Supramalleolar Osteotomies

Chopra, Varun; Sabatier, Paul; Ng, Alan

doi:10.1016/j.cpm.2017.05.003

Cited by 21 publications

(17 citation statements)

References 33 publications

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“…Therefore, for ankle OA, surgery should be performed as soon as possible. Supermalleolar osteotomy can treat varus and valgus ankle OA; its purpose is to restore the alignment, correct the deformity, and redistribute the load in the ankle joint, thereby improving the biomechanics of the lower limbs and delaying the progression of ankle OA …”

Section: Discussionmentioning

confidence: 99%

3D Printing-Assisted Supramalleolar Osteotomy for Ankle Osteoarthritis

et al. 2022

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Ankle osteoarthritis (OA) is an important factor that causes pain and dysfunction after ankle joint movement. In early and mid-term ankle OA, supramalleolar osteotomy can delay the progression of disease and maximize the preservation of ankle joint function. Three-dimensional printing (3DP) technology has brought us new hope, which can improve the accuracy of osteotomy, reduce the number of fluoroscopy, reduce the amount of blood loss, and achieve personalized and accurate treatment. The data of 16 patients with ankle OA in our center from January 2003 to July 2020 were retrospectively analyzed and divided into the 3DP group and the traditional group according to different treatment methods. Seven patients in the 3DP group used the 3DP personalized osteotomy guide; nine patients were treated by traditional osteotomy. All patients were followed up for 13.9 ± 3.1 months after the operation. The operation time in the 3DP group was 126.4 ± 11.1 min, its intraoperative blood loss was 85.7 ± 24.1 mL, and its intraoperative fluoroscopy time was 2.4 ± 0.2, which were all significantly less than 167.3 ± 12.2 min, 158.3 ± 22.8 mL, and 5.8 ± 0.2 times in the traditional group (P < 0.05), respectively. In the 3DP group, its postoperative tibial anterior surface (TAS) angle was 90.6 ± 0.3° and the talar tilt (TT) angle was 2.2 ± 0.6°, which were all significantly different compared with its preoperative data of 83.4 ± 1.7 and 8.0 ± 1.5°, respectively (P < 0.05). Compared with traditional osteotomy, 3DP-assisted supramalleolar osteotomy for varus and valgus ankle OA can significantly shorten the operation time and reduce intraoperative bleeding and the frequency of intraoperative fluoroscopy; personalized 3DP osteotomy guides and models can assist in the accurate correction of varus deformity during operation, restore the lower limb alignment, and improve the biomechanical status of the lower limbs. In addition, the 3DP of porous tantalum has good histocompatibility, and its interface structure and porosity are more conducive to bone ingrowth. For complex bone defects and revision prostheses, matching implants can be printed individually, which could realize the personalized precise treatment.

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Section: Discussionmentioning

confidence: 99%

3D Printing-Assisted Supramalleolar Osteotomy for Ankle Osteoarthritis

et al. 2022

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“…Gross et al noted a prognostic indicator and worse outcome once there was a cystic lesion or the lesion was bipolar (kissing lesion in both side), so the surgeon should be cautious once this type of lesion is there [39]. Complications have been stated as rare [40]. The malunion or nonunion rate is up to 22% [40].…”

Section: Discussionmentioning

confidence: 99%

“…Complications have been stated as rare [40]. The malunion or nonunion rate is up to 22% [40]. Infection and wound healing problems have an incidence reported of up to 22% [40].…”

Section: Discussionmentioning

confidence: 99%

Joint-Preserving Surgery in Varus Ankle Osteoarthritis

Alajlan

Santini

Alsayel

et al. 2022

JCM

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Ankle deformity is a disabling condition especially if concomitant with osteoarthritis (OA). Varus ankle OA is one of the most common ankle OA deformities. This deformity usually leads to unequal load distribution in the ankle joint and decreases joint contact surface area, leading to a progressive degenerative arthritic situation. Varus ankle OA might have multiple causative factors, which might present as a single isolated factor or encompassed together in a single patient. The etiologies can be classified as post-traumatic (e.g., after fractures and lateral ligament instability), degenerative, systemic, neuromuscular, congenital, and others. Treatment options are determined by the degree of the deformity and analyzing the pathology, which range from the conservative treatments up to surgical interventions. Surgical treatment of the varus ankle OA can be classified into two categories, joint-preserving surgery (JPS) and joint-sacrificing surgery (JSS) as total ankle arthroplasty and ankle arthrodesis. JPS is a valuable treatment option in varus ankle OA, which should not be neglected since it has showed a promising result, optimizing biomechanics and improving the survivorship of the ankle joint.

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“…The main cause of such deformities and concomitant asymmetric joint degeneration is post-traumatic instability of the joint [ 46 ]. Depending on the level of deformity, type of fixation, soft tissue covering, and joint presentation (congruent/incongruent), different types of osteotomies can be used [ 47 ]. Alternatively, technically more demanding multiplanar dome-shaped osteotomy ( Figure 7 ) may preserve the congruity of the joint better than wedge osteotomies [ 48 ].…”

Section: Preservationmentioning

confidence: 99%

The Surgical Treatment of Osteoarthritis

Brumat

Kunšič

Novak

et al. 2022

Life

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Osteoarthritis is a degenerative condition affecting the whole joint with the underlying bone, representing a major source of pain, disability, and socioeconomic cost worldwide. Age is considered the strongest risk factor, albeit abnormal biomechanics, morphology, congenital abnormality, deformity, malalignment, limb-length discrepancy, lifestyle, and injury may further increase the risk of the development and progression of osteoarthritis as well. Pain and loss of function are the main clinical features that lead to treatment. Although early manifestations of osteoarthritis are amenable to lifestyle modification, adequate pain management, and physical therapy, disease advancement frequently requires surgical treatment. The symptomatic progression of osteoarthritis with radiographical confirmation can be addressed either with arthroscopic interventions, (joint) preservation techniques, or bone fusion procedures, whereas (joint) replacement is preferentially reserved for severe and end-stage disease. The surgical treatment aims at alleviating pain and disability while restoring native biomechanics. Miscellaneous surgical techniques for addressing osteoarthritis exist. Advanced computer-integrated surgical concepts allow for patient personalization and optimization of surgical treatment. The scope of this article is to present an overview of the fundamentals of conventional surgical treatment options for osteoarthritis of the human skeleton, with emphasis on arthroscopy, preservation, arthrodesis, and replacement. Contemporary computer-assisted orthopaedic surgery concepts are further elucidated.

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Supramalleolar Osteotomies

Cited by 21 publications

References 33 publications

3D Printing-Assisted Supramalleolar Osteotomy for Ankle Osteoarthritis

3D Printing-Assisted Supramalleolar Osteotomy for Ankle Osteoarthritis

Joint-Preserving Surgery in Varus Ankle Osteoarthritis

The Surgical Treatment of Osteoarthritis

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