Intra-articular opening osteotomy combined with lateral ligament reconstruction for varus ankle arthritis

BackgroundTakakura 3B ankle arthritis is featured as obliteration of ankle space with subchondral bone contact. Among these patients, some have medial distal tibial platform erosion. It is hard to treat this kind of patients. The purpose of this study was to evaluate the therapeutic outcomes of intra-articular opening osteotomy combined with lateral ligament reconstruction for Takakura 3B ankle arthritis with medial distal tibial platform erosion.MethodsFrom September 2009 to May 2016, 17 patients with Takakura 3B ankle arthritis were reviewed, including 3 male and 14 female patients. All underwent the operation of intra-articular opening osteotomy combined with lateral ligament reconstruction. All patients were available for analysis. The main outcome measurements included TT angle, AOFAS score, VAS score, SF-36 scale, and AOS scale.ResultsAll patients were followed for a mean follow-up of 87.2months (range, 49 to 129months). The VAS scale improved from 5.5 1.6 to 2.3 +/- 1.9. The mean AOFAS score improved from 47.7 +/- 15.7 to 75.8 +/- 12.0. The SF-36 scale improved from 41.6 +/- 14.0 to 67.7 +/- 14.6. The AOS improved from 60.9 +/- 13.9 to 28.2 +/- 17.7. The TT angle improved from 14.3 +/- 5.0 degrees to 5.3 +/- 4.0 degrees. The TAS and TLS changed from 83.4 +/- 2.6 degrees and 77.5 +/- 2.3 degrees to 90.7 +/- 2.3 degrees and 78.6 +/- 2.2 degrees. However, the LTAS was not corrected significantly.Conclusion Intra-articular opening osteotomy combined with lateral ligament reconstruction is an effective method to treat varus ankle arthritis with medial distal tibial platform erosion.

Automated summary

The study showed that intra-articular opening osteotomy combined with lateral ligament reconstruction is an effective method to treat Takakura 3B ankle arthritis with medial distal tibial platform erosion.