Campbell, MD, Senior Editor Baltimore, MD, United States
Thomas O. Clanton, MD Vail, CO, United States
George B. Holmes Jr., MD Chicago, IL, United States
Ellie Pinsker, PhD Toronto, ON, Canada
Stefan Rammelt, MD, PhD Dresden, Germany
Robert A. Vander Griend, MD, Senior Editor Gainesville, FL, United States
Specialty Content Editors
Jason T. Bariteau, MD Atlanta, GA, United States
Brad D. Blankenhorn, MD Providence, RI, United States
Daniel D. Bohl, MD, MPH Chicago, IL, United States
Laura Certain, MD, PhD Salt Lake City, UT, United States
Julia Crim, MD Columbia, MO, United States
Sarah Ettinger, MD Hannover, Germany
T. Wade Fallin, MS Salt Lake City, UT, United States
Ward Glasoe, PhD, PT Minneapolis, MN, United States
Jessica E. Goetz, PhD Iowa City, IA, United States
Gregory P. Guyton, MD Baltimore, MD, United States
Thomas G. Harris, MD Pasadena, CA, United States
Pooya Hosseinzadeh, MD St Louis, MO, United States
Casey J. Humbyrd, MD, MBE Philadelphia, PA, United States
A. Holly Johnson, MD New York, NY, United States
Michael J. Jurynec, PhD Salt Lake City, UT, United States
Meghan Kelly, MD, PhD New York, NY, United States
William R. Ledoux, PhD Seattle, WA, United States
Amy L. Lenz, PhD Salt Lake City, UT, United States
Michael S. Pinzur, MD Maywood, IL, United States
Anthony I. Riccio, MD Dallas, TX, United States
Anthony Sakellariou, BSc MBBS FRCS (Orth) Camberley, Surrey, United Kingdom
Oliver N. Schipper, MD Arlington, VA, United States
Sorin Siegler, PhD Philadelphia, PA, United States
Richard Sloane, MS, MPH Durham, NC, United States
Carolyn M. Sofka, MD, FACR New York, NY, United States
Maryam Soltanolkotabi, MD Salt Lake City, UT, United States
Jeff D. Swenson, MD Salt Lake City, UT, United States
H. Thomas Temple, MD Miami, FL, United States
International Editors
Andrew J. Goldberg, MD, MBBS, FRCS(Tr&Orth) London, United Kingdom
Beat Hintermann, MD Liestal, Switzerland
Keun-Bae Lee, MD, PhD Gwangju, Republic of Korea
Marius Molund, MD, PhD Grålum, Norway
Christopher J. Pearce, MB ChB, FRCS (Tr&Orth), MFSEM(UK) Singapore, Singapore
Manuel J. Pellegrini, MD Santiago, Chile
Simon R. Platt, MB ChB, FRCS, FRACS Gold Coast, Australia
Chamnanni Rungprai, MD Bangkok, Thailand
Kelly C. Stéfani, MD, PhD São Paulo, Brazil
Sjoerd A. Stufkens, MD, PhD Amsterdam, The Netherlands
Yuki Tochigi, MD, PhD Koshigaya, Saitama, Japan
Federico G. Usuelli, MD Milan, Italy
Alastair S.E. Younger, MB ChB, ChM, FRCSC Vancouver, BC, Canada
Contemporary Review Editors
Christopher P. Chiodo, MD Boston, MA, United States (Senior Editor)
Elizabeth A. Cody, MD Stamford, CT, United States
Christopher E. Gross, MD Charleston, SC, United States (Assistant Editor)
Electronic Media Editorial Board
Shannon F. Alejandro, MD Dallas, TX, United States
Adam D. Bitterman, DO Hempstead, NY, United States
Lauren E. Geaney, MD Farmington, CT, United States
Thomas A. McDonald, MD Hartford, CT, United States
Glenn G. Shi, MD Jacksonville, FL, United States (Chair)
Ettore Vulcano, MD Miami Beach, FL, United States
Managerial Board
Donald R. Bohay, MD, FACS Grand Rapids, MI, United States
Elizabeth A. Cody, MD Stamford, CT, United States
Bruce E. Cohen, MD Charlotte, NC, United States
Scott J. Ellis, MD New York, NY, United States
James R. Holmes, MD Ann Arbor, MI, United States
Harold B. Kitaoka, MD Rochester, MN, United States
E. Greer Richardson, MD, ex-officio Memphis, TN, United States
Charles L. Saltzman, MD, ex-officio Salt Lake City, UT, United States
David B. Thordarson, MD Los Angeles, CA, United States
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  • Foot & Ankle International (FAI) welcomes articles that contribute to orthopaedic science as it relates to the foot and ankle. Articles are welcome from all countries and all sources under the following conditions:

    • Articles are accepted only for exclusive publication in Foot & Ankle International.
    • Publication does NOT constitute official endorsement of opinions presented in articles.
    • Published articles and illustrations become the property of Foot & Ankle International.
    • Manuscripts not prepared according to the instructions below WILL be returned pending compliance.
    • Basic Science Models: All basic science models should represent clinically relevant and realistic situations. The editors strongly discourage the use of surrogate Bone models (e.g., Sawbones) except as detailed below:
    1. Method development for biomechanical testing using actual bone.
    2. Determining mechanical properties and/or mechanical performance of an implant that exclude the mechanical properties and/or mechanical performance of the implant-sawbones interface.
    3. Determining mechanical properties and/or mechanical performance of different implant-bone constructs with anatomically (geometrically) representative sawbones models that are validated for mechanical properties and implant-bone interface properties.
    4. Bone anatomy related geometric studies (e.g., osteotomy correction, surgical navigation registration, certain imaging investigations)

    In addition, other biomechanical studies have been published periodically that have inaccurate models. One area that has had numerous publications over the last few years has been that of Achilles tendon rupture using an Achilles transection model which is very different from a clinical rupture with significant shredding of tissue at the rupture site. These types of studies should try to simulate an Achilles tendon rupture more accurately (i.e., some degree of shredding at the damaged tendon site).

