Foot & Ankle Orthopaedics最新文献

{"title":"Response to \"Letter Regarding: Dual-Incision Achilles Tendon Repair Using Krackow Sutures With Over-the-Top Knot Placement for Early Rehabilitation Without Immobilization: A Retrospective Case Series\".","authors":"Kaho Yasuda, Akifumi Fujita, Gantaro Minami, Hiromitsu Moriuchi","doi":"10.1177/24730114261473612","DOIUrl":"10.1177/24730114261473612","url":null,"abstract":"","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261473612"},"PeriodicalIF":0.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Diagnosis to Definitive Treatment: Diagnostic Delay and Outcomes After Endoscopic-Assisted Fasciotomy for Chronic Exertional Compartment Syndrome.","authors":"Cesar A Ramirez, Seif Al Masry, Gabrielle M Meli, Jose Zermeño, Faris Jafri, Edward Haupt","doi":"10.1177/24730114261471437","DOIUrl":"10.1177/24730114261471437","url":null,"abstract":"<p><strong>Background: </strong>Chronic exertional compartment syndrome (CECS) is an often-overlooked cause of exertional lower leg pain that is frequently misdiagnosed. Overlapping symptoms and inconsistent diagnostic approaches may delay diagnosis and prolong morbidity. The purpose of this study was to characterize the diagnostic journey of patients ultimately treated surgically for CECS and to report postoperative outcomes.</p><p><strong>Methods: </strong>A retrospective chart review was performed following IRB approval. Patients diagnosed with CECS and treated operatively by the senior author between 2020 and 2025 were identified using <i>Current Procedural Terminology</i> (<i>CPT</i>), <i>International Classification of Diseases, Ninth</i> and <i>Tenth Revision</i> (<i>ICD-9</i> and <i>ICD-10</i>) codes. Demographics, symptom duration, prior diagnostic workup, operative details, and postoperative outcomes were collected. Median follow-up was 42 weeks (range, 15-184 weeks). Descriptive statistics were reported.</p><p><strong>Results: </strong>Thirteen patients met inclusion criteria (mean age, 27.3 years; mean BMI, 28.3). Mean symptom duration prior to definitive diagnosis was 51.5 months, and bilateral symptoms were present in 12 patients. Most patients underwent extensive diagnostic testing and multiple unsuccessful conservative treatment strategies before referral. All patients underwent endoscopic-assisted anterolateral compartment release, with open posterior compartment fasciotomy performed when clinically indicated. Nine patients underwent bilateral procedures. At final follow-up, all patients reported symptomatic improvement and return to baseline activity. Four patients required additional evaluation for persistent posterior compartment symptoms, and 2 ultimately underwent further posterior compartment release. There were no intraoperative complications.</p><p><strong>Conclusion: </strong>CECS remains a frequently delayed diagnosis because of nonspecific symptoms, substantial overlap with other causes of exertional lower-leg pain, and limitations of currently available diagnostic tools. Although the effect of diagnostic delay on postoperative outcomes could not be directly assessed, prolonged delays were associated with substantial diagnostic burden and management complexity. Following fasciotomy, all patients reported symptomatic improvement and return to baseline activity. Greater awareness of CECS and a structured diagnostic approach may help facilitate earlier recognition and treatment.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261471437"},"PeriodicalIF":0.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Outcomes of Concomitant Deltoid and/or Syndesmotic Reconstruction With Broström for Global Chronic Ankle Instability: The Role of Deltoid Stability.","authors":"Steven M Hadley, Eric H Durudogan, Rachel Bergman, Sarah J Westvold, Carolyn J Hu, Tanya Kukreja, Muhammad Y Mutawakkil, Milap Patel, Cesar de Cesar Netto, Anish R Kadakia","doi":"10.1177/24730114261471506","DOIUrl":"10.1177/24730114261471506","url":null,"abstract":"<p><strong>Background: </strong>Medial and syndesmotic instability are risk factors for failure to return to pre-injury activity following Broström. This investigation aims to understand the extent to which superficial deltoid reconstruction (DR) and/or syndesmotic reconstruction (SR) affect global ankle stability in patients with global chronic ankle instability (GCAI) as measured by the validated Cumberland Ankle Instability Tool (CAIT) and Patient-Reported Outcomes Measurement Information System (PROMIS).