Distal tibial osteotomy may reduce pain in short-term for patients with ankle osteoarthritis
Patients with ankle arthritis, a widened mortise and minor talar tilt experienced less pain in the short term after distal tibial osteotomy without fibular osteotomy, according to study results.
From January 2008 to May 2011, 18 patients (mean age: 57 years) suffering from medial ankle osteoarthritis (OA) with mortise widening underwent distal tibial osteotomy without fibular osteotomy and were followed for a mean of 34 months. Valgus stress radiographs and intraoperative examination were used for the diagnosis of mortise widening.
Clinical outcomes were assessed preoperatively and postoperatively using the American Orthropaedic Foot & Ankle Society (AOFAS) scale, ankle osteoarthritis scale (AOS) score and VAS for pain. Using weight-bearing radiographs, the researchers also evaluated translation of the talus with the ankle mortise, talar tilt, medial distal tibial angle and the anterior distal tibial angle.
Results showed a significant difference after surgery in the mean medial distal tibial angle (86.8° to 92.9°) and mean anterior distal tibial angle (81.1° to 84.3°), but mean talar did not change significantly, according to the researchers.
At the latest follow-up, the mean AOS score was 29.8 points. AOFAS score improved significantly, from 78.9 points to 89 points, and VAS pain score decreased significantly, from 6.7 points to 2.7 points. After the distal tibial osteotomy, the center of the talus moved laterally within the ankle mortise.
According to the researchers, nine of the 18 patients needed implants removed, and one patient underwent total knee arthroplasty due to postoperative deterioration. No other complications were reported. – by Monica Jaramillo
Disclosure: The researchers report no relevant financial disclosures.