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Background: The outcomes of medial meniscal allograft transplantation (MMAT) combined with high tibial osteotomy (HTO) compared with isolated MMAT remain unclear. Purpose: To compare the clinical and radiological results of MMAT combined with HTO and isolated MMAT. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study included 42 consecutive patients, who were divided into group M (isolated MMAT; n = 22) and group H (MMAT combined with HTO with a varus angle >3°; n = 20). Group differences in subjective knee scores, isokinetic muscle strength test, and radiological outcomes (Kellgren-Lawrence grade, mechanical axis, graft extrusion, graft status, and articular cartilage loss) were compared. Results: The mean follow-up period was 29.2 ± 4.9 months and 27.4 ± 5.3 months for groups M and H, respectively. The Lysholm score improved from 55.4 ± 9.5 to 81.3 ± 9.7 and from 52.6 ± 8.9 to 84.2 ± 10.2 in groups M and H, respectively (both P <.001). The International Knee Documentation Committee subjective score improved from 51.4 ± 10.3 to 79.6 ± 9.4 and from 49.3 ± 11.4 to 81.4 ± 8.3 in groups M and H, respectively (both P <.001). Both groups showed no significant differences in subjective knee scores and isokinetic extensor strength at the final follow-up. The rate of preoperative and postoperative high International Cartilage Regeneration & Joint Preservation Society grade (≥3) did not differ between the 2 groups. Group M showed greater coronal graft extrusion than did group H (3.3 ± 0.7 mm vs 2.7 ± 0.8 mm; P =.014); the rate of pathologic graft extrusion (≥3 mm) was not higher in group M (40.9%) than in group H (20%) with the number of patients available (P =.143). Both groups showed no significant difference in the graft status. Graft tears were observed in 2 patients (9%) in group M and 1 patient (5%) in group H (P =.607). Conclusion: Clinical scores significantly improved after isolated MMAT and MMAT combined with HTO compared with preoperative values, and their short-term outcomes were similar. Postoperative graft extrusion was greater in patients who underwent isolated MMAT, implying that active correction of varus alignment during MMAT may help in intra-articular biomechanics. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the feasibility of the fluid-attenuated inversion recovery sequence with fat suppression (FLAIR-FS) for the assessment of ankle synovitis without contrast enhancement. FLAIR-FS and contrast-enhanced, T1-weighted sequences (CE-T1) of 94 ankles were retrospectively reviewed by two radiologists. Grading of synovial visibility (four-point scale) and semi-quantitative scoring of synovial thickness (three-point scale) were performed in four compartments of the ankle in both sequences. Synovial visibility and thickness in FLAIR-FS and CE-T1 images were compared, and agreement between both sequences was assessed. Synovial visibility grades and synovial thickness scores for FLAIR-FS images were lower than those for CE-T1 images (reader 1, p = 0.016, p < 0.001; reader 2, p = 0.009, p < 0.001). Dichotomized synovial visibility grades (partial vs. full visibility) were not significantly different between both sequences. The agreement in synovial thickness scores between the FLAIR-FS and CE-T1 images was moderate to substantial (κ = 0.41–0.65). The interobserver agreement between the two readers was fair for synovial visibility (κ = 0.27–0.32) and moderate to substantial for synovial thickness (κ = 0.54–0.74). In conclusion, FLAIR-FS is a feasible MRI sequence for the evaluation of ankle synovitis without contrast enhancement. [ABSTRACT FROM AUTHOR]

Background and Objectives: Studies analyzing magnetic resonance imaging (MRI) after simultaneously performing lateral meniscal allograft transplantation (MAT) and capsulodesis are currently rare. This study aimed to compare the MRI results between the group that performed lateral MAT alone and the group that performed both lateral MAT and capsulodesis simultaneously. Materials and Methods: A total of 55 patients who underwent lateral MAT with a 1-year follow-up MRI were included. The patients were divided into two groups according to the surgical procedure: group I (isolated lateral MAT, n = 26) and group C (combined lateral MAT and capsulodesis, n = 29). Differences between groups were compared regarding subjective knee scores, graft extrusion, graft signal, articular cartilage loss, and joint space width (JSW). Results: The subjective knee scores improved significantly in both groups (all, p < 0.001), and there were no significant differences in these scores between both groups at the 1-year follow-up. Group C showed less coronal graft extrusion at the 1-year follow-up (1.1 ± 1.7 mm vs. 2.4 ± 1.8 mm, p < 0.001). Pathologic coronal graft extrusion (≥3 mm) was found in seven (26.9%) patients in group I and three (10.3%) in group C. Concerning the graft signal, group C showed less grade 3 signal intensity in the posterior root of the graft. There were no significant differences in preoperative and postoperative cartilage status between groups. Regarding JSW, there were no significant differences in postoperative JSW between both groups. However, in group C, JSW significantly increased from 3.9 ± 0.4 mm to 4.5 ± 1.4 mm (p = 0.031). Conclusions: In lateral MAT, capsulodesis (open decortication and suture anchor fixation) could reduce graft extrusion without complications. In the future, large-volume and long-term prospective comparative studies are needed to confirm the clinical effects following capsulodesis. [ABSTRACT FROM AUTHOR]

Background: MRI analysis of subtalar ligaments in the tarsal sinus has not been well performed. We retrospectively investigated the appearance of subtalar ligaments using 3D isotropic MRI and compared imaging findings of subtalar ligaments between patients with subtalar instability (STI) and controls.Methods: Preoperative MRIs of 23 STI patients treated with arthroscopic subtalar reconstruction were compared to MRIs of 23 age- and sex-matched control subjects without STI. Thickness and width of anterior capsular ligament (ACL) and interosseous talocalcaneal ligament (ITCL) as well as thickness of calcaneofibular ligament (CFL) and anterior talofibular ligament (ATFL) were measured. Abnormalities in ACL, ITCL, CFL, ATFL, cervical ligament, and inferior extensor retinaculum were analyzed.Results: STI patients had significantly smaller ACL thickness and ACL width than controls (ACL thickness: 1.73 mm vs. 2.22 mm, p = 0.007; ACL width: 7.21 mm vs. 8.80 mm, p = 0.004). ACL thickness of ≤2.1 mm had a sensitivity of 66.7% and a specificity of 66.7% for diagnosis of STI. ACL width of ≤7.9 mm had a sensitivity of 80.0% and a specificity of 76.2% for the diagnosis of STI. However, thickness and width of ITCL, thickness of CFL, or thickness of ATFL was not significantly different between the two groups. Absence or complete tear of ACL was significantly more frequent in STI patients than that in controls (34.8% vs. 8.7%, p = 0.035). Complete tear of CFL and ATFL was more common in STI patients than that in controls, although the difference between the two groups was not statistically significant. Abnormalities of ITCL, cervical ligament, or inferior extensor retinaculum were not significantly different between the two groups.Conclusions: MRI features of thin or narrow ACLs may suggest STI. Absence or complete tear of ACL was significantly more common in STI patients than that in controls. [ABSTRACT FROM AUTHOR]