Weight-Bearing-Line Analysis in Supramalleolar Osteotomy for Varus-Type Osteoarthritis of the Ankle

Haraguchi, Naotsugu; Ota, Koki; Tsunoda, Naoya; Seike, Koji; Kanetake, Yoshihiko; Tsutaya, Atsushi

doi:10.2106/jbjs.m.01327

Cited by 93 publications

(83 citation statements)

References 16 publications

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“…Additionally, Kim et al [11] reported that no radiological outcome seemed to have a significant influence on the clinical outcomes. We agree with Mann et al [18] that realignment surgery of the ankle joint with osteotomy is worthwhile, even for high TT patients, because the osteotomy will redistribute the contact forces of the ankle joint and move the mechanical axis point of the ankle laterally [13], prolong the viability of a more normally aligned joint, and even restore the TT to a neutral position (Fig. 6).…”

Section: Discussionsupporting

confidence: 91%

“…Other limitations included that we only used the Maryland foot score for functional evaluations and that the pre- and postoperative radiological evaluations did not include the weight-bearing full leg anterior-posterior view, which would be useful for the full leg alignment evaluation. Haraguchi et al [13] used hip-to-calcaneus radiographs to evaluate lower limb alignment in SMOT patients and reported that when the preoperative mechanical axis point was more medial than the tibial plafond, the point was insufficiently moved to the lateral side, and the clinical outcomes were less satisfactory. This finding is important for preoperative evaluations and selecting the proper operation for mid-stage varus ankle OA patients.…”

Section: Discussionmentioning

confidence: 99%

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The role of fibular for supramalleolar osteotomy in treatment of varus ankle arthritis: a biomechanical and clinical study

Zhao

Liang

et al. 2016

J Orthop Surg Res

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BackgroundSupramalleolar osteotomy (SMOT) is a well-accepted treatment method for mid-stage varus ankle osteoarthritis (OA). However, few studies have examined the role of fibular osteotomy in SMOT. The objective of the current study was to compare the biomechanical and clinical outcomes of SMOT with and without fibular osteotomy.MethodsEight cadaveric lower legs with 10° varus/valgus SMOT models were tested using a Tekscan ankle sensor. Tibiotalar joint contact with and without fibular osteotomy conditions were compared. Forty-one varus ankle OA patients treated with SMOT were included; 22 underwent fibular osteotomy, and 19 did not. The Maryland foot score and radiological angles were used for clinical evaluation.ResultsThe mean contact area and pressure did not differ significantly between normal and varus/valgus conditions with the fibula preserved. After fibular osteotomy, the mean contact area decreased and the mean contact pressure increased significantly in varus and valgus conditions (P < 0.01). The loading center moved to the opposite direction with and without fibular osteotomy in varus/valgus conditions. After a mean follow-up of 36.6 months (range 17–61), there was no significant difference in the Maryland scores of the two groups. However, in the fibular osteotomy group, the talar tilt angle decreased (P < 0.05), and the tibiocrural angle improved significantly (P < 0.01).ConclusionsFibular osteotomy facilitates the translation of tibiotalar contact pressure and is helpful for varus ankle realignment in patients with large talar tilts and small tibiocrural angles.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

The role of fibular for supramalleolar osteotomy in treatment of varus ankle arthritis: a biomechanical and clinical study

Zhao

Liang

et al. 2016

J Orthop Surg Res

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“…The talar tilt angle was completely corrected postoperatively (from 14.5 to 1.2 degrees), and the tibiocrural angle also was well corrected. ‡References 1,3,4,7,8,10,[12][13][14][15][18][19][20]24,26,27. …”

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confidence: 99%

Supramalleolar Osteotomy With or Without Fibular Osteotomy for Varus Ankle Arthritis

Zhao

Liang

et al. 2016

Foot Ankle Int.

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“…Supramalleolar osteotomy (SMOT) is an effective procedure for the treatment of midstage asymmetric ankle osteoarthritis [1][2][3][4]. Related studies have proved that the key factors affecting the postoperative curative effect of SMOT are the postoperative ankle Takakura stage [5], lower limb power line [6] and ankle angles [7]; but SMOT uses conventional operation (CO) method often does not perfectly accomplish these surgical aims leading to some patients have unsatisfactory outcomes [8,9]. The reasons include preoperative planning dependence on freehand drawing, and surgeons determine the operative procedure all depend on the surgeon's experiences and fluoroscopies [10].…”

Section: Introductionmentioning

confidence: 99%

Simulated operation combines patient-specific guide technology is superior to conventional technology for supramalleolar osteotomy: a retrospective comparative study

Wang

et al. 2020

Preprint

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Background: Over the past seven years, our team has designed a simulated operation combines patient-specific guide (SO-PSI) assisted supramalleolar osteotomy (SMOT) method and applied it to the clinic. This study aimed to determine the difference between SO-PSI technology and conventional operation (CO) technology for SMOT in preoperative planning, intraoperative application and postoperative curative effect. Methods: We retrospectively analyzed the data of SMOT in our hospital between October 2014 and December 2018; 28 patients were enrolled and divided into CO group (n=17) and SO-PSI group (n=11); the mean follow-up time was 33.4 (range, 13 to 59) months. We analyzed and compared perioperative data, accuracy of preoperative planning and intraoperative application, difference between pre- and post-operative of radiologic ankle angles, and change of AOFAS score, VAS, range of motion of ankle and Takakura stage after operation. Then we performed statistical analyses. Results: All ankle alignments and positions of two groups have been recovered. Compared with CO group, SO-PSI group has a shorter operative time and a postoperative hospital stay, a decreased number of fluoroscopies and a reduction of albumin, a longer preoperative planning time and a preoperative hospital stay and an increased hospitalization expenses. In SO-PSI group, the ankle angles between preoperative planning and postoperative shown good correlation, but not in CO group; the mean tibial ankle center discrepancy of SO-PSI group was 1.86±1.06 mm. After follow-up, all radiologic parameters of two groups significantly improved, but the improvement of tibial anterior surface angle and tibiotalar tilt angle of SO-PSI group were more obvious than that of CO group; AOFAS score, VAS, range of motion of ankle and Takakura stage of two groups improved after operation; but overall the improvements of SO-PSI group were better than the CO group. Conclusions: SO-PSI technology can carry out the preoperative plan accurately and quickly in SMOT; In general, compared with the conventional technology, SO-PSI technology has advantages in preoperative planning, intraoperative application and postoperative curative effect. Keywords: Supramalleolar osteotomy; Simulated operation; Patient-specific guide; Accuracy of preoperative planning; Practicability of application

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Weight-Bearing-Line Analysis in Supramalleolar Osteotomy for Varus-Type Osteoarthritis of the Ankle

Cited by 93 publications

References 16 publications

The role of fibular for supramalleolar osteotomy in treatment of varus ankle arthritis: a biomechanical and clinical study

The role of fibular for supramalleolar osteotomy in treatment of varus ankle arthritis: a biomechanical and clinical study

Supramalleolar Osteotomy With or Without Fibular Osteotomy for Varus Ankle Arthritis

Simulated operation combines patient-specific guide technology is superior to conventional technology for supramalleolar osteotomy: a retrospective comparative study

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