Supramalleolar Osteotomy for Ankle Varus Deformity Alters Subtalar Joint Alignment

Burssens, Arne; Susdorf, Roman; Krähenbühl, Nicola; Peterhans, Ursina; Ruiz, Roxa; Barg, Alexej; Hintermann, Beat

doi:10.1177/10711007221108097

Cited by 17 publications

(3 citation statements)

References 67 publications

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“…Meanwhile, earlier-stage ankle OA is often asymmetric, involving only part of the joint surface [ 3 ]. Therefore, many clinicians have recently attempted joint-preserving surgery, such as supramalleolar osteotomy, but the clinical outcomes were not always satisfactory [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Hindfoot motion according to subtalar compensation and ankle osteoarthritis stage analyzed by a multi-segment foot model

Kang,

Kim,

Kim

et al. 2024

J Orthop Surg Res

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Background The biomechanics of the hindfoot in ankle osteoarthritis (OA) are not yet fully understood. Here, we aimed to identify hindfoot motion in a gait analysis using a multi-segment foot model (MFM) according to ankle OA stage and the presence of subtalar compensation defined by hindfoot alignment. Methods We retrospectively reviewed the medical records, plain radiographs, and gait MFM data of 54 ankles admitted to our hospital for the treatment of advanced ankle OA. Spatiotemporal gait parameters and three-dimensional motions of the hindfoot segment were analyzed according to sex, age, body mass index, Takakura classification, and the presence of subtalar compensation. Twenty ankles were categorized as compensated group, and 34 ankles as decompensated group. Results No spatiotemporal gait parameters differed significantly according to the presence of subtalar compensation or ankle OA stage. Only normalized step width differed significantly (P = 0.028). Average hindfoot motion (decompensation vs. compensation) did not differ significantly between the sagittal and transverse planes. Graphing of the coronal movement of the hindfoot revealed collapsed curves in both groups that differed significantly. Compared with Takakura stages 3a, 3b, and 4, cases of more advanced stage 3b had a smaller sagittal range of motion than those of stage 3a (P = 0.028). Coronal movement of the hindfoot in cases of Takakura stage 3a/3b/4 showed a relatively flat pattern. Conclusions The spatiotemporal parameters were not affected by the hindfoot alignment resulting from subtalar compensation. The sagittal range of hindfoot motion decreased in patients with advanced ankle OA. Once disrupted, the coronal movement of the subtalar joint in ankle OA did not change regardless of ankle OA stage or hindfoot compensation state.

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Section: Introductionmentioning

confidence: 99%

Hindfoot motion according to subtalar compensation and ankle osteoarthritis stage analyzed by a multi-segment foot model

Kang,

Kim,

Kim

et al. 2024

J Orthop Surg Res

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“…For this reason, semiautomated measurements are often used to assess complex 3-dimensional (3D) anatomy. 1,5,9 The 3D software can automatically measure the angle between bone axes after the manual registration of the bones. Sangoi et al 18 assessed differences in measurements done manually on 2D slices of WBCT vs 3D computer models in cavus feet.…”

Section: Introductionmentioning

confidence: 99%

3D Analysis of Joint-Sparing Charcot-Marie-Tooth Surgery Effect on Initial Standing Foot Alignment

Song,

Michalski,

Pfeffer

2024

Foot Ankle Int.

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Background: The complex deformities in cavovarus feet of Charcot-Marie-Tooth (CMT) disease are difficult to evaluate. The aim of this study was to quantify the initial standing alignment correction achieved after joint-sparing CMT cavovarus reconstruction using pre- and postoperative weightbearing computed tomography (WBCT). Methods: Twenty-nine CMT cavovarus reconstructions were retrospectively analyzed. Three-dimensional measurements were performed using semiautomated software (Bonelogic 2.1) to investigate changes in sagittal, axial, and coronal parameters. Pre- and postoperative data were compared, along with normative data. Correlation among the preoperative measurements and the amount of correction in sagittal, axial, and coronal parameters were analyzed. Results The sagittal, axial, and coronal malalignment of the hindfoot, and the sagittal and axial malalignment of the forefoot, was significantly improved after corrective surgery ( P < .05). Sagittal Meary angle (from 14.8 to 0.1 degrees), axial talonavicular angle (TNA, from 3.6 to 19.2 degrees), and coronal hindfoot alignment (from 11.0 to −11.1 degrees) showed significant changes postoperatively ( P < .001). Hindfoot, forefoot sagittal, and forefoot axial parameters reached comparable outcomes compared with normative value ( P > .05). Regarding amount of correction, Spearman correlation demonstrated that axial Meary angle and TNA were most strongly related to improvement in sagittal Meary angle and coronal hindfoot alignment. Conclusion: Preoperative and postoperative WBCT measurements demonstrated that joint sparing CMT cavovarus reconstruction significantly improved sagittal, axial, and coronal deformities of CMT, and sagittal Meary angle was restored toward normative values. Apparent axial plane correction, the majority of which occurred at the talonavicular joint, had the strongest correlation with deformity correction in multiple planes. This suggests that soft tissue releases and correction of the talonavicular joint may be a key component of a cavovarus foot correction. Level of Evidence: Level IV, retrospective case series.

