Osteotomien zur Entlastung der Varusarthrose im oberen Sprunggelenk

Knupp, Markus; Pagenstert, Geert; Valderrábano, Víctor; Hintermann, Beat

doi:10.1007/s00064-008-1308-9

Cited by 50 publications

(3 citation statements)

References 15 publications

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“…Valgus feet are corrected with a medial closing wedge osteotomy. 2,3 If the talus is extruded anteriorly out of the mortise, the correction is conducted in a biplanar fashion, e. g. additional anterior opening or posterior closing wedge, to improve talar coverage in the anteroposterior direction. 1 In all osteotomies, the aim is an overcorrection of the TAS angle of 3 to 5 degrees.…”

Section: Surgical Techniquementioning

confidence: 99%

Treatment of Asymmetric Arthritis of the Ankle Joint with Supramalleolar Osteotomies

Knupp

Hintermann²

2012

Foot Ankle Int.

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Section: Surgical Techniquementioning

confidence: 99%

Treatment of Asymmetric Arthritis of the Ankle Joint with Supramalleolar Osteotomies

Knupp

Hintermann²

2012

Foot Ankle Int.

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“…A medial opening-wedge osteotomy may not be feasible in patients with a preoperative varus malalignment of more than 10° as the fibula may restrict the degree of overcorrection as well as the medial soft-tissue compromise due to excessive widening of the medial osteotomy gap of the distal tibia. 17) In case of a large degree of varus correction, an anterior crescentic osteotomy can be performed to correct by rotation. The lateral closing-wedge osteotomy involves a lateral wedge closing osteotomy or a fibula osteotomy.…”

Section: Surgical Techniquesmentioning

confidence: 99%

“… 18) There is considerably less flexibility in the straight transverse fibular osteotomy, which can result in fibular malposition. 17 19) Kirschner wires are drilled into the tibia in the preoperatively defined direction after the fibula is removed. The periosteum is incised and elevated after testing of the Kirschner wire position by fluoroscopy.…”

Section: Surgical Techniquesmentioning

confidence: 99%

Supramalleolar Distal Tibiofibular Osteotomy for Medial Ankle Osteoarthritis: Current Concepts

Lacorda¹,

Jung

2020

Clin Orthop Surg

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The supramalleolar osteotomy is a joint-preserving surgical procedure. It is a very good treatment option for the asymmetric varus ankle and medial compartment osteoarthritis. The primary objective of the procedure is to shift medial concentration of stress toward the lateral intact articular cartilage to redistribute the joint loads during ambulation. Several studies have shown that deformities of the ankle result in uneven load distribution in the ankle joint, which eventually leads to articular cartilage degeneration. Since the lateral articular cartilage is intact, joint-sacrificing procedures such as total ankle replacement or ankle arthrodesis are not the most appropriate treatment choices for medial compartment arthritis. Results of supramalleolar osteotomies are very promising in terms of functional outcome and pain relief. In younger patients with medial compartment varus ankle osteoarthritis or even with a normal tibial anterior surface angle, supramalleolar osteotomies can be performed to realign the ankle to promote regeneration of the asymmetrically damaged cartilage. In this review article, we will discuss the indications, complications, surgical techniques, and outcomes of the supramalleolar osteotomy reported in the current literature.

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Changes of density distribution of the subchondral bone plate after supramalleolar osteotomy for valgus ankle osteoarthritis

et al. 2014

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CT-osteoabsorptiometry (CT-OAM) has been used to visualize subchondral bone plate density distribution regarding to its mineralization. The purpose of this study was to display and analyze the density distribution of the subchondral bone plate before and after supramalleolar realignment osteotomies. We retrospectively analysed pre-and postoperative CT images of nine consecutive patients with post-traumatic unilateral valgus ankle OA. The distribution charts of CT-OAM scans were quantitatively analyzed for subchondral bone plate density distribution. VAS for pain and the Tegner activity scale were used to assess clinical outcome. At a mean follow-up of 20 AE 5.6 months (range 13-27), we observed a significant pre-to postoperative decrease of the mean high-density area ratio in tibia (lateral and posterior area) (p 0.05) and the talus (lateral area) (p 0.05). Pairwise comparison between the pre-and postoperative mineralization at the articular surface showed a significant decrease of the high-density area ratio for the tibia and the talus. The VAS decreased from 6.2 AE 0.9 pre-to 2.8 AE 0.9 postoperatively (p ¼ 0.027), and the Tegner score inclined from 4.5 AE 1.1 preoperatively to 5.3 AE 0.7 after surgery (p ¼ 0.082). The tibial and talar subchondral bone plate density, regarding to its mineralization, decreased after supramalleolar medial closing wedge osteotomy in patients with valgus ankle OA. The results of this study suggest that realignment surgery may decrease peak bone density areas corresponding to the alignment correction and contribute to a homogenization of the subchondral bone plate mineralization. ß

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Osteotomien zur Entlastung der Varusarthrose im oberen Sprunggelenk

Cited by 50 publications

References 15 publications

Treatment of Asymmetric Arthritis of the Ankle Joint with Supramalleolar Osteotomies

Treatment of Asymmetric Arthritis of the Ankle Joint with Supramalleolar Osteotomies

Supramalleolar Distal Tibiofibular Osteotomy for Medial Ankle Osteoarthritis: Current Concepts

Changes of density distribution of the subchondral bone plate after supramalleolar osteotomy for valgus ankle osteoarthritis

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