J Korean Orthop Assoc.  2013 Apr;48(2):89-95. 10.4055/jkoa.2013.48.2.89.

Supramalleolar Tibial Osteotomy for Medial Compartment Ankle Osteoarthritis

• Park JT
• Eom JS
• Jung HG

• KMID: 1424092
• DOI: http://doi.org/10.4055/jkoa.2013.48.2.89

Abstract

PURPOSE
The aim of this study is to evaluate the clinical and radiologic outcomes of supramalleolar tibial osteotomy for medial compartment ankle osteoarthritis (OA) and to verify the efficacy of the supramalleolar osteotomy.
MATERIALS AND METHODS
This study is based on 9 ankles of the medial compartment ankle OA treated with supramalleolar tibial osteotomy from August 2007 to June 2011 with at least 1 year follow-up. As for the functional evaluation, visual analogue scale (VAS) pain scores and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were evaluated. On radiographs, tibial anterior surface (TAS) angles, tibial lateral surface angles were measured. The severity of ankle OA was classified by the Takaura staging system.
RESULTS
The mean VAS pain scores improved to 0.6 and AOFAS scores improved to 89.3. Radiographically, TAS angle increased to 93.5degrees postoperatively. Seven ankles showed improvement of the ankle arthritis grading from IIIa to II according to Takakura's staging.
CONCLUSION
Supramalleolar tibial osteotomy for patients with medial compartment varus ankle OA showed satisfactory clinical and radiological outcome. We confirmed that the procedure is recommendable for medial compartment varus ankle OA especially for Takakura stage IIIa.

Keyword

medial compartment ankle osteoarthritis; supramalleolar tibial osteotomy; Takakura stage

MeSH Terms

Animals
Ankle
Arthritis
Follow-Up Studies
Foot
Humans
Osteoarthritis
Osteotomy

Figure

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  Figure 1 (A) Anteroposterior view demonstrates measurement of tibial anterior surface angle (TAS) and talar tilt angle (TT). (B) Measurement of wedge angle (astrix) and wedge height (arrow). (C) Lateral view demonstrates measurement of tibial lateral surface angle (TLS).

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  Figure 2 A 55-year-old woman with medial compartment ankle osteoarthritis. (A) Preoperative standing radiograph (B) treated by supramalleolar tibial and fibula osteotomies, which resulted in an excellent functional outcome.

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