Foot and Ankle

Foot and Ankle

Managing infection is a significant challenge for surgeons treating patients with lower extremity problems such as diabetic foot osteomyelitis (DFO) and diabetic foot ulcers (DFU). Initially treated in a community setting , these cases deteriorate over time and many require hospitalisation, and ultimately amputation.
Foot complications, including diabetes-related lower-extremity problems, impacted 131 million individuals, globally (1.8% of the population) in 2016 – including 18.6-million-foot ulcers and 6.8 million amputations.1

Global impact of diabetes-related lower extremity complications in 2016 with 131 million affected


In the USA, hospitalised DFO and DFU cases over the last 5-years have been growing at 8% per annum and account for over 500,000 patients every year – and more than 230,000 amputations.  At this rate there will be over 750,000 DFO/DFU patients annually by 2026.2



Total ankle joint replacement surgery in the USA also continues to grow rapidly at an annual rate of 14%, with lower extremity procedures carrying a higher risk of surgical site infection (SSI) of up to 6.5% compared to up to 3.6% for elective orthopaedic surgeries such as knee and hip arthroplasty.3

References and regulatory statements

  1. Yuqi Zhang, Peter A. Lazzarini, Steven M. McPhail, Jaap J. van Netten, David G. Armstrong, Rosana E. Pacella; Global Disability Burdens of Diabetes-Related Lower-Extremity Complications in 1990 and 2016. Diabetes Care 1 May 2020; 43 (5): 964–974.
  2. Definitive Healthcare
  3. Prissel, M. A., & Roukis, T. S. (2016). Total ankle replacement based on worldwide registry data trends. Primary and Revision Total Ankle Replacement: Evidence-Based Surgical Management, 31-40.