</p><p><strong>Methods: </strong>All 574 patients who underwent lateral ankle ligament reconstruction at a single institution (2013-2024) were retrospectively reviewed. Revisions, allografts, nonanatomic reconstructions, flexor digitorum longus transfers, progressive collapsing foot deformity, hindfoot arthrodesis, ankle arthroplasties, fractures, those without minimum 1-year follow-up, and those who did not complete preoperative CAIT were excluded. Forty-three of 71 patients with concurrent deltoid and/or syndesmotic injury completed postoperative PROMIS/CAIT. GCAI was determined via history, examination, imaging, and intraoperative findings. Primary outcome was postoperative change in CAIT.</p><p><strong>Results: </strong>For patients who underwent concomitant DR (13/43), the mean CAIT score improved by 16.0 ± 8.9 points (<i>P</i> < .001). The mean PROMIS physical function (PF) was 53.8 ± 6.8, the mean PROMIS pain interference (PI) was 46.7 ± 8.5, and the mean postoperative CAIT score was 22.0 ± 7.8. For those who had SR (16/43), the mean CAIT improved by 8.0 ± 12.6 (<i>P</i> = .02). The mean PROMIS PF, PI, and postoperative CAIT scores among those who underwent associated SR were 49.3 ± 8.2, 51.3 ± 8.9, and 16.0 ± 9.1, respectively. For patients who underwent both SR and DR (14/43), average CAIT improved by 17.7 ± 7.0 (<i>P</i> < .001). Mean PF, PI, and postoperative CAIT were 51.9 ± 6.3, 48.2 ± 6.7, and 22.3 ± 7.0, respectively. Change in CAIT was significantly higher in DR and DR+SR compared to SR alone (<i>P</i> = .05).</p><p><strong>Conclusion: </strong>Concomitant DR/SR in patients undergoing Broström may be associated with significant improvements in ankle stability from preoperative baseline. Those with DR and DR+SR had the largest improvements in CAIT, which may suggest the role of deltoid stability in GCAI. Therefore, addressing global stability should be considered in some GCAI patients.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261471506"},"PeriodicalIF":0.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Regarding \"Dual-Incision Achilles Tendon Repair Using Krackow Sutures With Over-the-Top Knot Placement for Early Rehabilitation Without Immobilization: A Retrospective Case Series\".","authors":"Filippo Spiezia, Francesco Oliva, Filippo Migliorini, Nicola Maffulli","doi":"10.1177/24730114261473610","DOIUrl":"10.1177/24730114261473610","url":null,"abstract":"","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261473610"},"PeriodicalIF":0.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Management of Chronic Distal Tibiofibular Syndesmotic Instability: A Scoping Review of Techniques and Outcomes.","authors":"Jacob W McDevitt, Eric H Durudogan, Frederic J Washburn, Milap S Patel, Muhammad Y Mutawakkil, Anish R Kadakia","doi":"10.1177/24730114261469187","DOIUrl":"10.1177/24730114261469187","url":null,"abstract":"<p><strong>Background: </strong>Chronic distal tibiofibular syndesmotic instability is a diagnostically challenging condition associated with persistent pain, functional limitation, and progressive tibiotalar arthritis. Despite a growing range of surgical options, no consensus exists regarding optimal technique, patient selection, or expected outcomes, and no validated classification system has been established to guide treatment.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with PRISMA-ScR guidelines and the Arksey and O'Malley methodologic framework. PubMed/MEDLINE, Embase, and the Cochrane Library were searched through February 2026 with no date restrictions. Eligible studies included skeletally mature patients undergoing surgical treatment for chronic syndesmotic instability, defined as 6 or more months from injury to intervention, with a minimum 6-month follow-up.</p><p><strong>Results: </strong>Twelve studies encompassing 122 patients met inclusion criteria. All were Level IV or V evidence. Surgical techniques included tendon graft reconstruction (n = 42), arthroscopic-assisted stabilization (n = 44), suture-button or suture anchor fixation (n = 25), and distal tibiofibular arthrodesis (n = 11). AOFAS scores improved by 20 to 50 points across technique categories. Complication and unplanned reoperation rates were low. Return to sport was achieved in all athletic cohorts. Arthroscopic instability grade influenced the ceiling of functional recovery. Complication and reoperation rates were low.