Mid- to Long-term Clinical Outcome and Gait Biomechanics After Realignment Surgery in Asymmetric Ankle Osteoarthritis

Nüesch, Corina; Huber, Cora; Paul, Jochen; Henninger, Heath B.; Pagenstert, Geert; Valderrábano, Víctor; Barg, Alexej

doi:10.1177/1071100715577371

Cited by 33 publications

(28 citation statements)

References 83 publications

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“…Some authors reported a significant decrease of the TT 4,10,13,18,19 ; however, some did not. 1,12,14,27 Tanaka et al 27 reported that in all patients with a preoperative TT greater than 10 degrees, the joint space did not improve to normal.…”

Section: Discussionmentioning

confidence: 96%

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Supramalleolar Osteotomy With or Without Fibular Osteotomy for Varus Ankle Arthritis

Zhao

Liang

et al. 2016

Foot Ankle Int.

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Section: Discussionmentioning

confidence: 96%

“…The talar tilt angle was completely corrected postoperatively (from 14.5 to 1.2 degrees), and the tibiocrural angle also was well corrected. ‡References 1,3,4,7,8,10,[12][13][14][15][18][19][20]24,26,27. …”

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confidence: 99%

Supramalleolar Osteotomy With or Without Fibular Osteotomy for Varus Ankle Arthritis

Zhao

Liang

et al. 2016

Foot Ankle Int.

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“…The role of TT in SMOT is highly controversial. Some authors have reported a significant decrease of the TT [4, 7, 8, 11, 17]; however, others have not [3, 12, 15, 19]. Tanaka et al [12] reported that in all patients with a preoperative TT greater than 10°, the joint space did not return to normal.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported that SMOT could restore the weight-bearing alignment of the ankle joint [3–5], decrease the contact pressure of the medial part of the tibiotalar joint [6], restore the congruence of the tibiotalar joint surface [5, 7, 8], improve the chondromalacia [9], postpone the OA progress [10], and even reverse the radiological ankle OA stages [2, 9, 11, 12]. …”

Section: Introductionmentioning

confidence: 99%

The role of fibular for supramalleolar osteotomy in treatment of varus ankle arthritis: a biomechanical and clinical study

Zhao

Liang

et al. 2016

J Orthop Surg Res

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BackgroundSupramalleolar osteotomy (SMOT) is a well-accepted treatment method for mid-stage varus ankle osteoarthritis (OA). However, few studies have examined the role of fibular osteotomy in SMOT. The objective of the current study was to compare the biomechanical and clinical outcomes of SMOT with and without fibular osteotomy.MethodsEight cadaveric lower legs with 10° varus/valgus SMOT models were tested using a Tekscan ankle sensor. Tibiotalar joint contact with and without fibular osteotomy conditions were compared. Forty-one varus ankle OA patients treated with SMOT were included; 22 underwent fibular osteotomy, and 19 did not. The Maryland foot score and radiological angles were used for clinical evaluation.ResultsThe mean contact area and pressure did not differ significantly between normal and varus/valgus conditions with the fibula preserved. After fibular osteotomy, the mean contact area decreased and the mean contact pressure increased significantly in varus and valgus conditions (P < 0.01). The loading center moved to the opposite direction with and without fibular osteotomy in varus/valgus conditions. After a mean follow-up of 36.6 months (range 17–61), there was no significant difference in the Maryland scores of the two groups. However, in the fibular osteotomy group, the talar tilt angle decreased (P < 0.05), and the tibiocrural angle improved significantly (P < 0.01).ConclusionsFibular osteotomy facilitates the translation of tibiotalar contact pressure and is helpful for varus ankle realignment in patients with large talar tilts and small tibiocrural angles.

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“…Supramalleolar osteotomy (SMOT) is an effective procedure for the treatment of midstage asymmetric ankle osteoarthritis [1][2][3][4]. Related studies have proved that the key factors affecting the postoperative curative effect of SMOT are the postoperative ankle Takakura stage [5], lower limb power line [6] and ankle angles [7]; but SMOT uses conventional operation (CO) method often does not perfectly accomplish these surgical aims leading to some patients have unsatisfactory outcomes [8,9].…”

Section: Introductionmentioning

confidence: 99%

Simulated operation combines patient-specific guide technology is superior to conventional technology for supramalleolar osteotomy: a retrospective comparative study

Wang

et al. 2020

Preprint

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Background: Over the past seven years, our team has designed a simulated operation combines patient-specific guide (SO-PSI) assisted supramalleolar osteotomy (SMOT) method and applied it to the clinic. This study aimed to determine the difference between SO-PSI technology and conventional operation (CO) technology for SMOT in preoperative planning, intraoperative application and postoperative curative effect. Methods: We retrospectively analyzed the data of SMOT in our hospital between October 2014 and December 2018; 28 patients were enrolled and divided into CO group (n=17) and SO-PSI group (n=11); the mean follow-up time was 33.4 (range, 13 to 59) months. We analyzed and compared perioperative data, accuracy of preoperative planning and intraoperative application, difference between pre- and post-operative of radiologic ankle angles, and change of AOFAS score, VAS, range of motion of ankle and Takakura stage after operation. Then we performed statistical analyses. Results: All ankle alignments and positions of two groups have been recovered. Compared with CO group, SO-PSI group has a shorter operative time and a postoperative hospital stay, a decreased number of fluoroscopies and a reduction of albumin, a longer preoperative planning time and a preoperative hospital stay and an increased hospitalization expenses. In SO-PSI group, the ankle angles between preoperative planning and postoperative shown good correlation, but not in CO group; the mean tibial ankle center discrepancy of SO-PSI group was 1.86±1.06 mm. After follow-up, all radiologic parameters of two groups significantly improved, but the improvement of tibial anterior surface angle and tibiotalar tilt angle of SO-PSI group were more obvious than that of CO group; AOFAS score, VAS, range of motion of ankle and Takakura stage of two groups improved after operation; but overall the improvements of SO-PSI group were better than the CO group. Conclusions: SO-PSI technology can carry out the preoperative plan accurately and quickly in SMOT; In general, compared with the conventional technology, SO-PSI technology has advantages in preoperative planning, intraoperative application and postoperative curative effect. Keywords: Supramalleolar osteotomy; Simulated operation; Patient-specific guide; Accuracy of preoperative planning; Practicability of application

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Mid- to Long-term Clinical Outcome and Gait Biomechanics After Realignment Surgery in Asymmetric Ankle Osteoarthritis

Abstract: Level III, comparative study.

Cited by 33 publications

References 83 publications

Supramalleolar Osteotomy With or Without Fibular Osteotomy for Varus Ankle Arthritis

Supramalleolar Osteotomy With or Without Fibular Osteotomy for Varus Ankle Arthritis

The role of fibular for supramalleolar osteotomy in treatment of varus ankle arthritis: a biomechanical and clinical study

Simulated operation combines patient-specific guide technology is superior to conventional technology for supramalleolar osteotomy: a retrospective comparative study

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