Son Hyuck Sung, Choi Jung Gyu, Ahn Jungtae, Jeong Bi O
Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
Foot Ankle Int. 2021 Apr;42(4):431-439. doi: 10.1177/1071100720970937. Epub 2020 Nov 20.
In patients with end-stage varus ankle osteoarthritis (OA), hindfoot varus malalignment resulting from the varus deformity of the ankle joint is common. Although total ankle arthroplasty (TAA) performed to correct varus deformity of the ankle joint has the effect of correcting hindfoot alignment, no reports to date have described how much hindfoot alignment correction can be achieved. The purpose of this study was to identify correlation between ankle deformity correction and hindfoot alignment change after performing TAA in patients with end-stage varus ankle OA.
A total of 61 cases that underwent TAA for end-stage varus ankle OA and followed up for at least 1 year were enrolled for this study. Correlation between changes of tibial-ankle surface angle (TAS), talar tilt (TT), and tibiotalar surface angle (TTS) and changes of hindfoot alignment angle (HA), hindfoot alignment ratio (HR), and hindfoot alignment distance (HD) measured preoperatively and at postoperative year 1 was analyzed.
TAS, TT, and TTS changed from 83.9 ± 4.1 degrees, 5.8 ± 5.0 degrees, and 78.1 ± 5.9 degrees, respectively, before operation to 89.2 ± 2.1 degrees, 0.4 ± 0.5 degrees, and 88.7 ± 2.3 degrees, respectively, after operation. HA, HR, and HD also changed from -9.2 ± 4.6 degrees, 0.66 ± 0.18, and -11.2 ± 6.9 mm to -3.7 ± 4.1 degrees, 0.48 ± 0.14, and -5.0 ± 5.3 mm. All the changes were statistically significant ( .001, respectively). The regression slope of correlation was 0.390 ( = 0.654) between TTS and HA; 0.017 ( = 0.617) between TTS and HR; and 0.560 ( = 0.703) between TTS and HD.
In patients with end-stage varus ankle OA, changes of hindfoot alignment could be predicted based on degree of ankle deformity corrected with TAA.
Level IV, case series.
在终末期内翻型踝关节骨关节炎（OA）患者中，踝关节内翻畸形导致的后足内翻排列不齐很常见。尽管进行全踝关节置换术（TAA）以纠正踝关节内翻畸形有纠正后足排列的作用，但迄今为止尚无报告描述能实现多少后足排列的纠正。本研究的目的是确定终末期内翻型踝关节OA患者行TAA后踝关节畸形矫正与后足排列变化之间的相关性。
本研究纳入了61例行TAA治疗终末期内翻型踝关节OA且随访至少1年的病例。分析术前及术后1年测量的胫距表面角（TAS）、距骨倾斜（TT）和胫距关节表面角（TTS）的变化与后足排列角（HA）、后足排列率（HR）和后足排列距离（HD）变化之间的相关性。
TAS、TT和TTS分别从术前的83.9±4.1度、5.8±5.0度和78.1±5.9度变为术后的89.2±2.1度、0.4±0.5度和88.7±2.3度。HA、HR和HD也分别从-9.2±4.6度、0.66±0.18和-11.2±6.9毫米变为-3.7±4.1度、0.48±0.14和-5.0±5.3毫米。所有变化均具有统计学意义（分别为P<.001）。TTS与HA之间的相关回归斜率为0.390（P = 0.654）；TTS与HR之间为0.017（P = 0.617）；TTS与HD之间为0.560（P = 0.703）。
在终末期内翻型踝关节OA患者中，可根据TAA纠正的踝关节畸形程度预测后足排列的变化。
IV级，病例系列。
