About

Erin F. Alaia, MD, is a musculoskeletal radiologist with expertise in magnetic resonance imaging (MRI) for sports injuries and post-operative evaluation. She is an associate professor of radiology and orthopedic surgery at NYU Langone, dedicated to advancing the field of musculoskeletal radiology through collaborative research and education. Her focus is on orthopedic sports MRI, particularly post-operative MRI in patients with sports injuries and MRI of the knee. With more than a decade of experience, she has developed a deep understanding of diagnosing and managing sports-related injuries. Her dual appointment in radiology and orthopedic surgery allows her to bridge the gap between imaging and clinical practice, ensuring a comprehensive approach to patient care. Dr. Alaia is a member of the International Skeletal Society and actively participates in the Society of Skeletal Radiology, the Radiological Society of North America (RSNA), and the American Roentgen Ray Society. She has authored or co-authored over 50 peer-reviewed scientific papers, presented numerous scientific podium presentations at national meetings, and received an RSNA Research Seed Grant in 2022 for her work on the clinical utility of hip and knee MRI in older patients with atraumatic pain. She also peer-reviews scientific manuscripts and serves on the consulting editorial board for Skeletal Radiology. Her journey into medicine was driven by a desire to make a meaningful impact on patients' lives through advanced imaging techniques, and she is committed to fostering a collaborative environment that prioritizes patient wellness, research, and education.

Research topics

• Medicine
• Surgery
• Internal medicine
• Artificial Intelligence
• Medical physics
• Pathology
• Radiology
• Intensive care medicine

Selected publications

• Optimizing Outcomes in Revision Anterior Cruciate Ligament Reconstruction.

  PubMed · 2026-01-01

  other

  Revision anterior cruciate ligament reconstruction, although increasing in incidence, is associated with inferior outcomes compared with primary anterior cruciate ligament reconstruction. Anterior cruciate ligament graft failure is often multifactorial, even in the setting of traumatic anterior cruciate ligament graft tear. Surgeons should assess for technical, biologic, and patient-related risk factors for anterior cruciate ligament graft failure through a comprehensive history, physical examination, and imaging evaluation. It is important to review the causes of anterior cruciate ligament graft failure and provide a framework for preoperative workup and planning to optimize outcomes in revision anterior cruciate ligament reconstruction. Surgical considerations include staging of surgery and graft choice. Indications for concomitant procedures include lateral extra-articular procedures, slope-correcting osteotomy, and meniscus repair or transplantation.

  Publisher

• Donor-recipient sex mismatch does not affect graft survivorship after knee osteochondral allograft transplantation

  The Knee · 2025-06-11 · 1 citations

  article
  PublisherDOI

• OwnTheBone–The Expanding Landscape of Knee-based Osteotomy

  Clinics in Sports Medicine · 2025-05-22

  editorialOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Imaging of Reparable and Irreparable Rotator Cuff Tears

  Seminars in Musculoskeletal Radiology · 2025-02-01

  review

  This review offers a comprehensive discussion of magnetic resonance imaging (MRI) for the assessment of rotator cuff tendon repair and joint-preserving surgical options for patients with irreparable rotator cuff tears. Deciding to proceed with arthroscopic repair of a rotator cuff tendon tear is impacted both by clinical factors and morphological imaging features. Preoperative clinical and imaging features also predict the likelihood of success of a rotator cuff tendon repair and are important to recognize. In patients with irreparable rotator cuff tears and relatively preserved glenohumeral cartilage, various joint-preserving surgical options are available and seen increasingly in clinical practice.The acceptable range of postoperative imaging findings correlating with a functionally intact rotator cuff repaired tendon, and MRI findings that are either suggestive of or definitive for rotator cuff tendon repair failure are discussed in detail, with attention to the Sugaya classification. Ancillary features, such as progressive retraction of the myotendinous junction and the degree of muscle fatty atrophy, can be used as problem-solving tools in cases equivocal for rotator cuff retear. Finally, this review discusses in detail the most common joint-preserving treatment options for patients with irreparable rotator cuff tears, including an in-depth focus on superior capsular reconstruction.

  PublisherDOI

• Technical Tips and Tricks for Knee Osteotomy.