    In addition, the Editorial Board has decided not to publish any additional language/country specific translations of outcome instruments. While the methodology is important within the specific country or for the language of interest, it is not germane to the other countries of our international audience.


    Bibliometric methods are used to help estimate how much influence or impact a selected research article or individual researcher has had on the wider research community. It usually does this by counting the number of times an article is cited after it is published. These analyses can be used to track researcher output and impact related tenure, promotion and grant funding decisions.

    Their utility to the readership of Foot & Ankle International is minimal at best. For this reason FAI will not publish bibliometric papers.


    Manuscripts must be submitted electronically at, where authors will be required to set up an online account in the Sage Track system powered by ScholarOne.

    GETTING HELP: If you need additional help while in the Sage Track site, you can click on the ‘Online Help’ link in the upper right hand corner of any page. This will take you directly to ScholarOne Support.

    Before submitting your manuscript to be considered for publication in FAI using this system, please read over and follow the instructions below carefully. It is imperative that your submission be properly prepared and formatted. Failure to do so will result in your submission being returned to you for correction.

    As part of the submission process you will be required to warrant that you are submitting your original work, that you have the rights in the work, and that you have obtained and can supply all necessary permissions for the reproduction of any copyright works not owned by you, that you are submitting the work for first publication in the Journal and that it is not being considered for publication elsewhere and has not already been published elsewhere. Please see our guidelines on prior publication and note that FAI may accept submissions of papers that have been posted on pre-print servers; please alert the Editorial Office when submitting (contact details are at the end of these guidelines) and include the DOI for the preprint in the designated field in the manuscript submission system. Authors should not post an updated version of their paper on the preprint server while it is being peer reviewed for possible publication in the journal. If the article is accepted for publication, the author may re-use their work according to the journal's author archiving policy.

    If your paper is accepted, you must include a link on your preprint to the final version of your paper.

    If you have any questions about publishing with Sage, please visit the Sage Journal Solutions Portal.

    1. What do we Publish?
      1.1 Aims & Scope
      1.2 Writing your paper
      1.3 Make your article discoverable
    2. Editorial Polices
    3. English Language Editing Services
    4. Manuscript Preparation
    5. Formatting
      5.1 Word Length and Artwork Limits
      5.2 Text
      5.2.1 Numbers
      5.2.2 Percentages and Units
      5.2.3 Decimals
      5.2.4 Ranges
      5.2.5 Word Usage
      5.3 Cover Letter/Title Page File
      5.4 Manuscript Body
      5.4.1 Title
      5.4.2 Abstract
      5.4.3 Clinical Relevance
      5.4.4 Level of Evidence
      5.4.5 Keywords
      5.4.6 Introduction
      5.4.7 Materials and Methods
      5.4.8 Results
      5.4.9 Discussion
      5.4.10 References
      5.4.11 Legends
      5.4.12 Artwork
      5.4.13 Visual Abstracts
    6. Case Reports
    7. Letter to the Editor
    8. Letter in Reply
    9. Meta-analysis/Systematic Review
    10. Short Reports
    11. Commentaries
    12. Technique Tips
    13. Technique Videos
    14. Total Ankle Arthroplasty (TAA) Articles
      14.1 Guidelines for Reporting TAA Problems and Complications Resulting in Re-Operation
    15. Contemporary Reviews
      15.1 Format of a Contemporary Review
    16. "Learning Curve" Manuscripts
    17. NIH and Wellcome Trust-Funded Submissions
    18. Manuscript Clearances
      19.1 Authorship
      19.1.2 AI Tools and Authorship
      19.2 Conflict of Interest
      19.3 Plagiarism and Duplicate Submission
      19.4 Informed Consent and Ethics Approval
      19.5 Disclosure of Off-Label Use
      19.6 Randomized Controlled Trials (RTCs)
      19.7 Reporting Guidelines Checklist
      19.8 Writing Assistance
      19.9 Research Data
    19. Manuscript Submission
      20.1 Uploading
      20.2 Orcid
      20.3 Checking Manuscript Status
    20. Post-Submission
      21.1 Review
      21.2 Revision
      21.3 Publication
      21.4 Online First publication
      21.5 Access to your published article
      21.6 Promoting your article
    21. Further Information
    22. Appealing the Publication Decision

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    1. What do we publish?

    1.1 Aims & Scope

    Before submitting your manuscript to FAI, please ensure you have read the Aims & Scope.

    1.2 Writing your paper

    The Sage Author Gateway has some general advice and on how to get published, plus links to further resources. Sage Author Services also offers authors a variety of ways to improve and enhance their article including English language editing, plagiarism detection, and video abstract and infographic preparation.

    1.3 Make your article discoverable

    For information and guidance on how to make your article more discoverable, visit our Gateway page on How to Help Readers Find Your Article Online.

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    2. Editorial Policies

    FAI is committed to delivering high quality, fast peer-review for your paper, and as such has partnered with Publons. Publons is a third party service that seeks to track, verify and give credit for peer review. Reviewers for FAI can opt in to Publons in order to claim their reviews or have them automatically verified and added to their reviewer profile. Reviewers claiming credit for their review will be associated with the relevant journal, but the article name, reviewer’s decision and the content of their review is not published on the site. For more information visit the Publons website.

    The Editor or members of the Editorial Board may occasionally submit their own manuscripts for possible publication in the journal. In these cases, the peer review process will be managed by alternative members of the Board and the submitting Editor/Board member will have no involvement in the decision-making process.

    3. English Language Editing Services

    Authors who would like to refine the use of English in their manuscripts might consider using the services of a professional English-language editing company. We highlight some of these companies at Please be aware that Sage has no affiliation with these companies and makes no endorsement of them. An author's use of these services in no way guarantees that his or her submission will ultimately be accepted. Any arrangement an author enters into will be exclusively between the author and the particular company, and any costs incurred are the sole responsibility of the author.

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    4. Manuscript Preparation

    Manuscripts must be submitted electronically at, where authors will be required to set up an online account in the Sage Track system powered by ScholarOne.

