Service de chirurgie orthopédique et traumatologique, CHRU Tours, 37044 Tours cedex 9, France.
Faculté de médecine de Tours, 37032 Tours cedex 1, France; Service de chirurgie orthopédique et traumatologique, CHRU Tours, 37044 Tours cedex 9, France.
Orthop Traumatol Surg Res. 2022 Nov;108(7):103390. doi: 10.1016/j.otsr.2022.103390. Epub 2022 Aug 6.
The severity of a foot or ankle deformity is a major prognostic factor for the success of ankle replacement. Varus deformity is at once the most arthrogenic and the most frequent.
The severity of preoperative varus is a negative factor for ankle replacement survival.
A retrospective study compared results in a continuous series of 57 Salto-Talaris® ankle replacements according to preoperative varus: 31 moderate (5-15̊) and 26 severe (> 15̊). Radiological and clinical assessment at a minimum 1 year focused on complications, revision and implant exchange and on AOFAS score, range of motion and tibiotalar angle at last follow-up.
At a mean 2.4 years' follow-up, implant survival in the moderate and severe varus groups was respectively 83% and 92%. Postoperative AOFA score and range of motion improved significantly in both groups, without significant difference. Analysis of cumulative survival showed no significant intergroup difference.
Severity of preoperative varus did not impact implant survival. Only postoperative alignment and stability emerged as survival factors. These results were related to the quality of associated procedures aiming to reduce deformity and to achieve ligament balance.
IV, retrospective comparative study.
足部或踝关节畸形的严重程度是踝关节置换成功的一个主要预后因素。内翻畸形既是最具关节病性的，也是最常见的畸形。
术前内翻的严重程度是踝关节置换术生存的一个负面因素。
回顾性研究比较了连续 57 例 Salto-Talaris®踝关节置换术的结果，根据术前内翻程度分为 31 例中度（5-15°）和 26 例重度（>15°）。至少 1 年的影像学和临床评估重点是并发症、翻修和植入物更换，以及 AOFAS 评分、踝关节活动度和距下关节角度的最后随访。
平均随访 2.4 年后，中度和重度内翻组的植入物存活率分别为 83%和 92%。两组术后 AOFAS 评分和活动度均显著改善，无显著差异。累积生存率分析显示两组间无显著差异。
术前内翻的严重程度并不影响植入物的存活率。只有术后的对线和稳定性成为生存的因素。这些结果与旨在减少畸形和实现韧带平衡的相关手术的质量有关。
IV，回顾性比较研究。
