Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Orthop Surg Res. 2021 Jan 6;16(1):7. doi: 10.1186/s13018-020-02143-1.
Takakura 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.
From 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.
All patients were followed for a mean follow-up of 87.2 months (range, 49 to 129 months). 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° to 5.3 ± 4.0°. The TAS and TLS changed from 83.4 ± 2.6° and 77.5 ± 2.3° to 90.7 ± 2.3° and 78.6 ± 2.2°. However, the LTAS was not corrected significantly.
Intra-articular opening osteotomy combined with lateral ligament reconstruction is an effective method to treat varus ankle arthritis with medial distal tibial platform erosion.
Takakura3B 踝关节关节炎的特征是踝关节间隙消失，伴软骨下骨接触。这些患者中，有些存在胫骨远端内侧平台侵蚀。治疗这类患者较为困难。本研究旨在评估关节内切开截骨联合外侧韧带重建治疗伴胫骨远端内侧平台侵蚀的 Takakura3B 踝关节关节炎的疗效。
2009 年 9 月至 2016 年 5 月，回顾性分析 17 例 Takakura3B 踝关节关节炎患者，男 3 例，女 14 例。所有患者均接受关节内切开截骨联合外侧韧带重建术。所有患者均获得随访，平均随访 87.2 个月（49~129 个月）。主要观察指标包括 TT 角、AOFAS 评分、VAS 评分、SF-36 量表和 AOS 量表。
所有患者术后 VAS 评分由术前的 5.5±1.6 分改善至术后的 2.3±1.9 分，AOFAS 评分由术前的 47.7±15.7 分改善至术后的 75.8±12.0 分，SF-36 量表评分由术前的 41.6±14.0 分改善至术后的 67.7±14.6 分，AOS 评分由术前的 60.9±13.9 分改善至术后的 28.2±17.7 分，TT 角由术前的 14.3±5.0°改善至术后的 5.3±4.0°，TAS 和 TLS 由术前的 83.4±2.6°和 77.5±2.3°改善至术后的 90.7±2.3°和 78.6±2.2°，但 LTAS 无明显改善。
关节内切开截骨联合外侧韧带重建是治疗伴胫骨远端内侧平台侵蚀的内翻型踝关节关节炎的有效方法。