    GETTING HELP: If you need additional help while in the Sage Track site, you can click on the ‘Online Help’ link in the upper right hand corner of any page. This will take you directly to ScholarOne Support.

    Before submitting your manuscript to be considered for publication in FAI using this system, please read over and follow the instructions below carefully. It is imperative that your submission be properly prepared and formatted. Failure to do so will result in your submission being returned to you for correction.

    Qualitative or mixed methods research reports will not be considered for publication in FAI or FAO.

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     5. Formatting

    FAI follows the American Medical Association (AMA) 11 style guidelines with some modifications to references listed alphabetically (see References). The majority of the following formatting settings are standard on most word processing software.

    5.1 Word Length and Artwork Limits

    Scientific Manuscript: 3,000 words, Abstract: 300 words, 4 Tables, 8 Figures
    Systematic Review/Meta-Analysis: 3,000 words, Abstract: 250 words, 4 Tables, 4 Figures
    Short Reports: 1,200 words; 3 figures/tables; 10 references
    Letter to the Editor: 400 words; 1 figure/table
    Letter in Reply: 500 words; 1 figure/table
    Contemporary Review: 4,000 words; 3 tables; 10 figures

    5.2 Text

    Preferred formats for the text and tables of your manuscript are Word DOC, RTF, XLS. All text is 12-point font double-spaced in a clean and legible font: either Arial, Times New Roman, or Calibri. Manuscript margins are 1.25 inches on the sides and 0.5 inch top and bottom.

    MAIN HEADINGS are bold upper-case.

    Subheadings are simply bold.

    Manuscript titles are bold underlined.

    All lines of manuscript must be consecutively numbered using your software's continuous line numbering feature. Do NOT number the lines manually.

    Do not start each manuscript section on its own page.

    5.2.1 Numbers

    Numerals are used to express numbers except in the following circumstances:

    1. At the beginning of a sentence, title, subtitle, or heading
    2. Common fractions
    3. Accepted usage (idiomatic expressions and numbers used as pronouns)
    4. Other uses of “one” in running text
    5. Ordinals first through ninth
    6. Numbers spelled out in quotes or text

    5.2.2 Percentages and Units

    The numerator and denominator should be included for all percentages. Round off the percentages when the denominator is less than 100. Percentages should not be used when the value of n is less than 20.

    All measurements should be given in SI units.

    "Degrees" is always spelled out when measure angles; only use the degree symbol for temperature, followed by C or F or K.

    5.2.3 Decimals

    Place a zero before the decimal point in numbers less than 1, except when expressing probability values (P, α, and β). For example, 0.5 mg/kg, but P = .16. Commas are not to be used in decimals.

    Except for P values, round decimals to the value consistent with measurement.

    5.2.4 Ranges

    Ranges in running text should not be expressed using hyphens; try “to” or “through” as necessary. Ranges can be used in parenthetical text or in tables (unless one of the numbers is a negative number). When giving an average and a range in parenthesis, only list the unit once after the parenthesis, unless doing so would be confusing (such as an average in years with a range in months). When giving ranges for average values, please format as follows:

    The average age was 46 (range, 38-74) years.
    (median age, 46 years; range, 38-74)

    5.2.5 Word Usage

    Words placed in quotation marks, indicating that they have a meaning other than the one found in a dictionary, should be defined.

    The symbols > and < should only be used in equations, such as (p < 0.005). If used in a sentence, spell out: These studies showed less than 5% involvement.

    Use the following words without hyphens as shown:

    Use the term 'significant' only to describe statistical significance. A P value is required when this word is used.
    Surgical procedures should be described in the past tense.
    In-text figure callouts must be spelled out and included BEFORE punctuation: (Figure 1).

    Always list manufacturer, city, and USPS state abbreviation or country of origin for devices and
    brand names.
    Power ranges and correlations should be italicized: P = .05, r = 0.0003.
    Student t test should have Student capitalized because it is a proper noun (but the phrase is not italicized).
    Do not capitalize 'scarf osteotomy' or 'chevron osteotomy' unless they begin a sentence.

    5.3 Cover Letter/Title Page File

    All submissions to FAI must include a cover letter containing the manuscript title and the full names, academic degrees, academic status, and affiliation of all authors (corresponding AND contributing) attributed to the manuscript. A corresponding author must be clearly designated, with a full mailing and e-mail address for correspondence with that author included. Please make sure all cover letter information is as correct as possible; it will be used to set how the authors are listed in the printed article. The cover letter should be uploaded as the title page file on the manuscript submission.

    Authors may list up to 2 academic degrees after their names, but no initials for organizations.

    5.4 Manuscript Body

    Manuscripts should be organized in the following order:

    5.4.1 Title

    The manuscript title does not need to be on its own page or included in a repeating header.

    5.4.2 Abstract

    When required, an abstract should include a maximum of 300 words and broken into four sections: Background, Methods, Results, and Conclusion. A fifth section (Clinical Relevance) should be added for basic-science articles.

    5.4.3 Clinical Relevance

    If yours was a laboratory study (Basic Science), briefly describe its relevance to clinical orthopedic medicine.

    5.4.4 Level of Evidence

    If your manuscript has an applicable Level of Evidence, please include it here.

    Authors are encouraged to follow the JBJS guidelines found at:
    J Bone Joint Surg Am, 2015 Jan 07; 97 (1): 1 -2.

    5.4.5 Keywords

    Keywords should describe the information contained in the paper, including any terms unique to the paper’s subject. All keywords should have the first letter of each word capitalized and listed using semicolons.

    5.4.6 Introduction

    State the problem that led to the study and the specific purpose of the study. It can include a brief review of the literature that is dealt with in the Discussion section.

    5.4.7 Materials and Methods

    Provide demographic data on the study population and define the period during which the study was conducted, the specific criteria for inclusion and exclusion of patients, the indications for the operative procedure, and the duration of follow-up.

