Perioperative axial loading computed tomography findings in varus ankle osteoarthritis: Effect of supramalleolar osteotomy on abnormal internal rotation of the talus. Issue 2 (February 2021)

• Record Type: Journal Article
• Authors: Song, Jae Hwang; Kang, Chan; Kim, Tae Gyun; Lee, Gi Soo; Lee, Jeong Kil; Ahn, Ki Jun; Kim, Dong Hwan; Lee, Seok Won
• Is Part Of: Foot and ankle surgery. Volume 27:Issue 2(2021)
• Page Start: 217
• Page End: 223
• Publication Date: 2021-02
• Subjects: Ankle -- Axial loading CT -- Osteoarthritis -- Supramalleolar osteotomy -- Talus rotation -- Chronic ankle instability; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2020.04.006
• Languages: English
• ISSNs: 1268-7731

Abstract

Highlights: Abnormal internal rotation of talus is pathologic feature of varus ankle OA. AL CT with >70% axial load offered the same effects of full weight bearing. Abnormal internal rotation of the talus was significantly corrected after SMO. Correction of internal rotation the talus is an key factor in varus ankle OA. Abstract: Background: We used axial loading computed tomography (AL CT) to evaluate preoperative and postoperative talocrural joints of patients who underwent supramalleolar osteotomy (SMO) to treat varus ankle osteoarthritis. Methods: We performed retrospective analyses of 16 patients (18 feet) who underwent SMO including fibular osteotomy. Radiographic assessment was performed with weightbearing radiographs and AL CT. Clinical outcomes were assessed based on American Orthopedic Foot & Ankle Society (AOFAS) scale, visual analog scale (VAS) for pain, and Foot and Ankle Ability Measure (FAAM). Results: The mean 2-year follow-up tibial-ankle surface angle, talar tilt angle, Takakura stage, and tibial-lateral surface angle were all significantly different relative to preoperative parameters ( P < .05). The mean 6-month follow-up talus rotation ratio was significantly corrected compared to the preoperative value ( P = .001). The mean 2-year follow-up AOFAS, VAS at gait, and FAAM scores were all significantly improved relative to preoperative measurements ( P = .001). Conclusions: Abnormal internal rotation of the talus in mild to moderate varus ankle osteoarthritis found on AL CT was significantly corrected after SMO. Level of evidence: Therapeutic Level IV