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Research Article| Volume 61, ISSUE 2, P333-338, March 2022

Treatment of Early to Intermediate Stage Ankle Osteoarthritis With Nonosteotomy Approaches: Intermediate-Term Efficacy

Published:September 17, 2021DOI:https://doi.org/10.1053/j.jfas.2020.07.008

      ABSTRACT

      This study aimed to investigate the intermediate-term efficacy of nonosteotomy approaches in the treatment of early to intermediate stage ankle osteoarthritis (OA). Forty-two patients received treatment for early to intermediate stage ankle osteoarthritis with nonosteotomy approaches were reviewed. The surgical satisfaction was evaluated at 1 year after surgery and the last follow-up period; the American Orthopaedic Foot and Ankle Society (AOFAS) scale and Visual Analog Scale (VAS) were employed for the evaluation of function and pain, respectively, and the stage of ankle osteoarthritis was determined. At 1 year surgery and the last follow-up period, the surgical satisfaction was 37 (88.1%) and 35 (83.3%), respectively, and the favorable function was noted in 34 (80.9%) and 32 (76.2%), respectively. The AOFAS score significantly increased from 50.62 ± 10.81 (range 30-60) before surgery to 81.43 ± 12.00 (range 75-95) at 1 year after surgery (p < .0001) and 79.67 ± 10.34 (range 70-96) at the last follow-up period (p < .0001 vs before surgery; p = .107 vs 1 year). The VAS score reduced from 5.07 ± 1.57 (range 4-7) before surgery to 1.97 ± 1.41 (range 0-3) at 1 year (p < .0001) and 1.80 ± 1.15 (range 0-3) at the last follow-up period (p < .0001 vs before surgery; p = .265 vs 1 year). Moreover, the AOFAS score and VAS score in patients with ankle osteoarthritis at different stages were improved significantly after surgery (p < .0001). Intermediate-term follow-up period shows that nonosteotomy approaches are able to relieve pain and improve postoperative function in the treatment of early to intermediate stage ankle osteoarthritis; the improvement determined according to imaging examination is not completely consistent with that determined based on clinical function.