    The section must also describe the statistical methods used in the study:

    • The statement that "no significant difference was found between two groups" cannot be made unless a power study was done and the value of alpha or beta is reported. A large number of patients (at least 60, and often more, in each group or subgroup) is required to make such a statement. If no such power study was done, the author must state: "With the numbers available, no significant difference could be detected."
    • Ninety-five percent confidence in intervals is required whenever the results of survivorship analysis are given in the text or in graphs. Authors are encouraged to use 95% confidence intervals in addition to or instead of standard deviations when reporting results.
    • Use of the word "correlation" requires reporting of the Pearson product-moment correlation coefficient r.


    With regard to sample size for a study we would make the following suggestions:

    1. It would be optimal if all applicable submitted research to address in the methods section consideration for sample size calculation. This means a post-hoc calculation for retrospective research, and ideally an a priori calculation for prospective research (or a post-hoc calculation when an a priori calculation was not completed).
    2. If an a priori sample size calculation was not done at all, then this should be addressed in the discussion as a weakness in the design and should warn the reader of this shortfall. Furthermore, in this circumstance, the authors should discretely provide the reader with the data necessary to be able to calculate a post hoc power analysis on their own.
    3. If a sample size calculation was done and the study was found to be underpowered, then, in the discussion exactly how many subjects would be required for the research to be completed with adequate power should be provided.

    We recommend that authors use the following UCSF "sample size and power calculation" web page:

    5.4.8 Results

    Provide a detailed report on the data obtained during the study. Results obtained after less than two years of follow-up are rarely accepted. It is essential that all data in the text be consistent with data both in the Abstract and in any illustrations, legends, or tables included.

    Total ankle studies should have two year follow-up for positive outcomes; there is no required follow-up length for negative outcomes.

    5.4.9 Discussion

    Include a review of the literature, with emphasis on previous findings that agree with those of the present study. The Discussion should also state both the strengths and the weaknesses of the study.

    5.4.10 References

    References MUST be listed alphabetically and consecutively numbered in the reference section, and that
    numbering must be used in the reference citations within the text of the article. Follow the instructions below.

    A journal article reference listing breaks down into the following sections:

    [Authors]. [Title]. [Journal Abbreviation]. [Year];[Volume(Issue)]:[Page Range]. doi: 10.1177/1071100713511435

    The bibliography must be titled “References” and be an alphabetical listing of references that are cited in the preceding text. Titles of foreign-language articles and books should appear in their published language. When citing a book, give the specific pages used unless the entire book was used. If an article has a DOI, it may be included at the end of the reference as shown above.

    In cases where there are more than 6 authors for a given article, list the first 3 authors with an “et al.”
    after them.

    Reference examples:

    Journal article:

    1. Ostrum RF, Meo PD, Subramanian R. A critical analysis of the anterior-posterior radiographic anatomy of the ankle syndesmosis. Foot Ankle Int. 1995;16(3):128-131. doi: 10.1177/107110079501600304


    1. Basmajian JV. Primary Anatomy. Baltimore, MD: William & Wilkins; 1970.

    All references must be cited in the text. Citations must be superscript and be placed after periods and commas and before semi-colons and colons. For example:

    The foot is connected to the ankle.15

    The foot is connected to the ankle4,6-9,22; the knee,4 thigh,10 and ankle54 are all parts of the leg.

    We no longer accept references of papers given at meetings, personal communications, doctoral theses, or obscure references that cannot be verified.

    5.4.11 Legends

    All artwork (figures and tables) submitted must have text included here, listed in order. Explain what each illustration shows rather than simply defining it. Give the amount of magnification of all photomicrographs. Define all arrows and other such indicators appearing, when necessary. If an illustration is of a patient who is identified by a case number in the text or table, include that case number in the legend. If a piece of artwork has been published elsewhere prior to this article and permission to include it has been granted, include proper attribution in the figure legend here.

    5.4.12 Artwork

    Submit artwork figure files in color, as color will display in the online version. The print version will run in black and white; color illustrations will not be printed unless the author or institution pays the expense of including the color in the print issue (contact the publisher for cost).

    Resolution on artwork files provided must be at least 300 dpi or higher to ensure best-quality reproduction in the printed article. Tables must be submitted in editable software (Word or Excel) and may appear following references in the main manuscript file or as separate files.

    Label each illustration (i.e. Fig. 1, Fig. 2A, etc.) in the order they are to appear in print before uploading them to Sage Track. When uploading, please upload each figure or table as a separate file.

    Although FAI discourages submission of artwork previously published elsewhere, when such artwork is deemed essential, the author MUST include a letter from the original holder of the copyright, granting permission for their use. Give full information about the previous publication, including the specific page on which the illustration appeared.

    All artwork figures must comply with HIPAA regulations and remove any identifiable information on the patient, author or author institution.

    5.4.13 Visual Abstracts

    A visual abstract is meant to be a clear, quick, and concise pictorial representation of research that has been published in Foot & Ankle International and Foot & Ankle Orthopaedics. It is meant to support the written abstract that accompanies all papers submitted for review to the journal and used to represent the study on social media.

    • Download the Visual Abstract PowerPoint Template from the Submission Guidelines.
    • Identify 3-4 key and objective points to use on the visual abstract that represent the manuscript. Example: Background, Methods, Outcomes. Avoid subjective interpretation of results not directly explained by your methods/results.
    • Enter the title and key poin­­ts onto the template and fill in the authors and year on the bottom.
    • Add images to convey each key point. Be sure to use ONLY images and graphics used in your manuscript or that you have copyright clearance to use.
    • Save your PowerPoint slide as a JPEG or PNG and submit it as a supplementary file with the title “Visual Abstract.”
    • If accepted, the Visual Abstract will be published with the online version of your article.

    AOFAS will use the Visual Abstract to promote your study on our social media channels.

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    6. Case Reports

    Case reports will no longer be considered for publication in Foot & Ankle International. Please submit case reports directly to Foot & Ankle Orthopaedics.

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    7. Letter to the Editor

    Letters may have no more than 3 authors. The text should include the full name, academic degrees, and a single institutional affiliation for each author and the email address for the corresponding author.

