What is an IRB, why do we need it, and what is a private IRB?

Many foot and ankle specialists have interest in publishing research or technique articles to share their expertise with colleagues. It is now commonplace for medical journals to require all studies that involve patients or patient data to have institutional review board (IRB) approval. Working with an IRB can be a source of frustration or delay, but this does not necessarily need to be the case. The purpose of this review article is to clearly define what an IRB is and does, as well as why the IRB was created and continues to be necessary, and to review what IRB options exist, including the "private" IRB. This background knowledge can help the foot and ankle researcher have a better understanding of the process and perhaps improve efficiency.