  PubMed · 2025-01-01

  article

  Osteotomies around the knee have a variety of indications, including pain reduction, functional improvement, knee joint stabilization, and articular cartilage preservation. Thorough preoperative planning is essential, including a determination of the precise location of any deformity (proximal tibia, distal femur, or both). High tibial osteotomies and distal femoral osteotomies can be performed in isolation, or jointly in the form of a double-level osteotomy, for correction of coronal and/or sagittal deformity of the knee. There are many technical tips and tricks to simplify these cases for safe and effective execution, including selection of the proper procedure for a given deformity, selection of optimal osteotomy hinge points, and soft-tissue handling for different surgical approaches.

  Publisher

• Poster 166: Effect of Preoperative Bone Marrow Edema on Functional and Patient Reported Outcomes following High Tibial Osteotomy and Distal Femoral Osteotomy

  Orthopaedic Journal of Sports Medicine · 2025-09-01

  articleOpen accessSenior author

  Objectives: High tibial osteotomies (HTOs) and distal femoral osteotomies (DFOs) are used to address lower limb malalignment in the setting of unicompartmental arthritis and/or soft tissue injuries. There is a paucity of research in regards the influence of preoperative bone marrow edema (BME) on outcomes after these procedures. The purpose of this study was to assess the association between preoperative BME on return to sport and patient reported outcomes following high tibial osteotomy and distal femoral osteotomy. Methods: We conducted a retrospective review of 153 knees undergoing primary HTO and DFOs with preoperative MRI’s available at our institution, from 2011 to 2021. BME was evaluated using magnetic resonance imaging (MRI). Preoperative subchondral BME on the tibia and femur was analyzed for the existence, position, extent, and volume of the BME. Associations between preoperative BME and postoperative outcomes at a mean follow-up of 5.36 ± 2.79 were evaluated. Outcomes asses were return to sport (RTS), IKDC, Lysholm, VAS pain, VAS, Tegner score, VAS sports, KOOS Symptoms, KOOS Pain, KOOS ADL,KOOS Sports, and KOOS QoL. Results: The final cohort size was 153 knees undergoing high tibial osteotomy (HTO) or distal femoral osteotomy (DFO). Of these, 108 patients (70.6%) completed patient-reported outcomes (PROs). Among the 153 knees analyzed, 112 knees (73.2%) showed evidence of bone marrow edema in the femur, tibia, or both. The average bone marrow edema volume was 4.2 ± 10.1 cm³ in the femur, 1.6 ± 4.1 cm³ in the tibia, and 5.7 ± 11.2 cm³ combined in the femur and tibia. There was no significant correlation with bone marrow edema and multiple PRO’s or return to sport in the HTO cohort. Nor was there any significant correlation with combined bone marrow edema and PRO’s or return to sport for the HTO cohort. There was no significant correlation with bone marrow edema and multiple PRO’s or return to sport in the DFO cohort. However with increasing bone marrow edema volume in the tibia in the DFO cohort, we found worsened IKDC (β=-1.685, p=0.020), VAS pain (β=1.808, p=0.037), VAS satisfaction (β=-1.685, p=0.020), VAS sports (β=2.297, p=0.015), KOOS Pain (β=- 2.390, p=0.009), and KOOS ADL (β=-2.523, p=0.008) at final follow-up. Conclusions: The present study demonstrated that increasing bone marrow edema volume in the tibia correlated very strongly with decreased PROs in DFO patients. However, preoperative subchondral BME did not influence return to sport in HTO or DFO patients. There was no correlation between patient reported outcomes with the existence, position, extent, and volume of BME in HTO patients. Our findings suggest increasing preoperative bone marrow edema in the tibia may be associated with worse outcomes following DFO.

  PublisherDOI

• Patient-Specific Cutting Guides for Alignment-Correcting Osteotomy About the Knee: A Study of Accuracy, Cost, and Surgical and Fluoroscopic Safety