    Letters discussing a recent article in this journal should be submitted within 4 months of publication of the article in print. Letters received after 4 months will rarely be considered. Letters should not exceed 400 words of text, one (1) figure or table and 5 references (including a required citation to the related article). All data presented must be fully citable and cited in the supporting reference list (unpublished data must not be described in the letter). 

    These submissions are subject to minor editorial alterations, may be shortened without the authors' approval, and are published both in print and on the journal website.

    The editor routinely invite the author(s) of the related article to respond in writing. Letters that include specific questions for the original article's authors are prioritized for publication. Published letters are accompanied by either a reply from the original authors or the statement "Reply declined."

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    8. Letter in Reply

    Replies by authors should not exceed 500 words of text, one (1) figure or table, and 6 references (including a required citation to the related article). The text should include the full name, academic degrees, and a single institutional affiliation for each author and the email address for the corresponding author. Replies need to be submitted within 30 days, or the letter to the editor may be published without an author reply with the statement "Reply declined."

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    9. Meta-analysis/Systematic Review

    Systematic reviews and meta-analysis techniques are used to review and pool data obtained from high quality studies usually with Level I or II evidence. These techniques require determination of a specific health care question, selection of studies which meet research methodology and quality standards, and then application of rigorous methodology to minimize error, bias, and inaccurate or misleading conclusions. It is recommended that authors have or obtain expertise in these types of studies and plan their methodology accordingly. Studies which conclude that the quality of existing literature is not adequate (poor) and that more studies are needed, provide little useful information to the reader and will seldom be accepted for publication.

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    10. Short Reports

    Short reports are suitable for the presentation of research that presents preliminary data on novel treatments, extends previously published research including the reporting of additional controls, confirmatory results in other settings or even patients from the same cohort. Authors must clearly acknowledge any work upon which they are building, both published and unpublished. The Editor may ask authors to convert a full-length submission to a Short Report for the purposes of publication. Reviews, case reports, and technique tips are not considered for publication under this category.

    Briefly summarize the results of original data. Each short report is considered a scientific publication; authors must meet all requirements regarding responsible conduct of research (eg., appropriate IRB approval, data integrity, data retention).

    Short reports are limited to 1200 words with 3 figures and/or tables (not counting the title page, abstract, references, or legends). We allow a maximum of 10 highly relevant references. Online supplementary materials are permitted. Abstracts are limited to 225 words and include Background, Methods, Results, and Conclusion. The text body should include the following truncated sections: Introduction, Methods, Results, Discussion/Conclusion with enough detail or appropriate references to help others reproduce the investigation. Include Clinical Relevance for basic-science articles or Level of Evidence for clinical research articles. Keywords should describe the information contained in the paper, including any terms unique to the paper’s subject.

    11. Commentaries

    Invited commentaries are solicited with approval of the Editor-In-Chief. The invited commentaries should be concise (not to exceed 1000 words) and should express the personal opinion of the author(s). An invited commentary should have a maximum of ten (10) references and generally no tables or figures. Invited commentaries are related to manuscripts published in FAI but may include timely subjects of interest including topics of social significance. Unsolicited commentaries may be considered, but pre-approval by the Editor-In-Chief is strongly recommended.

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    12. Technique Tips

    Technique tips will no longer be considered for publication in Foot & Ankle International. Please submit technique tips directly to Foot & Ankle Orthopaedics.

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    13. Technique Videos

    Authors submitting articles that describe an operative technique are invited to submit a technique video to accompany and enhance the article and its global impact. Please follow the guidelines below:

    • Submit within 20 days of article acceptance if possible (video displays in-line with online article) or Submit within 60 days (video attached as supplement to online article)
    • No industry advertisements or logos
    • Must remove any identifiable information on the patient (per HIPAA regulations)
    • Include disclosures for all authors
    • Goal < 3 minutes; maximum 5 minutes. 
    • No background music 
    • Acceptable formats are avi, mov, mp4, and mpeg. FLV (Flash video) is NOT accepted.
    • Minimum resolution level: 1280 x720p
    • Includes these elements of a procedure
      • Equipment needed
      • Positioning
      • Critical steps described with narration - Notably: if speaking in English to narrate is problematic, please simply write a few words in English to explain each step on the video
      • Postop dressing/Protocol

    The video will be posted with the online version of your article at FAI in perpetuity. In addition, the FAI contributor agreement gives AOFAS non-exclusive rights to use (WHICH MEANS YOU CAN STILL USE FOR OTHER PURPOSES) and distribute the video for educational purposes, including posting on the AOFAS OnDemand Education Center (ONE) and social media. If an identifiable non-author participant is featured in the video, an additional release form will be required.

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    14. Total Ankle Arthroplasty (TAA) Articles

    1. TAA manuscripts must have a minimum of two-year follow-up for all patients in the study. Complications or implant issues can be reported with shorter follow-up. All repeat surgeries must be documented for all time points from the time of the index TAA.
    2. The template below should be used as a guide for authors in reporting complications resulting in reoperation(s). This is based on the COFAS Ankle Arthritis Study Group coding system for reporting reoperations. Overlap will occur for some of these categories as individual patients may have had more than one re-operation. The intent is to distinguish between different types of complications resulting in reoperation (instead of simply reporting that a certain number of patients in a study had re-operations).
    3. The Editorial Board of FAI also recognizes the need for an international consensus in reporting TAA outcomes. This includes patient reported outcomes, objective clinical and radiographic measurements, and a system for reporting complications and adverse events. TAA joint registries are also essential so that we can learn from our successes but also from our failures and maintain surveillance to identify non-random causes for failure.
    4. Repeat surgery can be reported individually or as a series of events. The authors should outline which method was used. Documentation of resource utilization (additional surgery time, days in hospital or additional clinic visits) for repeat surgery will assist in determining the impact of the complication or repeat surgery.
    5. Non-surgical complications (such as DVT, pulmonary embolism or infection treated by antibiotics) should also be documented.

