Treatment of Asymmetric Arthritis of the Ankle Joint with Supramalleolar Osteotomies

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

“…Hindfoot alignment was assessed using the medial distal * References 8,13,28,36,38,42,43,53,70,73. at NORTH DAKOTA STATE UNIV LIB on July 12, 2015 fai.sagepub.com Downloaded from tibial angle 6,72 (normal value, 89-92 degrees), tibiotalar angle 74 (normal value, 91.5 ± 1.2 degrees), and the moment arm of the calcaneus 63 (normal value, -1.6 ± 7.2 mm) ( Table 2). Ankle OA was graded using the classification according to Takakura et al 73 (Table 2).…”

Supramalleolar Osteotomies

“…27,50 Correction of supramalleolar malalignment helps normalize the intra-articular load distribution and thereby diminish excessive asymmetric cartilage load. 51 By manipulating the distal fibula into a varus or valgus position by 1 , the contact area of the tibiotalar joint is reduced by more than 50% showing the importance of the fibula in SMO. 52 Knupp and colleagues 53 evaluated the intra-articular pressures with varying SMOs.…”

“…Recognition of hindfoot malalignment is Algorithm for the Deformed Ankle pivotal because 63% of the patients with ankle joint arthritis present with a malaligned hindfoot. 51,54 Clinical studies examining SMO in patient populations encompassing cerebral palsy, spina bifida, heomophilic, postpronational external rotation ankle fracture malunions, and varus and valgus ankle deformities are prolific throughout the literature with short-to midterm follow-up. SMO's have been found to reduce pain, preserve tibiotalar function, increased American Orthopaedic Foot and Ankle Society scores by an average of 25 points from before operation to after operation with minimal deformity reoccurrence.…”

Hallux valgus, ankle osteoarthrosis and adult acquired flatfoot deformity: a review of three common foot and ankle pathologies and their treatments

“…9,10 Recently, conservative surgery around the ankle, including corrective osteotomies and soft tissues balancing, has gained popularity in treating early- to mid-stage ankle osteoarthritis. 11 …”

“…23,24 Today, conservative surgery has evolved towards a more refined approach including assessment of the type of deformity, the stage of ankle osteoarthritis, the main location of the deformity, and the combination of osseous and soft tissue procedures for morphologic and functional correction. 11 To date, only a few clinical reports are available but their results appear to be promising and, above all, they stimulate research in this field.…”