</p><p><strong>Conclusion: </strong>The available evidence, although limited to low-level retrospective studies, suggests that chronic distal tibiofibular syndesmotic instability may be surgically treatable across a range of clinical presentations, and functional improvement has been reported even in longstanding cases. The evidence is consistent with a phenotype-driven treatment approach, though prospective comparative data are lacking: ligament reconstruction or dynamic stabilization for patients without significant arthritis, and distal tibiofibular arthrodesis as a joint-sparing option for those with post-traumatic degenerative changes or fibular malunion. Severity of instability at the time of surgery appears to influence the ceiling of functional recovery, suggesting that earlier operative intervention in appropriate candidates may be beneficial, although this remains to be confirmed in prospective studies. Standardized classification and outcome reporting remain the primary barriers to advancing evidence-based care for this condition.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261469187"},"PeriodicalIF":0.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence After Combined Minimally Invasive Transverse-Akin and Distal Minimally Invasive Metatarsal Osteotomies: Association With Preoperative Deformity Severity in a Multicentre Retrospective Cohort Study.","authors":"Gil Genuth, Nadav Moses, Chris Brown, Peter Stavrou, Lukas D Iselin","doi":"10.1177/24730114261471555","DOIUrl":"10.1177/24730114261471555","url":null,"abstract":"<p><strong>Background: </strong>Recurrence after minimally invasive hallux valgus correction remains a concern, particularly following combined minimally invasive transverse-Akin (META) and distal minimally invasive metatarsal osteotomies (DMMOs). The influence of deformity severity on recurrence remains unclear.</p><p><strong>Methods: </strong>This retrospective multicentre cohort study included 120 patients treated with combined META and DMMO between 2019 and 2024. Patients were stratified into mild, moderate, and severe deformity groups (n = 40 each). Radiographic outcomes and PROMIS scores were assessed preoperatively and at 3 and 12 months. Recurrence was defined as hallux valgus angle (HVA) > 20°. Multivariable logistic regression identified predictors of recurrence.</p><p><strong>Results: </strong>All groups demonstrated significant radiographic correction and clinically meaningful PROMIS improvement. Recurrence rates at 12 months were 0% in mild, 30% in moderate, and 42.5% in severe deformities (<i>P</i> < .0001). Baseline HVA independently predicted recurrence (OR: 1.13 per degree; 95% CI: 1.07-1.21; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Combined META+DMMO was associated with substantial functional outcomes; however, recurrence increases substantially with deformity severity.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261471555"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Association of Surgical Setting With Costs and Complications in Ankle Arthrodesis: Medicare Claims Analysis.","authors":"Hyunkyu Ko, Brook I Martin, Sean Parham, Devon Nixon","doi":"10.1177/24730114261469180","DOIUrl":"10.1177/24730114261469180","url":null,"abstract":"<p><strong>Background: </strong>Ankle arthrodesis (AA) remains a reliable surgical treatment option for end-stage ankle arthritis in appropriately selected patients. Although traditionally performed in an inpatient (IP) setting, interest in these surgeries being done as an outpatient (OP) and ambulatory surgery center (ASC) settings has increased. We compared costs and post-operative complication rates for AA performed across these settings.</p><p><strong>Methods: </strong>Using Medicare fee-for-service claims (2016-2021), we retrospectively identified patients ≥65 years of age who underwent AA. Using subsequent inpatient and Part B (provider) claims, we evaluated postoperative complications within 1 year, defined by <i>International Classification of Diseases, Tenth Revision</i> (<i>ICD-10</i>) codes, including infection, thromboembolic events, and device-related issues. We also evaluated total episode and post-acute care costs within 90 days. We tested for differences in perioperative safety indicators and costs through multivariate regressions, controlling for age, sex, race, and Charlson Comorbidity Index (CCI), dementia, and the involvement of a surgical assistant. A propensity-matched analysis was performed to minimize selection by indication bias.