Evaluation of clinico-radiological outcome of fibular valgization osteotomy with supra-malleolar osteotomy in patients with ankle osteoarthritis

Lim, Ji Hong; Kang, Sung Jin; Im, Jemin; Kwon, Sae Him; Jung, Hong-Geun

doi:10.1007/s00264-023-05822-w

Cited by 3 publications

(3 citation statements)

References 33 publications

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“…Supramalleolar correction of varus ankle arthritis, including SMO, involves altering the ankle mortise without affecting the distal components to talus 8 9. Typically, the tibial anterior surface angle (TAS) increases, while the tibial medial malleolar angle and talocrural angle decrease postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, in case of varus ankle arthritis with the minimal medial translation of the talus, we suggest that, besides using the inframalleolar correction method described above, adding a fibular shortening and valgisation osteotomy as a standalone procedure while keeping the tibia intact could be a viable alternative to achieve more significant TT improvement 14. Several authors3 8 15 insisted that the relative length of the fibula to the tibia was important to determine the position and rotation of the talus. However, owing to the lack of relevant research, in-depth discussions and further studies on isolated fibular shortening and valgisation osteotomies are highly recommended.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of supramalleolar and inframalleolar correction for Takakura stage IIIB ankle arthritis in a single patient

Choi,

Suh

2024

BMJ Case Rep

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A man in his early 60s with bilateral Takakura stage IIIB varus ankle arthritis underwent calcaneal osteotomy on the right side and supramalleolar osteotomy (SMO) with fibular osteotomy on the left side. Both sides underwent identical procedures, including multiple drilling of the denuded talar dome and gutter, deltoid ligament release, anterior talofibular ligament (ATFL) reconstruction and posterior tibial tendon (PTT) lengthening. This aimed to minimise patient-related factors when assessing correction efficacy. Both procedures demonstrated a similar degree of improvement in talar tilt. Supramalleolar correction contributed more significantly to lateralising the talar centre, while greater improvement in preoperative hindfoot varus was achieved through inframalleolar correction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of supramalleolar and inframalleolar correction for Takakura stage IIIB ankle arthritis in a single patient

Choi,

Suh

2024

BMJ Case Rep

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“…publicaron una serie de pacientes con artrosis de tobillo medial que fueron tratados con una osteotomía de apertura medial comparativa adicionando o no una osteotomía de peroné; los resultados fueron un aumento del espacio de la gotera medial y una traslación lateral del astrágalo mayor en el grupo con osteotomía de peroné. 27 En nuestra experiencia, se realizó la osteotomía del peroné en pacientes con deformidad en varo para dar más espacio a la mortaja y así poder reducir el astrágalo. En aquellos con deformidad en valgo, se optó por el alargamiento del peroné cuando este estaba acortado (por antecedente de fractura de tobillo) y no contenía satisfactoriamente al astrágalo en su posición correcta.…”

Section: Discussionunclassified

Osteotomías supramaleolares en pacientes con artrosis de tobillo: resultados clínicos y radiográficos

Conti,

Verbner,

Valenti

et al. 2024

Rev. Asoc. Arg. Ort. y Traumatol

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Introducción: Las osteotomías supramaleolares son una opción terapéutica para la artrosis asimétrica de tobillo. El objetivo de este artículo es describir los resultados clínicos, radiográficos y subjetivos obtenidos en pacientes con artrosis de tobillo sometidos a una osteotomía supramaleolar. Materiales y Métodos: Estudio observacional descriptivo retrospectivo de pacientes sometidos a una osteotomía supramaleolar por artrosis de tobillo entre enero de 2010 y julio de 2017. Se analizaron las historias clínicas para recabar datos clínicos y radiográficos preoperatorios y posoperatorios. Resultados: Se incluyó a 13 pacientes: 8 con una desalineación del tobillo y retropié en valgo (61,5%) y 5 (38,5%) en varo. El puntaje medio posoperatorio de la escala analógica visual del grupo con deformidad en varo disminuyó de 9 ± 0,45 a 3 ± 1 (p <0,05) y de una media de 7,88 ± 0,35 a 2,15 ± 1,64 (p <0,05) en aquellos con deformidad en valgo. El puntaje medio de la escala de la AOFAS se modificó de 32,8 ± 16,2 antes de la cirugía a 82,1 ± 13,6 en el posoperatorio, en el grupo con deformidad en varo (p <0,05) y de 31 ± 17,3 a 93,1 ± 6,20, respectivamente, en aquellos con deformidad en valgo (p <0,05). Se constató la consolidación radiográfica en 12 pacientes (92,3%), en un promedio de 10.4 semanas. Conclusión: La osteotomía supramaleolar como tratamiento de la artrosis asimétrica de tobillo es una técnica predecible, con muy buenos resultados clínicos y radiográficos a corto y mediano plazo.

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The effects of medial soft tissue release for varus deformity during medial open wedge supramalleolar osteotomy: a cadaveric study

Kwak,

Woo,

Lee

et al. 2024

Biomed. Eng. Lett.

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BackgroundThe supramalleolar osteotomy (SMO) can redistribute the mechanical axis and balance the load on the joint in the varus ankle osteoarthritis. The purpose of this study was to investigate not only the effect of bular osteotomy but the effects of release of medial soft tissue (posterior tibialis tendon (PTT), deep deltoid ligaments) which act as medial stabilizing structures in medial open wedge SMO. MethodsTwelve fresh frozen human legs were obtained and disarticulated below the knee. All experiments were conducted in four steps. First, medial open wedge tibial osteotomy was done. Second, a bular osteotomy was performed in an inferomedial direction at the same level as that of the tibial osteotomy. Third, the deep deltoid ligament was released from the tibial attachments. Last, the total tenotomy of the PTT was performed behind the medial malleolus. After nishing each step, contact area, peak pressure and mean pressure were measured in the tibiotalar and talo bular joints. ResultsFibular osteotomy after medial open wedge SMO signi cantly decreased the mean and peak pressures in the talo bular joint. The medial soft tissue release showed a remarkable lateral shift and decrease in tibiotalar joint loading. ConclusionsSurgeons should take into account these effects of bular osteotomy and medial soft tissue release in open wedge SMO. Adequate release of the deltoid ligament and PTT could be a useful technique to minimize the tibiotalar joint stress.

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Evaluation of clinico-radiological outcome of fibular valgization osteotomy with supra-malleolar osteotomy in patients with ankle osteoarthritis

Cited by 3 publications

References 33 publications

Comparison of supramalleolar and inframalleolar correction for Takakura stage IIIB ankle arthritis in a single patient

Comparison of supramalleolar and inframalleolar correction for Takakura stage IIIB ankle arthritis in a single patient

Osteotomías supramaleolares en pacientes con artrosis de tobillo: resultados clínicos y radiográficos

The effects of medial soft tissue release for varus deformity during medial open wedge supramalleolar osteotomy: a cadaveric study

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