Subtalar arthrodesis is effective treatment for subtalar joint disease but could induce joint degeneration and ankle joint motion limitation related to talar declination and hindfoot height.

Objective This study was performed to analyze the clinical value of X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) examinations for the diagnosis of distal tibiofibular syndesmosis injuries in Weber type B ankle fractures with reference to the ankle arthroscopic findings. Methods This retrospective clinical study involved 52 patients with type B ankle fractures from August 2014 to January 2018. We analyzed the patients’ preoperative imaging data and judged the stability of the distal tibiofibular syndesmosis using X-ray, CT, and MRI examinations. We also evaluated the syndesmosis stability with arthroscopy both statically and dynamically. Results With the arthroscopic findings as the standard, the sensitivity of X-ray for diagnosing syndesmosis instability was 52.8%, the specificity was 100%, and the diagnostic efficiency was 67.3%. The sensitivity of CT for diagnosing syndesmosis instability was 77.8%, the specificity was 100%, and the diagnostic efficiency was 84.6%. The sensitivity of MRI for diagnosing syndesmosis instability was 100%, the specificity was 81.3%, and the diagnostic efficiency was 94.2%. Conclusion This study suggests that an arthroscopic examination may be recommended when the X-ray or CT features are different from the MRI findings while diagnosing tibiofibular syndesmosis instability in Weber type B malleolar fractures.

Subtalar arthrodesis is effective treatment for subtalar joint disease but could induce joint degeneration and ankle joint motion limitation related to talar declination and hindfoot height.

Background: Autologous osteochondral transplantation (AOT) is a treatment option for large or cystic osteochondral lesions of the talus (OLTs), with promising clinical results. However, donor-site morbidity (DSM) has always been a concern with this procedure. Purpose: To investigate the clinical and radiological outcomes of autograft harvesting from the medial trochlea for OLTs. Study Design: Case series; Level of evidence, 4. Methods: A total of 46 consecutive patients were included after AOT procedures for OLTs, with donor autografts (single or double plugs) harvested from the medial trochlea of the ipsilateral knee. Lysholm scores were collected postoperatively at 12-month intervals to assess clinical outcomes. Postoperative magnetic resonance imaging (MRI) was used to assess the donor site using the MOCART (magnetic resonance observation of cartilage repair tissue) score. DSM was evaluated at 12-month intervals. Statistical analysis was performed to compare patients treated with single-plug and double-plug AOT procedures and establish whether there was any correlation between MOCART and Lysholm scores. Results: The mean follow-up period was 98.3 months (range, 67-144 months). The Lysholm scores for all patients were 92.5 ± 6.1 and 99.9 ± 0.2 at the 12-month and final follow-ups, respectively. MRI of the donor sites was taken at an average of 93.8 ± 20.5 (range, 61-141) months postoperatively, and the mean MOCART score was 76.2 ± 4.9. The overall incidence of DSM in this study was 4.3% at 12 months, postoperatively, which decreased to 0% at the 24-month follow-up. There was no significant difference in either the Lysholm score ( P = .16) or the MOCART score ( P = .83) between the single-plug and double-plug groups at the final follow-up. There were no significant correlations between MOCART and Lysholm scores and patient age, number of grafts, or body mass index. Conclusion: According to the study findings, the DSM of donor autografts harvested from the medial trochlea was low, and the number (single or double) of grafts did not affect the functional outcome.