Long oblique fibular osteotomy yielded good clinical, radiographic outcomes
Published results showed patients who underwent lateral total ankle arthroplasty with long oblique fibular osteotomy experienced excellent 2-year survival rates with good clinical and radiographic outcomes and decreased rates of wound complications and symptoms related to the fibular implant.
Among 159 patients who underwent lateral total ankle arthroplasty with a Zimmer Trabecular Total Ankle (Zimmer Biomet) using either a short fibular osteotomy (n=50) or a long oblique fibular osteotomy (n=109), Jonathan R. M. Kaplan, MD, and colleagues assessed patient demographics, wound complications, the need for implant removal, VAS pain score, American Orthopaedic Foot & Ankle Society score and SF-12 mental and physical component summary scores. Researchers assessed tibiotalar alignment, implant alignment and fibular osteotomy healing with weight-bearing radiographs.
Results showed the tibial and talar components of the ankle replacements had a survival rate of 100%, and no patients experienced osteotomy nonunions. Researchers found improvements in all clinical parameters and excellent arthroplasty alignment in radiographs at all time points, with no significant differences between the short fibular osteotomy and long oblique fibular osteotomy groups. Patients in the long oblique osteotomy group had lower rates of wound dehiscence and fibular implant removal at both 2.8% compared with a 14% wound dehiscence rate and 28% fibular implant removal rate in the short oblique osteotomy group, according to results.
“Our study showed that by modifying the fibular osteotomy for the lateral approach total ankle arthroplasty from the traditional short osteotomy to a longer oblique osteotomy, the surgeon can decrease the rate of wound complications and decrease the rate of symptomatic fibula hardware,” Kaplan told Healio.com/Orthopedics. “This modification maintained excellent 2-year outcomes in line with that of previous publications while decreasing postoperative complications and, therefore, we highly recommend this technique for surgeons performing the lateral approach total ankle arthroplasty.” – by Casey Tingle
Disclosure: Kaplan reports no relevant financial disclosures.