    14.1 Guidelines for Reporting TAA Problems and Complications Resulting in Re-Operation

    1. No reoperation
    2. Hardware removal related to TAA
                (e.g. medial malleolus screw(s), fibular plate)
    3. Subsequent operative treatment related to TAA but not involving TAA components
                (e.g. osteotomy, fusion of other joint(s) of the foot, ligament repair/reconstruction)
    4. Operative treatment of periprosthetic fracture(s)
           a. At the time of the index procedure
           b. After the index procedure
    5. Debridement of gutter or heterotopic ossification with retention of components
    6. Polyethylene liner exchange for polyethylene wear or fracture
    7. Operative treatment of postoperative arthrofibrosis
                (e.g. joint debridement +/- capsulotomy, Achilles lengthening, PE liner exchange)
    8. Debridement +/- grafting of osteolytic cyst(s)
                (with retention of metal components +/- polyethylene exchange)
    9. Operative treatment of superficial infection or incision problem
                (e.g. I & D, secondary closure)
    10. Operative treatment of deep infection requiring debridement 
                (+/- polyethylene liner exchange but NOT removal of metal components)
    11. Deep Infection requiring removal of ALL components 
           a. One stage TAA revision to TAA
           b. Two stage TAA revision to TAA
           c. Conversion to “long term” cement spacer
           d. Conversion to arthrodesis
    12. Revision of metal components because of implant failure
                (e.g. aseptic loosening, subsidence, malposition, implant fracture----not for infection)
           a. Tibia
           b. Talus
           c. Both tibia and talus revised to TAA
           d. Removal of components and conversion to arthrodesis
    13. Amputation related to complications from TAA
                State reason(s): pain, infection, vascular compromise, failed prior treatments, patient choice, etc.

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    15. Contemporary Reviews

    A Contemporary Review serves to educate the readership about conditions and/or procedures. Covered topics typically have a narrow focus or describe new procedures associated with limited clinical evidence. Word count is 4000 words excluding references.

    Authors can contact the Senior Editor for Contemporary Reviews, Christopher P. Chiodo, MD, to find out if FAI or FAO have recently published a review article on that topic, if there is a similar submission in progress or if the subject matter is considered in scope for the journals. Email Dr. Chiodo at (cc: to inquire about your idea.

    Submit completed papers directly to the journal at All submitted Contemporary Review Articles will be considered by the Contemporary Review Editors

    15.1 Format of a Contemporary Review

    1. Introduction. Present a brief overview and purpose statement - Why is this condition worthy of a review?
    2. Background of the condition(s). Summarize relevant background information. This may include a historical survey, basic science, pertinent clinical studies, and current controversies related to the condition.
    3. Presentation. Briefly describe the typical clinical presentation of the condition(s).
       a. history
       b. physical examination
       c. radiographic/imaging and laboratory findings
    4. Treatment. Describe both non-operative and operative treatment options. 
       a. This section can be divided into subsections (e.g. addressing a treatment option or set of treatment options). Each subsection should then be comprised of one or more paragraphs. The introductory topic sentence(s) of each subsection should neatly frame the issue. When possible, this should be a specific, direct query that begs an affirmative or negative response. Sometimes the issue is framed with a broad, generalized question that is then broken with specific details in a succession of paragraphs.
    5. Complications. If applicable, describe the relevant and most common complications associated with a surgical procedure or non-operative treatment.
    6. Authors’ preferred method of treatment (optional). If applicable, this section can include your preferred treatment for a described condition. Please make sure to include your rationale and include any technique tips that you feel may help the reader.
    7. Summary of the Main Points. Include four to eight main points of your manuscript. These may include treatment options with a growing body of evidence in the literature. Significant, unresolved controversies may be included with a brief discussion of the opposing viewpoints.
    8. References. Alphabetical and as formatted per Foot and Ankle International guidelines. Try to use only recent or essential references.
    9. Figures and Legends: A key feature of the Contemporary Reviews is to illustrate anatomic pathology, key imaging findings and surgical technique.
       a. Maximum Number of Tables: 3
       b. Maximum Number of Figures: 10

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    16. "Learning Curve" Manuscripts

    Orthopaedic “learning curve” papers deal with the attainment of proficiency in new surgical techniques or implants. The development of psychomotor surgical skills is a complex educational process, poorly measured by surgical time or predefined benchmark skills as indirect measures of proficiency. The generalizability of such data is also poor, inadequately reflecting care by all surgeons in various settings. Learning curve papers thus offer little to the readership of Foot & Ankle International and therefore will not be considered for publication.

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    17. NIH and Wellcome Trust-Funded Submissions

    Authors should check the box at submission if a manuscript was funded by NIH or Wellcome Trust. If the article is accepted to FAI, the article will be automatically deposited to PubMed Central (PMC). This service previously cost $3,000 and was only available after the print publication of the article. It is now completely free and the article will be deposited automatically within 6 months for Wellcome Trust and 12 months for NIH.

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    18 Manuscript Clearances

    18.1 Authorship

    The corresponding author is required at submission to verify that the work has been submitted solely to FAI and is not published, in press, or submitted elsewhere.

    It is to be clearly understood that each author has participated in the design of the study, has contributed to the collection of the data, has participated in the writing of the manuscript, and assumes full responsibility for the content of the manuscript. Normally, no more than ten authors should be listed. Individuals who have contributed to only one segment of the manuscript or have contributed only cases should be credited in a footnote. (FAI does not allow use of such footnotes to thank individuals who made secretarial, technical, or other contributions that were part of their normal jobs, for which they were compensated.) If extenuating circumstances prevail, the cover letter should detail why the authors have taken exception to these recommendations and should state how each author has contributed to the manuscript.

    If the named authors for a manuscript change at any point between submission and acceptance, an Authorship Change Form must be completed and digitally signed by all authors (including any added or removed). An addition of an author is only permitted following feedback raised during peer review. Completed forms can be uploaded at Revision Submission stage or emailed to All requests will be moderated by the Editor and/or Sage staff.

    Important: Changes to the author by-line by adding or deleting authors are NOT permitted following acceptance of a paper.

