Background: This prospective study aimed to test the reliability and validity of hallux valgus angle (HVA) measurement on smartphone digital photographs compared with the standard radiographic evaluation.Methods: Twenty Seven female patients (45 feet) with forefoot deformity were evaluated with weight‐bearing anteroposterior foot radiographs and smartphone photographs. Radiographic hallux valgus angle (rHVA) was measured on digital radiographs. Two different photographic HVA measurement methods were used. In the first, the longitudinal axes of the first metatarsal and proximal phalanx were determined, and the angle between these axes was measured (pHVA), similar to the radiographic method. In the other method, the angle of the margo medialis pedis was measured on the photograph (pMMP). Two independent observers performed all measurements twice on two different occasions. Reliability analysis was performed using the interclass correlation coefficient. Agreement between the measurements was tested using Bland‐Altman analysis.Results: The repeated rHVA, pHVA and pMMP measurements showed excellent intra and inter‐observer reliability, with ICC values above 0.900. The mean rHVA, pHVA, and pMMP were statistically similar (p:0.929, 27.03°±8.7°, 27.11°±8.8° and 26.5°±9.0° respectively). The mean difference between the rHVA and pHVA was − 0.07°±5.1° (range, ‐‐9.67 to 9.56°), and the mean difference between the rHVA and pMMP was 0.53°±4.4° (range, ‐9.76° to 8.22°). There was a strong positive correlation between both photographic methods and radiographic measurements (rho = 0.809, p = 0.001 and rho = 0.872, p = 0.001). In the Bland Altman plot, the upper and lower LOAs (95%CI) ranged from − 10.11° to 9.93° for rHVA and pHVA, and from − 8.26° to 9.33° for rHVA and pMMP. Linear regression analysis showed a proportional bias for pHVA but not for the pMMP (p:0.010 versus p:0.633, respectively). The range of the mean difference (prediction interval) between the pMMP and rHVA was 17.59° and 20° for pHVA and rHVA. Simple linear regression showed that the rHVA was predicted by the following equation: rHVA = 4.73 + 0.84 × pMMP (r2 = 0.761, p < 0.001).Conclusions: Although measuring HVA through smartphone photographs is reliable, it is not a valid prediction method.Level of evidence: Level II, diagnostic assessment.

Purpose: The purpose of this study was to investigate how the choice of axial CT level affects the reliability and diagnostic accuracy of the Dejour classification for trochlear dysplasia and to evaluate a novel level defined at the most superior extent of the Blumensaat line. Materials and methods: Patients who presented with patellar instability or acute patellar dislocation between 2014 and 2024 and had preoperative CT scans were retrospectively reviewed. Fifty patients were randomly selected based on an a priori sample size calculation. For each knee, four axial CT levels were reconstructed: midpatellar level, Roman arc level, 3 cm above the joint line, and the top of the Blumensaat line. A consensus Dejour grade (A–D) was established by an experienced musculoskeletal radiologist and an orthopedic sports surgeon and used as the reference standard. Two orthopedic surgeons independently graded all 200 axial images twice at least 15 days apart. Quadratic weighted kappa (κ) with 95% confidence intervals (CI) was used to assess intra- and inter-observer reliability and agreement with the consensus. Diagnostic accuracy was defined as the proportion of correctly classified cases relative to the consensus and was compared across levels using Cochran’s Q test. Results: When all four levels were combined, intra-observer reliability was almost perfect for both observers (κ = 0.96 and 0.84; exact agreement 91% and 84%), and inter-observer reliability was substantial to almost perfect (κ = 0.72 and 0.78; exact agreement 72–73%). Agreement with the consensus across all levels was moderate (κ = 0.52–0.58; exact agreement 51–52%). Analyzing levels separately, intra-observer κ remained high at all levels, whereas inter-observer agreement and agreement with the consensus varied markedly. The midpatellar level showed only moderate inter-observer reliability and fair-to-moderate agreement with the consensus (κ = 0.36; accuracy 34–40%), whereas the top of the Blumensaat line showed the highest agreement with the consensus (κ 0.69) and the highest accuracy (up to 64%; pooled 61%); however, statistically significant between-level differences were detected in only one observer–time comparison. The 3 cm above the joint line and the Roman arc level demonstrated intermediate performance. Conclusions: Although intra-observer reliability of the Dejour classification is high regardless of axial CT level, both inter-observer agreement and diagnostic accuracy depend strongly on the selected slice. The axial CT level at the top of the Blumensaat line showed a consistent trend toward higher agreement and accuracy relative to the consensus standard and may be used as a standardized reference slice within routine multi-slice CT assessment to improve reproducibility; however, it should complement comprehensive imaging review and clinical evaluation.

Aim: This retrospective analysis aimed to evaluate the comparative efficacy of osteochondral autologous transplantation (OAT) versus autologous matrix-induced chondrogenesis (AMIC) in the management of osteochondral lesions of the talus (OLT). Materials and Methods: In this retrospective cohort study, 55 individuals (24 males, 31 females) with an average age of 40.7 ± 12.6 years (range 18-66 years) were included. The study assessed 59 ankles in total due to 4 patients undergoing bilateral procedures at separate intervals. Of these, 22 were treated using AMIC and 37 received OAT. Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scale preoperatively and at the latest follow-up. The Lysholm Knee Score was utilized for evaluating knee function in patients subjected to OAT. Serial radiographic examinations of the ankle were conducted to assess osteotomy union, reduction loss, graft subsidence, and progression of osteoarthritis (OA) using the Kellgren-Lawrence grading system for post-treatment OA evaluation. Results: Comparative analysis revealed no statistically significant differences between AMIC and OAT in terms of improvement in AOFAS scores (p=0.467), progression of OA (p=0.141), or complication rates (p=0.373). Conclusion: Both AMIC and OAT present as effective therapeutic options for OLT, with comparable success rates and outcomes.