</p><p><strong>Results: </strong>We included 7104 initial AA cases across surgical settings: 262 (3.7%) in ASC, 3047 (42.9%) in OP, and 3795 (53.4%) in IP. Compared with IP cases, OP and ASC surgeries were performed in younger, healthier (as assessed by CCI) patients and more frequently in male patients (<i>P</i> < .001). In multivariate analyses, IP cases had the highest infection rates (+7.2 percentage points compared with ASC, <i>P</i> = .001; +4.2 percentage points compared to OP, <i>P</i> = .016) and the highest 90-day total episode costs of $19 817 (95% CI: $18 137 to $21 497). Propensity-matched analyses were consistent with multivariable results, confirming the same directional associations but with modestly larger effect sizes.</p><p><strong>Conclusion: </strong>AA performed in ASC settings was associated with lower complication rates and substantially lower episode-of-care costs compared with IP and OP settings in this Medicare fee-for-service population, particularly among appropriately selected patients.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261469180"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Value of Calcaneofibular Ligament Tortuosity on Oblique Coronal MRI in Chronic Ankle Instability.","authors":"Jin Su Kim, Sang-Bum Kim, Ken Meng Tai","doi":"10.1177/24730114261471166","DOIUrl":"10.1177/24730114261471166","url":null,"abstract":"<p><strong>Background: </strong>Lateral ankle sprains are common injuries that may progress to chronic ankle instability (CAI). Although stress radiographs are widely used to assess mechanical instability, magnetic resonance imaging (MRI)-based parameters for evaluating calcaneofibular ligament (CFL) instability remain limited. The purpose of this study was to evaluate the diagnostic value of the CFL tortuosity angle (C angle) measured on oblique coronal MRI in patients with CAI and to examine its relationship with clinical and radiographic measures.</p><p><strong>Methods: </strong>A retrospective analysis of 120 patients (82 CAI, 38 controls) was performed. The C angle was measured on oblique coronal T2-weighted MRI. Talar tilt angle was assessed using stress radiography in the CAI group. Functional outcomes and ankle eversion strength were also evaluated.</p><p><strong>Results: </strong>A total of 120 patients were included, comprising 82 patients with CAI and 38 controls without a history of ankle sprain. The C angle was significantly greater in the CAI group compared with controls (76.5° ± 18.3° vs 31.9° ± 5.4°, <i>P</i> < .001). Receiver operating characteristic analysis demonstrated excellent diagnostic performance (area under the curve, 0.97), with an optimal cutoff of 40.9° (sensitivity, 97.6%; specificity, 100%). The C angle showed a moderate correlation with talar tilt angle (<i>r</i> = 0.327, <i>P</i> = .003) but limited association with functional scores and muscle strength.</p><p><strong>Conclusion: </strong>The CFL tortuosity angle on oblique coronal T2-weighted MRI demonstrated high diagnostic accuracy for CAI and may serve as a useful adjunctive parameter in evaluating ligament instability.</p><p><strong>Level of evidence: </strong>Level IV, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261471166"},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weber Classification Does Not Correlate with PROMIS Outcome Measures.","authors":"Steven M Hadley, John J Peabody, Rachel Bergman, Sarah J Westvold, Eric H Durudogan, Frederic Washburn, Shaun Chang, Muhammad Y Mutawakkil, Milap Patel, Anish R Kadakia","doi":"10.1177/24730114261469561","DOIUrl":"10.1177/24730114261469561","url":null,"abstract":"<p><strong>Background: </strong>It remains unclear whether Weber subtype correlates with outcomes measured by validated Patient Reported Outcomes Measurement Information System (PROMIS) following ankle fracture surgery. We examine whether Weber subtype correlates with PROMIS.</p><p><strong>Methods: </strong>This was a retrospective review of 527 patients who underwent ankle fracture surgery at a single institution (2016-2021). Two fellowship-trained orthopaedic surgeons independently reviewed all radiographs. Of the 527 who were included in final analysis evaluating complications, 182 with Weber B and Weber C fractures completed PROMIS physical function (PF) and pain interference (PI) measures. All 182 had anatomically reduced ankles and were included for analysis of PROMIS. Primary outcome was PROMIS.