    18.1.2 AI Tools and Authorship

    1. The use of AI programs including Large Language Models (LLM) to generate any content must be acknowledged in the Material & Methods Section.
    2. The specific AI/LLM model(s) and the methodology used to generate this content must be described in detail.
    3. The authors are responsible for validating the accuracy of AI generated content & verifying that this material was not published elsewhere or subject to copyright laws (e.g., plagiarism).
    4. Please note that AI/LLM programs or chatbots, for example ChatGPT, Bard, etc. cannot be listed as authors. For more information please review this link to the publishers policies on the use of generative AI tools in scholarly publications:

    18.2 Conflict of Interest

    For each manuscript accepted for publication, authors are responsible for recognizing and disclosing any conflict of interest that could be perceived to bias their work, acknowledging all financial support and any other personal connections. The FAI/FAO disclosure form should be submitted for each author upon initial manuscript submission to provide the reviewers and editors information regarding any reported conflicts during the review process. If necessary, authors will be required to submit one of the following statements:

    1. One or more of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article.
    2. One or more of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article. In addition, benefits have been or will be directed to a research fund, foundation, educational institution, or other nonprofit organization with which one or more of the authors is associated.
    3. Although none of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article, benefits have been or will be received but are directed solely to a research fund, foundation, educational institution, or other nonprofit organization with which one or more of the authors is associated.
    4. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
    5. The authors of this manuscript have chosen not to furnish information to FAI and its readers concerning any relationship that might exist between a commercial party and material contained in this manuscript that might represent a conflict of interest.

    In addition to the above, authors will also be asked to submit one of the following two statements:

    1. The author(s) received no financial support for the research, authorship, and/or publication of this article.
    2. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: _______.

    The statements selected by the author or authors will be printed on the first page of the published article. COPYRIGHT Material appearing in FAI is covered by copyright. As a general rule, permission will be given to recognized medical journals to reprint anything in these pages if permission is first obtained from FAI and if the material used is properly credited to FAI.

    18.3 Plagiarism and Duplicate Submission

    Plagiarism simply defined is using previously published work without properly citing the original publication in the text of a paper. It is unethical, infringes upon copyrighted material and the manner in which to deal with it has been discussed extensively by organizations such as the Committee on Publication Ethics (COPE). Since it is difficult to identify plagiarism by simply reading an article, the Editorial Board of Foot & Ankle International decided to begin screening submitted papers with plagiarism software, iThenticate, in August 2013. This software identifies passages in a paper that are identical to previously published papers.

    The Editorial Board discussed plagiarism and established a policy on October 28, 2013. With the policy, all papers and revisions of papers submitted to Foot & Ankle International will be screened with the iThenticate plagiarism software. Those papers that are identified to potentially have significant overlap with previous publications will then be reviewed by the Editorial Board. If the paper is found to have significant duplication with previous publications, it will be rejected before review and all of the authors of the paper will receive a letter giving the reason for rejection along with the iThenticate report for the paper in question. Authors may appeal if they feel the decision was unjustified or they may revise the text to eliminate the duplicated text at which time the article can be submitted to the journal again at which time the article will again be analyzed with the iThenticate software. If authors wish, they can have their papers analyzed by iThenticate prior to submission at their own cost.

    Duplicate submission refers to act of submitting a manuscript to more than one journal at the same time. Duplicate publication refers to the practice of publishing the same article in two or more different journals. Upon submitting an article to Foot & Ankle International, all corresponding authors must acknowledge by checking a box "Confirm that the manuscript has been submitted solely to this journal and is not published, in press, or submitted elsewhere." The Editorial Board has established a policy on duplicate submission or publication that authors who are found to have a duplicate submission or publication will be barred from submitting any papers for 1 year from the time of discovery of the duplicate submission or publication.

    18.4 Informed Consent and Ethics Approval

    All manuscripts dealing with a study of human subjects must include a statement that the subjects have given informed consent, and that the study has been approved by an institutional review board or similar committee. All studies should be carried out in accordance with the World Medical Association Declaration of Helsinki [Journal of Bone and Joint Surgery, 79-A 1089-1098, July 1997].

    Submitted manuscripts should conform to the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, and all papers reporting animal and/or human studies must state in the methods section that the relevant Ethics Committee or Institutional Review Board provided (or waived) approval. Please ensure that you have provided the full name and institution of the review committee, in addition to the approval number.

    For research articles, authors are also required to state in the methods section whether participants provided informed consent and whether the consent was written or verbal.

    Information on informed consent to report individual cases or case series should be included in the manuscript text. A statement is required regarding whether written informed consent for patient information and images to be published was provided by the patient(s) or a legally authorized representative. Please do not submit the patient’s actual written informed consent with your article, as this in itself breaches the patient’s confidentiality. The Journal requests that you confirm to us, in writing, that you have obtained written informed consent but the written consent itself should be held by the authors/investigators themselves, for example in a patient’s hospital record. The confirmatory letter may be uploaded with your submission as a separate file.

    Please also refer to the ICMJE Recommendations for the Protection of Research Participants.

    Authors need to include an ethical approval statement in the Title Page, with the correct statement completed:

    (i) Ethical approval for this study was obtained from *NAME OF ETHICS COMMITTEE OR INSTITUTIONAL REVIEW BOARD (APPROVAL NUMBER/ID)*.


    (ii) Ethical approval for this study was waived by *NAME OF ETHICS COMMITTEE OR INSTITUTIONAL REVIEW BOARD* because *REASON FOR WAIVER*.


    (iii) Ethical approval was not sought for the present study because *REASON*.

    18.5 Disclosure of Off-Label Use

    FDA/ Regulatory Agency Statement

    Some drugs or medical devices discussed in articles may not have been approved by the FDA or appropriate regulatory agency for the author’s country for the specific purpose reported upon in the article. The FDA has stated that it is the responsibility of the physician to determine the FDA clearance status of each drug or medical devices he or she wishes to use in clinical practice. The FAI Editorial Board has approved a policy that “off label” uses of a drug or medical device may be reported so long as the “off label” use of the drug or medical device is specifically disclosed (ie, it must be disclosed that the FDA or the appropriate regulatory agency for the author’s country has not cleared the drug or device for the described purpose). Any drug or medical device has been used “off label” if the described use was not set forth on the product’s approval label.

