BACKGROUND Total talar dislocation (TTD) is very uncommon for many orthopedic surgeons and emergency/trauma specialists. Scarce cases of TTD have been reported, mainly in the form of open fracture-dislocation injury. CASE SUMMARY We report a very rare injury of closed TTD with a follow-up period of 36 mo. Initial closed reduction was not successful because of a fractured highly unstable medial malleolus displaced into the ankle mortise, blocking the relocation of the talus. The patient was able to walk pain-free after the 3 rd month of surgery. At the 36-mo follow-up, there were 10 degrees of flexion loss and 10 degrees of extension loss in the tibiotalar joint. Furthermore, 5 degrees of subtalar joint inversion-eversion loss was present. CONCLUSION Open reduction should be performed for closed TTDs unless closed reduction is successful.

The reported incidence of complications following medial open-wedge high tibial osteotomy (MOWHTO) varies. The authors sought to assess the complications, additional surgeries, and joint survival following MOWHTO in patients with isolated medial compartment arthrosis during a mean follow-up of 10 years. This retrospective study involved patients implanted with spacer plates, angle adjustable plates, or inverse L-type plates with wedges between 2000 and 2010. A total of 504 knees from 441 patients were examined. Mean age of the study population was 52.6±7.0 years, with 56 (11.1%) knees from men and 448 (88.9%) from women. The 10-year Kaplan–Meier joint survival rate was 94.8%. Overall complication rate for MOWHTO was 63.7%, with complications in 20.3% of treated knees requiring additional surgery. In this population, although the overall complication rate and the need for additional surgery were high, the need for additional surgery resulting from serious complications was low (2.6%). The high joint survival rate and low rate of additional surgery for serious complications indicate that MOWHTO can be safely applied in patients with isolated medial gonarthrosis. [ Orthopedics . 2020;43(5):303–314.]

Aim:The purpose of this article is to compare the similarity of initial radiological diagnosis and pathological diagnosis between thoracal and lumbar vertebral bodies and the adequacy and the reliability of open and percutaneous biopsies performed via transpedicular approach in the lesions located in vertebral bodies.Materials and Methods:Thirty-three patients who had undergone transpedicular biopsy for vertebral body lesions were retrospectively evaluated. Seventeen patients were diagnosed by percutaneous transpedicular biopsy (11 in the lumbar vertebrae, 6 in the thoracal vertebrae). Sixteen patients were diagnosed by open transpedicular biopsy (9 in the lumbar vertebrae, 7 in the thoracal vertebrae).Results:The similarity ratio between the initial radiological diagnosis and the final pathological diagnosis was 71.4% in the open biopsy and was 69.2% in the percutaneous biopsy (P > 0.05). The similarity ratio between the initial radiological diagnosis and the final pathological diagnosis was 66.7% in the lumbar region and was 77.8% in the thoracal region (P > 0.05). For percutaneous biopsy group, the similarity ratio was 72.7% in the lumbar region and was 66.7% in the thoracal region (P > 0.05). For open biopsy group, the similarity ratio was 62.5% in the lumbar region and 83.3% in the thoracal region (P > 0.05). No complication was observed.Conclusion:Specimen adequacy of open biopsy was higher than percutaneous biopsy. Particularly, the open thoracal biopsy has provided the highest similarity ratio between the initial radiological diagnosis and the final pathological diagnosis.

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Background: The aim of this study was to compare the clinical and magnetic resonance imaging (MRI) outcomes of arthroscopic microfracture (MF) plus chitosan-glycerol phosphate/blood implant and MF alone for the treatment of the osteochondral lesions of the talus (OCLTs). Methods: Patients who underwent either MF plus chitosan (group 1, n = 32) or MF alone (group 2, n = 31) between 2015 and 2019 in 2 separate time periods were retrospectively analyzed. Visual analog scale (VAS) score and American Orthopaedic Foot & Ankle Society (AOFAS) score were used for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) system was used for MRI evaluation. The mean follow-up time was 32 ± 13 months (range, 12-61 months). Results: Postoperatively, we detected significant improvements in both groups in terms of VAS and AOFAS scores. However, we observed no statistically significant difference between groups in terms of clinical scores, except the mean VAS function score, which was significantly higher in group 1 ( P = .022). According to MOCART scale, complete repair with the filling of the chondral defect and intactness of the surface of the repair tissue were more common in group 1. However, these parameters did not significantly differ between groups ( P = .257 and .242, respectively). Conclusion: Arthroscopic MF plus chitosan glycerol phosphate/blood implant did not result in better clinical and MRI outcomes compared with MF alone in the treatment of OCLTs. Level of Evidence: Level III, retrospective comparative study.

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Objectives: The aim of this study was to evaluate correlation of post-reduction magnetic resonance imaging (MRI)-based parameters with residual acetabular dysplasia in developmental dysplasia of the hip (DDH) patients who underwent open reduction. Patients and methods: A total of 62 hips of 54 children (5 males, 57 females; mean age: 8.5±3.5 months; range, 0 to 24 months) with a diagnosis of DDH who underwent open reduction between January 2012 and January 2017 were retrospectively analyzed. The acetabular head index (AHI), head coverage index (HCI), sphericity, bony acetabular index (BAI), cartilage acetabular index (CAI), anterior acetabular index (AAI), posterior acetabular index (PAI), abduction angle (AA), and acetabular medial wall thickness were measured by MRI. The correlation between MRI measurements and residual acetabular dysplasia was evaluated. Results: The mean follow-up was 23.7±10.1 (range, 12 to 56) months. The mean age at the final examination was 47.6±10.4 months. The age at the time of operation (r=0.250, p=0.049), medial wall thickness (r=0.304, p=0.016), AAI (r=0.729, p<0.001), PAI (r=0.590, p<0.001), and early postoperative AI (r=0.900, p<0.001) at the third postoperative month were positively correlated with the last follow-up AI. The AHI (r=-0.512, p<0.001), sphericity (r=-0,661, p<0.001), and HCI (r=-0.554, p< 0.001) were negatively correlated with the last follow-up AI. Conclusion: Post-reduction MRI parameters can be used to evaluate correlation with persistent acetabular dysplasia in DDH patients.