Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University, 85, 2-Ka, Jur-dong, Chung-ku, Seoul 100-032, Republic of Korea.
Foot Ankle Int. 2011 Jul;32(7):693-9. doi: 10.3113/FAI.2011.0693.
Supramlleolar osteotomy has been recommended to correct varus deformity of the tibial plafond, however we have seen only a few ankles with significant deviation of alignment in early stage osteoarthritis, in which realignment treatments might be necessary to modify the course of the disease. Our hypothesis was that there are diverse radiographic features of the tibial plafond and hindfoot in varus ankle osteoarthritis.
The study included 154 ankles of 98 patients with medial osteoarthritis, and 80 ankles of 80 normal subjects. On weightbearing AP radiographs, the tibial anterior surface angle (TAS), tibial axis-medial malleolus angle (TMM) and talar tilt angle was measured. On weightbearing lateral radiographs, tibial lateral surface angle (TLS) was measured. On the hindfoot alignment view, the heel alignment angle and heel alignment ratio were obtained. Inter- and intraobserver reliabilities were obtained for all radiographic parameters. The radiographic parameters were compared among the normal ankles and the ankles in different stages of ankle arthritis by the Takakura classification.
Inter- and intraobserver reliability were very high for all radiographic parameters except TLS. There was no statistically significant difference in TAS among stages 2, 3a, and 3b. TAS was 86.9 +/- 2.4 degrees, 86.2 +/- 3.3 degrees, and 85.4 +/- 4 3.1 degrees in stage 2, 3a, 3b, respectively. There was no significant difference in hindfoot alignment among normal, stage 2, stage 3a. The hindfoot alignment angle was 0.5 +/- 8.1 degrees, 0.5 +/- 6.8 degrees, and 9.6 +/- 9.1 degrees in Stage 2, 3a, 3b, respectively.
Alignment of the tibial plafond and hindfoot was variable in early stage ankle osteoarthritis.
III, Retrospective Case Control Study
距下关节骨切开术已被推荐用于纠正距骨下关节的内翻畸形，然而，我们仅在少数早期骨关节炎病例中看到明显的对线偏差，在这些病例中，可能需要进行重新对线治疗以改变疾病进程。我们的假设是，在距骨下关节炎的内翻踝关节中，存在胫骨平台和后足的多种影像学特征。
该研究纳入了 98 例内侧骨关节炎患者的 154 例踝关节和 80 例正常对照者的 80 例踝关节。在负重前后位 X 线片上，测量胫骨前表面角（TAS）、胫骨轴-内踝角（TMM）和距骨倾斜角。在负重侧位 X 线片上，测量胫骨外侧表面角（TLS）。在后足对线视图上，获得跟骨对线角和跟骨对线比。所有影像学参数的组内和组间信度均进行了测量。根据 Takakura 分类，比较了正常踝关节和不同阶段踝关节关节炎的影像学参数。
除 TLS 外，所有影像学参数的组内和组间信度均非常高。在 2、3a 和 3b 期之间，TAS 没有统计学差异。在 2、3a 和 3b 期，TAS 分别为 86.9±2.4°、86.2±3.3°和 85.4±4.3°。在正常、2 期和 3a 期之间，后足对线没有显著差异。后足对线角分别为 0.5±8.1°、0.5±6.8°和 9.6±9.1°。
在早期踝关节骨关节炎中，胫骨平台和后足的对线是可变的。
III，回顾性病例对照研究
