Introduction: Arthroscopy for femoroacetabular impingement (FAI) yields inferior outcomes when subchondral edema and cystic degeneration are present. Subchondroplasty (SCP), which involves injecting osteoconductive calcium phosphate into Bone Marrow Lesions (BMLs), may enhance subchondral structural support and can be performed alongside hip arthroscopy. Materials and Methods: This single-center retrospective study included patients who underwent SCP for acetabular BMLs during primary hip arthroscopy for FAI from March 2019 to March 2023. Clinical and radiographic outcomes were recorded at ≥2-year follow-up. Survivorship with treatment failure as the endpoint was assessed using Kaplan–Meier analysis. Results: Thirty-four patients were evaluated at a mean 3.1-year follow-up. No perioperative, early, or late complications or adverse events occurred. No bone substitute migration or intra-articular extravasation was seen. Four patients (11.8%) showed osteoarthritis progression and required conversion to total hip arthroplasty; no intraoperative issues with acetabular preparation were encountered. All clinical scores improved significantly (p < 0.001), and 82.4% returned to sport. Conclusions: SCP performed during hip arthroscopy appears safe in selected patients with early hip osteoarthritis and BMLs. Calcium phosphate injection may help restore subchondral integrity and load distribution, though the independent contribution of SCP beyond standard arthroscopic management remains uncertain.

Background: This scoping review analyzes the available literature on pure total talar dislocation, focusing on its epidemiology, clinical presentation, imaging techniques, surgical options, rehabilitation protocols, and complications. Methods: Following the PRISMA-ScR guidelines, a comprehensive search was conducted across the PubMed, Web of Science, and Scopus databases. The search yielded 185 articles, of which 30 satisfied the inclusion criteria and focused on pure total talar dislocation without fractures. Data from each study were extracted, including patient demographics, injury characteristics, treatment methods, and outcomes. Results: The studies included case reports, case series, and reviews. Despite the heterogeneity of the studies, the key findings suggest that early reduction, careful wound management, and soft tissue preservation are crucial in minimizing complications such as avascular necrosis (AVN), post-traumatic arthritis, and infection. The long-term outcomes varied, and the risk of AVN remained high, particularly in cases with compromised blood supply to the talus. Conclusions: Pure total talar dislocation is a rare and challenging condition with no established management protocol. While talar reimplantation and joint fixation offer promising outcomes in preserving function, the risk of complications, particularly AVN, remains significant. Additional research is necessary to standardize treatment protocols and improve clinical outcomes for this rare but severe injury.

This scoping review aims to systematically examine and analyse the available literature on pure total talar dislocation, focusing on its epidemiology, clinical presentation, imaging techniques, surgical options, rehabilitation protocols, and complications. Following the PRISMA-ScR guidelines, a comprehensive search was conducted across PubMed, Web of Science, and Scopus databases. The search yielded 185 articles, from which 30 met the inclusion criteria, focusing on pure total talar dislocation without fractures. Data from each study were extracted, including patient demographics, injury characteristics, treatment methods, and outcomes. A total of 30 articles were included in this review after screening and quality assessment by five independent reviewers. The studies included case reports, case series, and reviews. Despite the heterogeneity of available studies, key findings suggested that early reduction, careful wound management, and soft tissue preservation are crucial in minimising complications such as avascular necrosis (AVN), post-traumatic arthritis, and infection. Long-term outcomes varied, and the risk of AVN remained high, particularly in cases with compromised blood supply to the talus. Pure total talar dislocation is a rare and challenging condition with no established management protocol. While talar reimplantation and joint fixation offer promising outcomes in preserving function, the risk of complications, particularly AVN, remains significant. Further research is needed to standardise treatment protocols and improve clinical outcomes for this rare but severe injury.