Acute on chronic stress fracture after a medial malleolar osteotomy following osteochondral lesion of the talus treatment.

A patient in his 40s presented at the outpatient clinic with sudden pain and swelling over his medial malleolus, 16 weeks after he had undergone osteoperiosteal autografting with a medial malleolar osteotomy for his tertiary osteochondral lesion of the talus. Postoperatively, the patient was treated using the regular evidence-based rehabilitation protocol of 5 weeks of non-weight-bearing and 5 weeks of partial weight-bearing. However, after the confirmed radiological union the patient experienced an acute on chronic stress fracture through the osteotomy line.

Fixation for Osteochondral Lesions of the Talus Leads to Successful Clinical Outcomes in 9 out of 10 Patients: a Systematic Review.

Importance: Osteochondral lesions of the talus (OLT) with an osteochondral fragment are amendable for fixation. Fixation aims to stabilize the osteochondral fragment while retaining the native cartilage. Though fixation for OLT is a promising treatment, no systematic overview of the literature on its efficacy and safety exists.

Second-Look Needle Arthroscopy After Prior Surgical Treatment for Cartilage Lesions of the Ankle: The Amsterdam and New York City Perspectives.

Objective: The purpose of this prospective study was to evaluate the quality of the reparative cartilage during second-look needle arthroscopy following talar osteoperiostic grafting from the iliac crest (TOPIC) or autologous osteochondral transplantation (AOT) procedure for the management of large osteochondral lesions (OCLs) of the talus.

Design: Prospective case series.

Methods: Patients who underwent second-look needle arthroscopy following either TOPIC or AOT procedure were prospectively recruited when they needed a second look.

Assessment of the Monocyte Subpopulations and M1/M2 Macrophage Ratio in Concentrated Bone Marrow Aspirate.

Objective: The purpose of this study was to determine the M1/M2 macrophage ratio in concentrated bone marrow aspirate (cBMA) in patients undergoing surgical intervention augmented with cBMA for osteochondral lesions of the talus (OLTs).

Design: Samples of peripheral blood (PB), bone marrow aspirate (BMA), and cBMA were collected during the procedure. The samples were analyzed by automated cell counting and multicolor fluorescence-activated cell sorting with specific antibodies recognizing monocytes (CD14+ CD16+) and the M1 (CD86+) and M2 (CD163+CD206+) populations within that monocyte population.

Does involvement of the anterior syndesmosis affect the functional outcome of acute ligamentous ankle injuries?

Purpose: To compare patient-reported outcomes between acute ligamentous ankle injuries 1) without anterior syndesmosis involvement and 2) with anterior syndesmosis involvement (without clinical instability).

Study Design: Prospective cohort study.

Methods: Between September 2016 and December 2020 all athletes (≥18) with an acute ankle injury presenting within 7 days post-injury were screened for eligibility.

Patient-responsive protein biomarkers for cartilage degeneration and repair identified in the infrapatellar fat pad.

Objectives: Cartilage defects (CDs) are regarded as early manifestation of osteoarthritis (OA). The infrapatellar fat pad (IPFP) is an important mediator in maintaining joint homeostasis, disease progression and tissue repair, with a crucial role of its secreted proteins. Here, we investigate the proteome of the IPFP in relation to clinical status and response to surgical treatment of CDs.

Editorial Commentary: Early Weightbearing in a Cast After Osteochondral Autograft Transplantation for Osteochondral Lesions of the Talus Is Feasible.

Osteochondral lesions of the talus (OLTs) should initially be treated nonoperatively. In case of failure of a large, irreparable (nonprimary) OLT, osteochondral transplantation techniques may be recommended. Harvesting an osteochondral graft from the ipsilateral knee is most commonly used.

Pain during prolonged sitting in subjects with patellofemoral pain in Dutch physical therapy clinics: an online questionnaire-based analysis.

Objectives: This study aimed to describe (1) differences between subjects with patellofemoral pain (PFP) with and without pain during prolonged sitting (PDPS), (2) minimum knee flexion angle and time to onset/disappearance of PDPS and (3) differences between those with PDPS at smaller/greater flexion angles and with fast/slow onset and disappearance of PDPS.

Design: Patient-reported online questionnaire.

Setting: Private physical therapy clinics in the Netherlands between May 2021 and March 2023.

Does free tendon length influence the injury risk of the Achilles tendon? A finite element study.

Purpose: The Achilles tendon is a common injury site, but anatomical risk factors for injury are relatively unexplored in the literature. This study aimed to evaluate whether changes in free tendon length would influence the results of a simulated rupture of the Achilles tendon.

Methods: Using a previously validated 3D finite element model of the free and aponeurotic Achilles tendon as a basis, two additional finite element models with 25% decreased and increased free tendon lengths were created.

The Effect of the Nordic Hamstring Exercise on Hamstring Muscle Activity Distribution During High-Speed Running Estimated Using Multichannel Electromyography: A Pragmatic Randomized Controlled Trial.