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“…To the best of our knowledge, SMOT has been shown to be effective in the correction of varus and valgus deformities of the ankle in adults and in the treatment of ankle arthritis [ 7 , 8 ], and it helps improve patients' quality of life [ 9 ]; nevertheless, there are not many reports on the efficacy of SMOT for the treatment of TAVD in adolescents at the developmental stage; therefore, the aim of this study was to retrospectively analyze the clinical data on the application of SMOT for the treatment of TAVD in adolescents at our institution and to evaluate the radiological and clinical outcomes of SMOT for the treatment of TAVD in adolescents.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of supramalleolar osteotomy in the treatment of traumatic ankle joint varus deformity in adolescents

Zhao,

Liu,

Zhao

et al. 2023

J Orthop Surg Res

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Background Supramalleolar osteotomy (SMOT) has emerged as a valuable treatment for ankle varus deformity; however, there are fewer reports of treatment outcomes in adolescents. The purpose of this study was to investigate the radiologic and clinical outcomes of SMOT for the treatment of traumatic ankle joint varus deformity (TAVD) in adolescents. Methods We reviewed 32 adolescent cases who underwent SMOT between February 2017 and February 2022 for TAVD. Radiologic assessment included tibial anterior surface angle (TAS), talar tilt angle (TT), and tibial lateral surface angle (TLS) preoperatively and at 3 months and 12 months postoperatively, and clinical assessment was performed using American Orthopaedic Foot and Ankle Society (AOFAS) scores, Visual Analogue Scale (VAS) scores, and ankle dorsiflexion–plantarflexion ROM including preoperative and 6 months postoperative and 12 months postoperative. Results All 32 patients were followed up completely with a mean follow-up of (20.3 ± 3.2) months. From the radiologic outcomes, the mean preoperative TAS improved from 61.53 ± 3.74 to 88 ± 1.72 at 12 months postoperatively, the mean preoperative TT decreased from 2.25 ± 1.32 to 0.5 ± 0.57 at 12 months postoperatively, the mean preoperative TLS improved from 76.72 ± 0.21 to 79.34 ± 1.52 at 12 months postoperatively, the differences between the above preoperative and 12 months postoperative radiologic outcomes were statistically significant (p < 0.05), the mean preoperative AOFAS score improved from 65.5 ± 9.40 to 92.34 ± 4.00 at 12 months postoperatively, the mean preoperative VAS score decreased from 2.44 ± 1.24 to 0.78 ± 0.75 at 12 months postoperatively, and the mean preoperative range of motion (ROM) of ankle improved from 50.16 ± 7.46 to 55.78 ± 4.77 at 12 months postoperatively. The differences between the above preoperative and 12 months postoperative clinical results were statistically significant (p < 0.05). Conclusion Our study demonstrated that SMOT was effective in correcting TAVD and significantly improving ankle function in adolescents, and that it is an efficient and successful method for restoring ankle joint congruence and normal hindfoot alignment.

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Supramalleolar Osteotomy for Ankle Varus Deformity Alters Subtalar Joint Alignment

Cited by 17 publications

References 67 publications

Hindfoot motion according to subtalar compensation and ankle osteoarthritis stage analyzed by a multi-segment foot model

Hindfoot motion according to subtalar compensation and ankle osteoarthritis stage analyzed by a multi-segment foot model

3D Analysis of Joint-Sparing Charcot-Marie-Tooth Surgery Effect on Initial Standing Foot Alignment

Efficacy of supramalleolar osteotomy in the treatment of traumatic ankle joint varus deformity in adolescents

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