  Orthopaedic Journal of Sports Medicine · 2025-07-01 · 6 citations

  articleOpen access

  Background: The utility and safety of patient-specific cutting guides (PSCGs) in osteotomies about the knee is uncertain. Purpose: To compare the cost, accuracy of radiographic correction, and safety of PSCG versus standard cutting guide (SCG) corrective osteotomies about the knee. Study Design: Cohort study; Level of evidence, 3. Methods: Patients undergoing high tibial osteotomy (HTO) or distal femoral osteotomy (DFO) were retrospectively reviewed from 2017 to 2022. Those who underwent 3-dimensional PSCG osteotomy were propensity matched to patients undergoing traditional osteotomies. Procedure time and fluoroscopic details were extracted from operative notes. Hip-knee-ankle (HKA) angle, posterior tibial slope (PTS), and mechanical axis deviation were measured on pre- and postoperative radiographs. Intraclass correlation coefficients were calculated to determine the reliability between the intended and resultant correction of HKA. Time-driven activity-based costing (TDABC) analysis was performed to compare procedure costs. Results: A total of 42 patients were included, with 11 HTOs and 10 DFOs in each group. Between the SCG and PSCG groups, respectively, final HKA (2.7° vs 1.9°; P = .36), PTS (9.6° vs 9.0°; P = .79), and mechanical axis deviation (10.2 vs 5.8 mm; P = .21) were similar. The intraclass correlation coefficient between the intended and measured HKA correction was 0.841 (good) in the PSCG group and 0.623 (moderate) in the SCG group. PSCG osteotomies had a mean procedure time that was 18.5 minutes shorter than SCG osteotomies ( P = .39). Fluoroscopy time (43 vs 99 seconds; P < .001), tourniquet time (99.9 vs 116.6; P = .12), and radiation dose (2.9 vs 7.8 mGy; P = .01) were lower in the PSCG group. TDABC analysis demonstrated a total cost of $27,026 for PSCG and $27,100 for SCG. The rate of hinge fractures (9.5% vs 33.3%) and return to the operating room (4.8% vs 19.0%) were lower in the PSCG group, although these differences were nonsignificant. Conclusion: Both traditionally guided osteotomies and PSCG-guided osteotomies accurately corrected lower extremity malalignment. Utilization of PSCG resulted in similar procedure times and cost, as well as less fluoroscopy and lower tourniquet time, compared with conventional osteotomy. PSCG trended toward a decreased rate of postoperative complications.

  PublisherDOI

• Randomized Controlled Trials Evaluating LET and ALL for Anterolateral Rotatory Instability in ACLR Are Fragile: A Systematic Review

  Sports Health A Multidisciplinary Approach · 2025-08-06 · 1 citations

  reviewOpen access

  CONTEXT: Lateral extra-articular tenodesis (LET) and anterolateral ligament (ALL) reconstruction have been adopted by some surgeons as augmentations during anterior cruciate ligament reconstruction (ACLR) to improve anterolateral rotatory instability. OBJECTIVE: The objective of this study was to assess the statistical robustness of outcomes reported in randomized controlled trials (RCTs) assessing the clinical significance of LET and ALL reconstruction in ACLR. METHODS: PubMed, Embase, and MEDLINE were systematically searched. RCTs published January 1, 2010 to December 31, 2024 assessing LET and ALL reconstruction during ACLR were included. Fragility index (FI) or reverse FI (rFI) was calculated for each outcome, representing the number of event reversals required to alter statistical significance for significant and nonsignificant outcomes, respectively. The fragility quotient (FQ) was determined by dividing the FI or rFI by sample size. LEVEL OF EVIDENCE: Level 1. RESULTS: Of 112 RCTs screened for inclusion, 17 were included for analysis, resulting in 51 total outcomes. The median FI across the 51 outcomes was 4 [interquartile range (IQR), 2-7] with an associated median FQ of 0.031 (IQR, 0.014-0.049). Statistically significant outcomes were more fragile (median FI, 3.5; median FQ, 0.015) than statistically nonsignificant outcomes (median rFI, 5; median FQ, 0.038). In 60.8% of all outcomes (31 of 51), the number of patients lost to follow-up was greater than the outcome's respective FI or rFI. In the 7 RCTs assessing LET, the median FQ was 0.015 (IQR, 0.012-0.042) across 23 outcomes. In the 10 RCTs assessing ALL, the median FQ was 0.035 (IQR, 0.019-0.051) across 28 outcomes. Graft failure, pivot shift, and Lachman/anterior laxity were the most common outcome categories reported, with median FQs of 0.017, 0.035, and 0.048, respectively. CONCLUSION: Outcomes reported in RCTs for LET and ALL reconstruction as augments of ACLR are statistically fragile, emphasizing the need for additional robust and adequately powered RCTs to better understand the impact of anterolateral augmentation on ACLR outcomes.

