Short-term effectiveness of calcaneal lateral displacement osteotomy with lateral ligament repair in treatment of Takakura stage Ⅱ varus-type ankle arthritis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SONG Jiafeng , HAN Ce , WANG Zhifeng , GENG Xiang , WANG Chen ,  WANG Xu , MA Xin

Department of Orthopedics, Huashan Hospital Affiliated to Fudan University, Shanghai, 200040, P. R. China;

Corresponding author：

WANG Xu, Email: wangxufoot@163.com

Keywords：

Ankle arthritis; calcaneus; osteotomy; lateral ligament repair

DOI：

10.7507/1002-1892.202301078

Video：

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Objective To investigate the short-term effectiveness of calcaneal lateral displacement osteotomy with lateral ligament repair in the treatment of Takakura stage Ⅱ varus-type ankle arthritis. Methods A retrospective analysis was performed on the clinical data of 13 patients with Takakura stage Ⅱ varus-type ankle arthritis treated with calcaneal lateral displacement osteotomy with lateral ligament repair between January 2016 and December 2020. There were 6 males and 7 females aged 31-65 years, with an average age of 53.6 years. The preoperative tibial-ankle surface angle (TASA) was (88.13±1.01)°, medial distal tibial angle (MDTA) was (86.36±1.49)°, tibial talar surface angle (TTSA) was (6.03±1.63)°, talar tilting angle (TTA) was (81.95±2.15)°, and tibiocalcaneal axis angle (TCAA) was (−5.74±6.81)°. The preoperative American Orthopedic Foot and Ankle Society (AOFAS) score was 56.3±7.1 and the pain visual analogue scale (VAS) score was 3.7±0.5. AOFAS scores, VAS scores, TTSA, TTA, and TCAA were compared between pre- and post-operatively. Results All 13 patients were followed up 14-41 months, with an average of 28.7 months. The osteotomies healed in all patients. The last follow-up revealed TTA, TTSA, and TCAA to be (88.27±1.19)°, (−0.13±1.37)°, and (2.09±5.10)° respectively, the AOFAS score was 84.3±4.2 and the VAS score was 0.7±0.5, all showing significant improvement when compared to preoperative values (P<0.05). Conclusion For patients with Takakura stage Ⅱ varus-type ankle arthritis, calcaneal lateral displacement osteotomy with lateral ligament repair can correct the lower limb force line, regain ankle stability, and achieving good short-term effectiveness.

Citation： SONG Jiafeng, HAN Ce, WANG Zhifeng, GENG Xiang, WANG Chen, WANG Xu, MA Xin. Short-term effectiveness of calcaneal lateral displacement osteotomy with lateral ligament repair in treatment of Takakura stage Ⅱ varus-type ankle arthritis. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(7): 782-787. doi: 10.7507/1002-1892.202301078 Copy

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14.	Kanemitsu M, Nakasa T, Ikuta Y, et al. Characteristic bone morphology change of the subtalar joint in severe varus ankle osteoarthritisJ Foot Ankle Surg2022613627632.
15.	Kang HW, Kim DY, Park GY, et al. Coronal plane calcaneal-talar orientation in varus ankle osteoarthritisFoot Ankle Int2022437928936.
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1. Alajlan A, Santini S, Alsayel F, et al. Joint-preserving surgery in varus ankle osteoarthritisJ Clin Med20221182194.
2. Knupp M, Stufkens SA, Bolliger L, et al. Classification and treatment of supramalleolar deformitiesFoot Ankle Int2011321110231031.
3. Barg A, Pagenstert GI, Hügle T, et alAnkle osteoarthritis: etiology, diagnostics, and classificationFoot Ankle Clin2013183411426.
4. Valderrabano V, Hintermann B, Horisberger M, et al. Ligamentous posttraumatic ankle osteoarthritisAm J Sports Med2006344612620.
5. Tanaka Y, Takakura Y, Hayashi K, et alLow tibial osteotomy for varus-type osteoarthritis of the ankleJ Bone Joint Surg (Br)2006887909913.
6. Myerson MS, Zide JRManagement of varus ankle osteoarthritis with joint-preserving osteotomyFoot Ankle Clin2013183471480.
7. Steffensmeier SJ, Saltzman CL, Berbaum KS, et al. Effects of medial and lateral displacement calcaneal osteotomies on tibiotalar joint contact stressesJ Orthop Res1996146980985.
8. Schmid T, Zurbriggen S, Zderic I, et al. Ankle joint pressure changes in a pes cavovarus model: supramalleolar valgus osteotomy versus lateralizing calcaneal osteotomyFoot Ankle Int201334911901197.
9. Takakura Y, Tanaka Y, Kumai T, et alLow tibial osteotomy for osteoarthritis of the ankleResults of a new operation in 18 patients. J Bone Joint Surg (Br)19957715054.
10. Hayashi K, Tanaka Y, Kumai T, et al. Correlation of compensatory alignment of the subtalar joint to the progression of primary osteoarthritis of the ankleFoot Ankle Int2008294400406.
11. Ohneda Y, Masuhara K, Takakura Y, et alAnalysis of stress distributions in the ankle joint using three dimensional rigid body spring modelJ Biomech Eng19846315319.
12. Yoshimoto K, Noguchi M, Yamada A, et al. Compensatory function of the subtalar joint for lower extremity malalignmentAdv Orthop201920197656878. doi: 10.1155/2019/7656878.
13. Krähenbühl N, Akkaya M, Deforth M, et alExtraarticular supramalleolar osteotomy in asymmetric varus ankle osteoarthritisFoot Ankle Int2019408936947.
14. Kanemitsu M, Nakasa T, Ikuta Y, et al. Characteristic bone morphology change of the subtalar joint in severe varus ankle osteoarthritisJ Foot Ankle Surg2022613627632.
15. Kang HW, Kim DY, Park GY, et al. Coronal plane calcaneal-talar orientation in varus ankle osteoarthritisFoot Ankle Int2022437928936.
16. Gleich ABeitrag zur operativen plattfussbehandlungArch Klin Chir1893461358362.
17. Dwyer FCOsteotomy of the calcaneum for pes cavusJ Bone Joint Surg (Br)195941-B18086.

Chinese Journal of Reparative and Reconstructive Surgery

Short-term effectiveness of calcaneal lateral displacement osteotomy with lateral ligament repair in treatment of Takakura stage Ⅱ varus-type ankle arthritis

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