Low tibial osteotomy for varus-type osteoarthritis of the ankle

Abstract

In this retrospective study we have assessed the results of low tibial valgus osteotomy for varus-type osteoarthritis of the ankle and its indications. We performed an opening wedge osteotomy in 25 women (26 ankles). The mean follow-up was for eight years and three months (2 years 3 months to 17 years 11 months). Of the 26 ankles, 19 showed excellent or good clinical results. Their mean scores for pain, walking, and activities of daily living were significantly improved but there was no change in the range of movement. In the ankles which were classified radiologically as stage 2 according to our own grading system, with narrowing of the medial joint space, and in 11 as stage 3a, with obliteration of the joint space at the medial malleolus only, the joint space recovered. In contrast, such recovery was seen in only two of 12 ankles classified as stage 3b, with obliteration of the joint space advancing to the upper surface of the dome of the talus. Low tibial osteotomy is indicated for varus-type osteoarthritis of stage 2 or stage 3a.

Single-Stage Supramalleolar Osteotomy for Coronal Plane Deformity

“…There were no cases of nonunion in this patient cohort [45]. In 2006, Tanaka et al [46] presented their results in 25 female patients (26 ankles) who underwent medial opening-wedge osteotomy with oblique fibular osteotomy. In all patients, an autograft from the iliac crest or tibia was used.…”

“…In 4 ankles, a substantial progression of ankle osteoarthritis resulted in poor outcome. In 2 patients, ankle arthrodesis was performed; another 2 patients were treated conservatively with intraarticular injections of hyaluronic acid [46]. Poorer results were found in patients who had involvement of the superior medial joint space than the medial gutter alone.…”

“…Medial closing-wedge OT (18), medial opening-wedge OT (7), lateral closing-wedge OT (4), others (6) Pagenstert et al [28] 2009 Post-traumatic (22) OA with valgus deformity SM medial closing-wedge OT (22) Pearce et al [24] 1994 Secondary (7) OA (hemophilic arthropathy) with valgus deformity SM medial closing-wedge OT (7) Stamatis et al [44] 2003 Primary ( [45] 1998 Post-traumatic varus deformity (9) SM medial opening-wedge OT (9) Tanaka et al [46] 2006 OA with varus deformity (26) SM medial opening-wedge OT with oblique fibular OT (9)…”

Treatment of osteochondral defects of the talus

“…Moon and co-workers compared the van Dijk scale 425 , the modified KellgrenLawrence scale 212 , and modified Takakura 380 scales, and concluded that all these scales were reliable and valid 291 . Interobserver and intraobserver comparisons (weighted Kappa) of each scale were found to be satisfactory (Kellgren and Lawrence, 0.51 to 0.81; Takakura, 0.65 to 0.88; van Dijk, 0.64 to 0.89).…”

Motion Versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis

“…Osteoarthritis generally progresses over time, and, as with other major lower extremity joints, the treatment of choice for end-stage ankle osteoarthritis is surgical. In young patients, debridement, resurfacing, and realignment have limited indications [2][3][4][5] . Ankle arthrodesis and ankle replacement, currently the most commonly performed procedures, have recognized potential complications and long-term problems [6][7][8][9][10][11][12] .…”