  PublisherOA PDFDOI

• Radiation safety among female orthopaedic surgeons: A survey of current knowledge and practices

  Bulletin of the Hospital for Joint Diseases/Bulletin of the Hospital for Joint Disease · 2025-12-01

  articleOpen accessCorresponding

  BACKGROUND: The objective of this study was to survey a cross-section of US female orthopaedic surgeons evaluating their education and attitudes on radiation safety and adherence to safety recommendations. METHODS: An online survey was distributed to female orthopaedic surgery faculty through the Forum, a society for women in orthopaedic surgery, and through internal institutional education networks (residency and fellowship programs). The first component of the survey gathered demographic information including practice setting, US state, and years in practice. The second component was a 10-question knowledge assessment. The third component captured personal experiences among respondents including satisfaction with radiation safety training, radiation safety practices, and level of concern regarding exposure risk. Responses from 66 participants from differing geographic locations were collected using Research Electronic Data Capture. RESULTS: Sixty-six female orthopaedic surgeons from 21 states completed the survey. Regular dosimeter usage was reported by 24.2% of respondents, and 36.4% of respondents reported always having well-fitted radiation protective equipment provided. The majority (56.1%) stated that they worry about the risks of radiation to their health. Regarding their radiation safety training, 60.6% of respondents rated their training as unsatisfactory or extremely unsatisfactory, and 90.9% of respondents stated that they think training efforts for radiation safety can improve. CONCLUSIONS: Female orthopaedic surgeons demonstrated an inadequate knowledge of adherence to radiation safety protocols and the majority expressed concern with long-term radiation exposure, particularly regarding health and pregnancy risk. To enhance radiation safety awareness and adherence among female orthopaedic surgeons, strategies should be tailored to this demographic, fostering confidence in their knowledge of radiation exposure and bolstering safety measures.

  PublisherDOI

• Feasibility of a UTE Stack‐of‐Spirals Sequence for Biexponential <i>T</i>_1ρ Mapping of Whole Knee Joint

  NMR in Biomedicine · 2025-02-10 · 5 citations

  articleOpen access

  ABSTRACT This study aimed to develop and evaluate a novel magnetization‐prepared, ultra‐short echo time (UTE)‐capable, stack‐of‐spirals sequence (STFL) to quantify monoexponential and biexponential T 1ρ maps of the whole knee joint, addressing limitations of existing MRI techniques in assessing bone‐patellar tendon‐bone (BPTB) donor site healing and graft remodeling after anterior cruciate ligament (ACL) reconstruction (ACLR). Experiments were performed with agar‐gel model phantoms, seven healthy volunteers (four males, average age 31.4 years old), and five ACLR patients (three males, average age 28.2 years old). Compared with a conventional Cartesian turbo fast low angle shot (CTFL) sequence, the STFL sequence demonstrated an improved signal‐to‐noise ratio (SNR), increasing from 16.5 for CTFL to 21.7 for STFL. In ACLR patients, the STFL sequence accurately detected increased fractions of short T 1ρ components within the ACL graft, rising from 0.15 to 0.38, compared with 0.11 to 0.18 with CTFL. Furthermore, the STFL sequence revealed significant decreases in the fraction of short T 1ρ components in the patellar tendon of ACLR patients (from 0.6 to 0.47) compared with healthy controls, whereas no significant changes were observed with the CTFL sequence. These findings suggest that the STFL sequence holds promise for noninvasive assessment of BPTB donor site healing and graft maturation following ACLR.

  PublisherOA PDFDOI

Frequent coauthors

• Laith M. Jazrawi

  Hinge Health

  32 shared

• Michael J. Alaia

  NYU Langone Health

  22 shared

• Zehava Sadka Rosenberg

  NYU Langone Health

  20 shared

• Michael P. Recht

  NYU Langone Health

  18 shared

• William R. Walter

  New York University

  17 shared

• Gregory Chang

  16 shared

• Erin Fitzgerald

  University of Missouri

  16 shared

• Eric J. Strauss

  New York University Langone Orthopedic Hospital

  15 shared

Awards & honors

• RSNA Research Seed Grant (2022)