    18.6 Randomized Controlled Trials (RTCs)

    Randomized Controlled Trials (RTCs) must be prospectively registered in a publicly searchable clinical trials registry before considering review for publication from 1 January, 2020. RTCs, which started after the date of electronic publication of the editorial policy for Foot & Ankle International (FAI) in the transition period in 2019, as well as RCTs with satisfactory evidence of starting before electronic publication of the editorial policy for FAI, shall be allowed retrospective registration in a publicly searchable clinical trials registry prior to review and potential publication. The Editorial Board, however, will reserve the right to make rare exceptions in the event of unusual studies in extenuating circumstances following guidance from the Editor in Chief with an explanatory note from the authors regarding the reasons and an Editorial note for the exception, published as a foot note to the article.

    18.7 Reporting Guidelines Checklist

    All full-length original clinical submissions require a checklist to be completed. The following checklists should be completed and submitted for these types of study:

    18.8 Writing Assistance

    Individuals who provided writing assistance, e.g. from a specialist communications company, do not qualify as authors and so should be included in the Acknowledgements section. Authors must disclose any writing assistance – including the individual’s name, company and level of input – and identify the entity that paid for this assistance. It is not necessary to disclose use of language polishing services.

    18.9 Research Data

    At Sage we are committed to facilitating openness, transparency and reproducibility of research. Where relevant, The Journal encourages authors to share their research data in a suitable public repository subject to ethical considerations and where data is included, to add a data accessibility statement in their manuscript file. Authors should also follow data citation principles. For more information please visit the Sage Author Gateway, which includes information about Sage’s partnership with the data repository Figshare.

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    19. Manuscript Submission

    19.1 Uploading

    Before submitting a manuscript, please gather the following information:

    • Author information: first and last names, institutions, degrees, and active e-mail addresses.
    • Manuscript title.
    • Manuscript abstract, where applicable (Can be cut and pasted from your manuscript).
    • Manuscript files in Word, WordPerfect, EPS, LaTeX, text, Postscript, or RTF format.
    • Figures/Images in TIFF, JPG, or Postscript.
    • FAI/FAO Disclosure Form, one per author. The form may be found here.

    19.2 Orcid

    As part of our commitment to ensuring an ethical, transparent and fair peer review process Sage is a supporting member of ORCID, the Open Researcher and Contributor ID. ORCID provides a unique and persistent digital identifier that distinguishes researchers from every other researcher, even those who share the same name, and, through integration in key research workflows such as manuscript and grant submission, supports automated linkages between researchers and their professional activities, ensuring that their work is recognized.

    The collection of ORCID IDs from corresponding authors is now part of the submission process of this journal. If you already have an ORCID ID you will be asked to associate that to your submission during the online submission process. We also strongly encourage all co-authors to link their ORCID ID to their accounts in our online peer review platforms. It takes seconds to do: click the link when prompted, sign into your ORCID account and our systems are automatically updated. Your ORCID ID will become part of your accepted publication’s metadata, making your work attributable to you and only you. Your ORCID ID is published with your article so that fellow researchers reading your work can link to your ORCID profile and from there link to your other publications.

    If you do not already have an ORCID ID please follow this link to create one or visit our ORCID homepage to learn more.

    19.3 Checking Manuscript Status

    After you submit your manuscript, you will receive an email confirmation with instructions on how you can view the status at any time. In your ‘My Manuscripts’ list on your Author Dashboard, you can view the details for submitted manuscripts.

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    20. Post-Submission

    20.1 Review

    Manuscripts are evaluated by the FAI editorial staff and sent to outside reviewers for anonymized peer review. A decision on a manuscript that has been rejected is returned as quickly as possible. It usually takes more time to make a decision regarding a paper being considered for publication. 

    For a list of editorial board members and reviewers, click here.

    20.2 Revision

    The editorial staff may require revisions be made to accepted manuscripts before publication. In this case, authors must follow the instructions for revisions included with the revision request. All changes to the text must be highlighted in the submitted revision to aid in the review process. Revised manuscripts will be evaluated by the editorial staff and further requests for revision may be made. All communication regarding revisions will be made with the corresponding author. Revisions should be made within 60 days of receiving the revision request. Revisions taking longer will be deleted from our files unless we are contacted by the author.

    20.3 Publication

    Once the final revised manuscript has been accepted, all authors (corresponding and contributing) will receive a letter stating that the manuscript is ready for publication. The corresponding author will sign the Contributor Agreement.

    Authors will be published in the order of the submitted Title Page. No corrections can be made after online publication, including corrections to author names and affiliations. All corrections must be made at the proofing stage.

    20.4 Online First publication

    Online First allows final articles (completed and approved articles awaiting assignment to a future issue) to be published online prior to their inclusion in a journal issue, which significantly reduces the lead time between submission and publication. Visit the Sage Journals help page for more details, including how to cite Online First articles.

    20.5 Access to your published article

    Sage provides authors with online access to their final article.

    20.6 Promoting your article

    Publication is not the end of the process! You can help disseminate your paper and ensure it is as widely read and cited as possible. The Sage Author Gateway has numerous resources to help you promote your work. Visit the Promote Your Article page on the Gateway for tips and advice.

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    21. Further Information

    Any correspondence, queries or additional requests for information on the Manuscript Submission process should be sent to the Editorial Office: at

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    22. Appealing the Publication Decision

    Authors may appeal decisions by contacting the Editor-in-Chief. Authors should recognize that a high burden of proof exists to overturning a negative peer-review decision. All appeals are reviewed by the Editor-in-Chief or his/her designated associate editor.

    If an author believes the decision regarding their manuscript was affected by a publication ethics breach, the author may contact the publisher with a detailed written description of their concern, and information supporting the concern, at

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