New Study Affirms Podiatrists as Leaders in Complex Ankle Surgery

A new study from Weil Foot & Ankle Institute (WFAI) offers powerful validation of the exceptional outcomes delivered by podiatric surgeons in total ankle arthroplasty. The results were resounding: revision rates were low for this complex surgery, and patients operated on by podiatric surgeons experienced no excess risk of revision or other postoperative complications compared to their orthopedic counterparts—solidifying podiatry’s standing as a premier specialty in foot and ankle surgery.

Published in the July 2025 issue of the Journal of Foot & Ankle Surgery, the study titled “Risk of Revision and Other Complications in Total Ankle Arthroplasty Do Not Differ by Surgeon Specialty” analyzed over 16,400 cases from 2010 to 2023 using the PearlDiver national healthcare claims database. Patients operated on by podiatrists experienced equally safe outcomes as those treated by other surgical specialties. Adjusted analyses showed no significant difference in rates of revision, infection, readmission, or venous thromboembolism. This reaffirms that what matters most in surgical success is not the label of a surgeon’s degree, but their expertise, training, and case volume. Put another way, “it’s not the surgeon’s genotype, but their phenotype” that’s most important – Dr. Adam Fleischer.

The implications are far-reaching for the field of podiatry, offering clear, peer-reviewed evidence to support the role of podiatrists as leaders in ankle replacement and revision surgery. At a time when surgical privileges and reimbursement policies are under scrutiny, this data empowers institutions, payers, and patients to recognize podiatric surgeons as essential specialists in advanced foot and ankle care.

Balance Health’s Executive Chairman, Dr. Lowell Weil Jr. also celebrated the achievement: “I’m proud that our research team and fellows have once again been recognized for their commitment to advancements in patient care, and proving that podiatrists provide the premier foot and ankle care in the United States.”

Authored by a research team including Dr. Adam Fleischer, Dr. Héctor Santiago, Dr. Jonathan Hook, and Lowell Weil Jr., of Weil Foot & Ankle Institute, the study appears in the Journal of Foot & Ankle Surgery (July 2025 edition). Using one of the most comprehensive healthcare claims databases in the U.S., it provides long-term data on total ankle arthroplasty survivorship across surgeon specialties, setting a new benchmark in evidence-based surgical evaluation.

Weil Foot & Ankle Institute is a nationally recognized leader in podiatric medicine, surgery, education, and research. The WFAI team is dedicated to advancing the science of foot and ankle care while improving patient outcomes through innovation and academic excellence.

Dr. Hector Santiago, WFAI Fellow at the time, was awarded 3rd place for his manuscript titled “Does Surgeon Type Affect Total Ankle Arthroplasty Survivorship in the US?” at the 2025 American College of Foot and Ankle Surgeons (ACFAS) Annual Scientific Conference. Additionally, this research was awarded 1st place in the Student Poster Competition at the Kaiser Permanente National Podiatric Surgical Conference, in Oakland, CA, with primary presenter Khushi Patel, MS3 student at Scholl.
Study Affirms Podiatrists as Leaders in Complex Ankle Surgery