      Level of Clinical Evidence

      Keywords

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      References

        • Jung HG
        • Parks BG
        • Nguyen A
        • Schon LC.
        Effect of tibiotalar joint arthrodesis on adjacent tarsal joint pressure in a cadaver model.
        Foot Ankle Int. 2007; 28: 103-108
        • Tanaka Y
        • Takakura Y
        • Hayashi K
        • Taniguchi A
        • Kumai T
        • Sugimoto K.
        Low tibial osteotomy for varus-type osteoarthritis of the ankle.
        J Bone Joint Surg Br. 2006; 88: 909-913
        • Lee WC.
        Extraarticular supramalleolar osteotomy for managing varus ankle osteoarthritis, alternatives for osteotomy: how and why?.
        Foot Ankle Clin. 2016; 21: 27-35
        • Myerson MS
        • Zide JR.
        Management of varus ankle osteoarthritis with joint-preserving osteotomy.
        Foot Ankle Clin. 2013; 18: 471-480
        • Al-Nammari SS
        • Myerson MS.
        The use of tibial osteotomy (Ankle Plafondplasty) for joint preservation of ankle deformity and early arthritis.
        Foot Ankle Clin. 2016; 21: 15-26
        • Choi JI
        • Lee KB.
        Comparison of clinical outcomes between arthroscopic subchondral drilling and microfracture for osteochondral lesions of the talus.
        Knee Surg Sports Traumatol Arthrosc. 2016; 24: 2140-2147
        • Buchhorn T
        • Sabeti-Aschraf M
        • Dlaska CE
        • Wenzel F
        • Graf A
        • Ziai P.
        Combined medial and lateral anatomic ligament reconstruction for chronic rotational instability of the ankle.
        Foot Ankle Int. 2011; 32: 1122-1126
        • Gould N
        • Seligson D
        • Gassman J.
        Early and late repair of lateral ligament of the ankle.
        Foot Ankle. 1980; 1: 84-89
        • Kitaoka HB
        • Alexander IJ
        • Adelaar RS
        • Nunley JA
        • Myerson MS
        • Sanders M.
        Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes.
        Foot Ankle Int. 1994; 15: 349-353
        • Ibrahim T
        • Beiri A
        • Azzabi M
        • Best AJ
        • Taylor GJ
        • Menon DK.
        Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales.
        J Foot Ankle Surg. 2007; 46: 65-74
        • Coughlin MJ
        • Saltzman CL
        • Anderson RB
        Mann's Surgery of the Foot and Ankle.
        9th ed. Elsevier Medicine, 2014: 1555
        • Knupp M
        • Lang TH
        • Zwicky L
        • Lötscher P
        • Hintermann B.
        Chronic ankle instability (medial and lateral).
        Clin Sports Med. 2015; 34: 679-688
        • McCriskin BJ
        • Cameron KL
        • Orr JD
        • Waterman BR.
        Management and prevention of acute and chronic lateral ankle instability in athletic patient populations.
        World J Orthop. 2015; 6: 161-171
        • Valderrabano V
        • Horisberger M
        • Russell I
        • Dougall H
        • Hintermann B.
        Etiology of ankle osteoarthritis.
        Clin Orthop Relat Res. 2009; 467: 1800-1806
        • Hintermann B
        • Knupp M
        • Barg A.
        Peritalar instability.
        Foot Ankle Int. 2012; 33: 450-454
        • Lee HS
        • Wapner KL
        • Park SS
        • Kim JS
        • Lee DH
        • Sohn DW.
        Ligament reconstruction and calcaneal osteotomy for osteoarthritis of the ankle.
        Foot Ankle Int. 2009; 30: 475-480
        • Pagenstert G
        • Leumann A
        • Hintermann B
        • Valderrabano V.
        Sports and recreation activity of varus and valgus ankle osteoarthritis before and after realignment surgery.
        Foot Ankle Int. 2008; 29: 985-993
        • Mann HA
        • Filippi J
        • Myerson MS.
        Intra-articular opening medial tibial wedge osteotomy (plafond-plasty) for the treatment of intra-articular varus ankle arthritis and instability.
        Foot Ankle Int. 2012; 33: 255-261
        • DIGiovanni BF
        • Fraga CJ
        • Cohen BE
        • Shereff MJ.
        Associated injuries found in chronic lateral ankle instability.
        Foot Ankle Int. 2000; 21: 809-815
        • Hertel J.
        Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability.
        J Athl Train. 2002; 37: 364-375
        • Yasuda T
        • Shima H
        • Mori K
        • Tsujinaka S
        • Neo M.
        Simultaneous reconstruction of the medial and lateral collateral ligaments for chronic combined ligament injuries of the ankle.
        Am J Sports Med. 2017; 45: 2052-2060
        • Shakked R
        • Sheskier S.
        Acute and chronic lateral ankle instability diagnosis, management, and new concepts.
        Bull Hosp Jt Dis (2013). 2017; : 71-80
        • Cho BK
        • Kim YM
        • Kim DS
        • Choi ES
        • Shon HC
        • Park KJ.
        Comparison between suture anchor and transosseous suture for the modified-Brostrom procedure.
        Foot Ankle Int. 2012; 33: 462-468
        • Maffulli N
        • Ferran NA.
        Management of acute and chronic ankle instability.
        J Am Acad Orthop Surg. 2008; 16: 608-615
        • Hollis JM
        • Blasier RD
        • Flahiff CM
        • Hofmann OE.
        Biomechanical comparison of reconstruction techniques in simulated lateral ankle ligament injury.
        Am J Sports Med. 1995; 23: 678-682
        • Reilingh ML
        • Beimers L
        • Tuijthof GJ
        • Stufkens SA
        • Maas M
        • van Dijk CN.
        Measuring hindfoot alignment radiographically: the long axial view is more reliable than the hindfoot alignment view.
        Skelet Radiol. 2010; 39: 1103-1108
        • Saltzman CL
        • el-Khoury GY.
        The hindfoot alignment view.
        Foot Ankle Int. 1995; 16: 572-576
        • Buck FM
        • Hoffmann A
        • Mamisch-Saupe N
        • Espinosa N
        • Resnick D
        • Hodler J.
        Hindfoot alignment measurements: rotation-stability of measurement techniques on hindfoot alignment view and long axial view radiographs.
        AJR Am J Roentgenol. 2011; 197: 578-582
        • Hintermann B
        • Knupp M
        • Barg A.
        Joint-preserving surgery of asymmetric ankle osteoarthritis with peritalar instability.
        Foot Ankle Clin. 2013; 18: 503-516