A Barg1,2, M Wiewiorski3, J Paul4, M Wurm5, M Jacxsens6,7, K Nykytina6, V Valderrabano8. 1. Orthopädische Klinik, Universität Utah, 590 Wakara Way, 84108, Salt Lake City, UT, USA. alexej.barg@hsc.utah.edu. 2. Harold K. Dunn Orthopädisches Forschungslabor, Orthopädische Klinik, Universität Utah, Salt Lake City, UT, USA. alexej.barg@hsc.utah.edu. 3. Klinik für Orthopädie und Traumatologie, Kantonsspital Winterthur, Winterthur, Schweiz. 4. Klinik für Orthopädie und Sportmedizin, Rennbahnklinik, Muttenz, Schweiz. 5. Abteilung für Sportorthopädie, Klinikum Rechts der Isar, Technische Universität München, München, Deutschland. 6. Harold K. Dunn Orthopädisches Forschungslabor, Orthopädische Klinik, Universität Utah, Salt Lake City, UT, USA. 7. Orthopädische Klinik, Universität Basel, Basel, Schweiz. 8. Orthopädie-Traumatologie, Schmerzklinik Basel, Genolier Swiss Private Clinic Group GSMN, Basel, Schweiz.
Abstract
BACKGROUND: The main indication for the supramalleolar osteotomy is asymmetric ankle osteoarthritis with concomitant supramalleolar valgus or varus deformity. The aim of this prospective study was to analyze short-term clinical and radiographic outcomes in patients with asymmetric ankle osteoarthritis. METHODS: A total of 16 patients with asymmetric ankle osteoarthritis and concomitant supramalleolar deformity - 7 patients with valgus deformity, 9 patients with varus deformity - were treated. Intraoperative and postoperative complications were recorded and analyzed. The clinical and radiographic outcomes were assessed after a mean follow-up of 3.6 ± 1.1 years. RESULTS: In 10 of 16 patients, removal of hardware was performed. The AOFAS hindfoot score increased significantly after surgery. All categories of the SF-36 score showed significant improvement. The average range of motion also increased significantly. Radiographic assessment showed neutral hindfoot alignment at the latest follow-up. The postoperative clinical outcomes were comparable in both patient groups. The time until complete osseous union was significantly longer in patients with opening wedge osteotomy. CONCLUSION: This prospective study demonstrated encouraging short-term results in patients with asymmetric ankle osteoarthritis who underwent supramalleolar osteotomy. In progressive ankle osteoarthritis, joint-nonpreserving treatment options including total ankle replacement or ankle arthrodesis should be discussed.
BACKGROUND: The main indication for the supramalleolar osteotomy is asymmetric ankle osteoarthritis with concomitant supramalleolar valgus or varus deformity. The aim of this prospective study was to analyze short-term clinical and radiographic outcomes in patients with asymmetric ankle osteoarthritis. METHODS: A total of 16 patients with asymmetric ankle osteoarthritis and concomitant supramalleolar deformity - 7 patients with valgus deformity, 9 patients with varus deformity - were treated. Intraoperative and postoperative complications were recorded and analyzed. The clinical and radiographic outcomes were assessed after a mean follow-up of 3.6 ± 1.1 years. RESULTS: In 10 of 16 patients, removal of hardware was performed. The AOFAS hindfoot score increased significantly after surgery. All categories of the SF-36 score showed significant improvement. The average range of motion also increased significantly. Radiographic assessment showed neutral hindfoot alignment at the latest follow-up. The postoperative clinical outcomes were comparable in both patient groups. The time until complete osseous union was significantly longer in patients with opening wedge osteotomy. CONCLUSION: This prospective study demonstrated encouraging short-term results in patients with asymmetric ankle osteoarthritis who underwent supramalleolar osteotomy. In progressive ankle osteoarthritis, joint-nonpreserving treatment options including total ankle replacement or ankle arthrodesis should be discussed.
Authors: Alexej Barg; Michael D Harris; Heath B Henninger; Richard L Amendola; Charles L Saltzman; Beat Hintermann; Andrew E Anderson Journal: Foot Ankle Int Date: 2012-08 Impact factor: 2.827
Authors: Charles L Saltzman; Michael L Salamon; G Michael Blanchard; Thomas Huff; Andrea Hayes; Joseph A Buckwalter; Annunziato Amendola Journal: Iowa Orthop J Date: 2005