</p><p><strong>Results: </strong>Among survey responders (n = 182), no significant difference existed between Weber B and Weber C anatomically reduced in mean PF (52.3 ± 9.9 vs 53.5 ± 9.2, <i>P</i> = .47) and PI (48.4 ± 8.8 vs 47.0 ± 7.7, <i>P</i> = .34). In adjusted-regression, Weber B and Weber C were not significantly different for mean PF (53.8 vs 53.9, <i>P</i> = .92) or PI (48.0 vs 46.4, <i>P</i> = .27). Body mass indexes (BMIs) of 30 or greater had worse mean PF (<i>P</i> = .04) and PI (<i>P</i> < .01). Compared with males, females had worse mean PF (<i>P</i> < .001) and PI (<i>P</i> < .01). Older patients had lower PF compared to younger (<i>P</i> = .01). In overall cohort (n = 527), Weber C radiographic complication rate was 32.3% (41/127) vs 11.5% (46/400) Weber B (<i>P</i> < .001), with higher syndesmotic loss of reduction and early-onset degenerative joint disease (DJD) rates (9.4% vs 1%, <i>P</i> < .001; 11.8% vs 2.5%, <i>P</i> < .001, respectively). Weber C was 3.52 times (95% CI: 2.08-5.98) as likely to have radiographic complication as Weber B.</p><p><strong>Conclusion: </strong>Patients with anatomically reduced ankles may achieve population mean PROMIS regardless of Weber subtype. Although at early follow-up Weber C fractures have higher radiographic complication rates, including early-onset DJD, proper reduction and stabilization may be especially important to help patients achieve equivalent functional outcomes to patients with Weber B fractures. Higher BMI, female sex, and older age may negatively affect outcomes.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261469561"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteochondral Lesions of the Talus Treated With Particulated Juvenile Cartilage Allograft in the Active Duty Military Population.","authors":"Colin Mizuo, Liliya Parkman, Tarina Ayazi, Haoning Hu, Ashley Adams","doi":"10.1177/24730114261471519","DOIUrl":"10.1177/24730114261471519","url":null,"abstract":"<p><strong>Background: </strong>Osteochondral defects (OCDs) of the talus frequently affect young, active individuals and carry a risk of chronic pain and joint degeneration. Particulated juvenile cartilage allograft (PJCA), harnesses the proliferative capacity of juvenile chondrocytes to restore hyaline cartilage without donor-site morbidity. This study evaluates the structural, clinical, and functional outcomes of PJCA implantation in active-duty military patients.</p><p><strong>Methods: </strong>We retrospectively reviewed 10 service members (10 male, mean age 28.4 years) who underwent arthroscopic PJCA implantation for symptomatic talar OCDs. Outcomes included defect dimensions and volume on magnetic resonance imaging (MRI), Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scores, visual analog scale (VAS) for pain, and Foot and Ankle Ability Measure (FAAM) subscales. Statistical analyses employed Wilcoxon signed-rank and Friedman tests (SPSS 28.0), with significance set at <i>P</i> <.05.</p><p><strong>Results: </strong>Median follow-up was 15.0 months (range 13.5-18.2). Lesion volume decreased from 0.77 to 0.02 cm³ (<i>P</i> = .027). Median MOCART scores improved from 25 to 75 (<i>P</i> = .027). Pain scores fell from 6.0 to 1.0 (<i>P</i> < .001). FAAM daily living scores increased from 50% to 87.5% (<i>P</i> < .001), and sports scores from 15% to 85% (<i>P</i> < .001). Nine of 10 patients returned to full duty (8/9 after a single limited-duty period, 1 required 2 limited-duty periods), and 1 required medical separation. No complications were observed.</p><p><strong>Conclusion: </strong>In this high-demand cohort, PJCA implantation was associated with radiographic evidence of defect fill, pain relief, functional restoration, and return to activity without donor-site morbidity. Despite the study's retrospective design and moderate follow-up, these findings support PJCA as a promising option for talar OCD repair. Prospective, randomized trials with extended follow-up are warranted to confirm durability and efficacy against established techniques.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"11 3","pages":"24730114261471519"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}