Objective: To evaluate the effect of the Nordic hamstring exercise on normalized muscle activity and relative contribution of the biceps femoris long head, semitendinosus, and semimembranosus through multichannel electromyography in the late-swing phase of high-speed running.

Design: A pragmatic, 2-arm, single-center randomized controlled trial. Participants were randomly assigned to a Nordic group or control group.

Outcomes Following Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus at 10-Year Follow-Up: A Retrospective Review.

Objective: The purpose of this study was to evaluate outcomes following autologous osteochondral transplantation (AOT) for the treatment of osteochondral lesions of the talus (OLT) at a minimum of 10-year follow-up.

Design: Retrospective chart review identified patients who underwent AOT for the treatment of OLT. Pre-operative magnetic resonance imaging (MRI) scans were obtained in all patients.

Patient-Reported Outcome Measures Show No Relevant Change Between 1-Year and 2-Year Follow-Up After Treatment for Anterior Shoulder Instability: A Systematic Review.

Purpose: To compare patient-reported outcome measures (PROMs) at 1-year and 2-year follow-up after treatment for anterior shoulder instability.

Methods: Randomized controlled trials and prospective studies that evaluated and reported PROMs after a capsulolabral repair (with or without remplissage), bone augmentation, or nonoperative treatment to treat anterior shoulder instability at both 1-year and 2-year follow-up were included. PROMs were compared between 1-year and 2-year follow-up; forest plots with mean difference were created to compare baseline, 1-year, and 2-year follow-up; and scatterplots were created to visualize clinical improvement over time.

Weightbearing Computed Tomography Can Accurately Detect Subtle Lisfranc Injury.

Background: Early detection of Lisfranc injury is critical for improving clinical outcomes, but diagnosing subtle injury can be difficult. Weightbearing computed tomography (WBCT) allows evaluation of such injuries in 3 dimensions (3D) under physiologic load. This study aimed to assess the utility of 1-, 2-, and 3-dimensional measurements on WBCT to diagnose subtle injury in isolated ligamentous Lisfranc injuries.

Outcomes Following the Use of Extracellular Matrix Cartilage Allograft for the Management of Osteochondral Lesions of the Talus: A Systematic Review.

Extracellular matrix cartilage allograft (EMCA) is a novel biological strategy utilized to augment the repair of osteochondral lesions of the talus (OLTs). However, there is no consensus on the precise role and outcomes following its use in the treatment of OLTs. The purpose of this systematic review was to evaluate the clinical and radiological outcomes following the use of EMCA for the treatment of OLT.

Analyzing Learning Curve Effects: Total Ankle Replacement Design Switch and Long-Term Survival.

Different aspects of the learning curve in total ankle replacement (TAR) have been studied in the short to mid-term, with 30 cases often considered critical. However, its impact on long-term (10- and 15-year) survival remains unclear. Therefore, we retrospectively analyzed 77 consecutive TARs performed by one orthopedic surgeon.

No difference between 5 and 6 weeks of non-weight bearing after osteochondral grafts for medial osteochondral defects of the talus with medial malleolar osteotomy.

Purpose: The present study aimed to compare the clinical outcomes and safety at a 1-year follow-up after 5 or 6 weeks of non-weight bearing after a Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for a medial osteochondral lesion of the talus (OLT).

Methods: A retrospective comparative case-control analysis of prospectively followed patients who underwent a TOPIC procedure with medial malleolus osteotomy was performed. Patients were matched in two groups with either 5 or 6 weeks of non-weight bearing.

Large variance in a lateral osteoarthritic population prior to and following lateral unicompartmental arthroplasty: An analysis of knee phenotypes.

Background: Disagreement exists on the optimal coronal alignment target for lateral unicompartmental knee arthroplasty (UKA). An improved understanding of the distribution of coronal alignment and joint line orientation in lateral osteoarthritis (OA) might prove beneficial. The aim of this study was to evaluate the pre- and postoperative Coronal Plane Alignment of the Knee (CPAK) distribution following lateral UKA and to evaluate the association between phenotypic variation and patient-reported outcome measures (PROMs).

The minimal important change is not a universal fixed value across diagnoses when using the FAOS and FAAM in patients undergoing elective foot and ankle surgery.

Purpose: This study aimed to calculate region and diagnosis-specific minimal important changes (MICs) of the Foot and Ankle Outcome Score (FAOS) and the Foot and Ankle Ability Measure (FAAM) in patients requiring foot and ankle surgery and to assess their variability across different foot and ankle diagnoses.

Methods: The study used routinely collected data from patients undergoing elective foot and ankle surgery. Patients had been invited to complete the FAOS and FAAM preoperatively and at 3-6 months after surgery, along with two anchor questions encompassing change in pain and daily function.

Most elite athletes return to preinjury competitive activity after surgical treatment for medial malleolus stress fractures.

Purpose: To provide return-to-performance outcomes after surgical treatment for medial malleolus stress fractures in the elite athlete. Additionally, to describe an individualised surgical approach in the management of medial malleolus stress fractures.

Methods: Five athletes (six ankles) underwent surgical treatment for a medial malleolus stress fracture.