Skip to main content

Deformity Correction in Ankle Osteoarthritis Using a Lateral Trans-Fibular Total Ankle Replacement: A Weight-Bearing CT Assessment.

Publication ,  Journal Article
VandeLune, C; Barbachan Mansur, NS; Iehl, C; Tazegul, T; Ahrenholz, SJ; de Carvalho, KAM; de Cesar Netto, C
Published in: Iowa Orthop J
2022

BACKGROUND: Ankle osteoarthritis (AO) is often secondary to prior trauma and frequently presents with joint deformity. Total ankle replacement (TAR) has been shown as a viable surgical option to reduce pain, improve function, and preserve ankle joint range of motion. The standard TAR uses an anterior approach, but recently a lateral trans-fibular approach has been developed. Our aim was to determine if the lateral TAR was able to correct alignment and improve patient reported outcomes (PROs) in patients with end-stage AO. METHODS: This IRB-approved, retrospective comparative study included 14 consecutive patients that underwent lateral trans-fibular approach TAR for end-stage AO. All patients had received pre-and post-operative WBCT imaging on the affected foot and ankle. Using multiplanar reconstruction of WBCT images, measures of coronal and sagittal plane ankle alignment: Foot and Ankle Offset (FAO), Talar Tilt Angle (TTA), Hindfoot Moment Arm (HMA), and Lateral Talar Station (LTS) were performed. PROs were collected pre- and postoperatively at the latest clinical follow-up. RESULTS: All patients demonstrated a significant deformity correction in all measurements performed: FAO (7.73%-3.63%, p=0.031), HMA (10.93mm - 5.10mm, p=0.037), TTA (7.9o-1.5o, p=0.003), and LTS (5.25mm-2.83mm, p=0.018). Four of the PROs measured exhibited significant improvement postoperatively, the Tampa Scale for Kinesiophobia (TSK) (42.7-34.5, p=0.012), PRO-MIS Global Physical Health (46.1-54.5, p=0.011), EFAS (5-10.3, p=0.004), and FAAM Daily Living (60.5-79.7, p=0.04). Multivariate analysis assessing the influence of deformity correction in the improvements of PROs found that PROMIS Global Physical Health was significantly associated with improvements in FAO and LTS, TSK associated with HMA, and FAAM Daily Living with FAO and TTA (p<0.05). CONCLUSION: The results of this retrospective comparative cohort study suggest that the lateral trans-fibular TAR can correct different aspects of AO deformity. The method also impacted PROs, particularly TSK, PROMIS Global Physical Health, EFAS, and FAAM Daily Living. Direct correlation between some of the deformity correction measurements and the significantly improved PROs was found. The obtained data could help surgeons when making treatment decisions and be the base for comparative prospective studies. Level of Evidence: III.

Duke Scholars

Published In

Iowa Orthop J

EISSN

1555-1377

Publication Date

2022

Volume

42

Issue

2

Start / End Page

36 / 46

Location

United States

Related Subject Headings

  • Weight-Bearing
  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Prospective Studies
  • Osteoarthritis
  • Humans
  • Cohort Studies
  • Arthroplasty, Replacement, Ankle
  • Ankle Joint
  • Ankle
 

Citation

APA
Chicago
ICMJE
MLA
NLM
VandeLune, C., Barbachan Mansur, N. S., Iehl, C., Tazegul, T., Ahrenholz, S. J., de Carvalho, K. A. M., & de Cesar Netto, C. (2022). Deformity Correction in Ankle Osteoarthritis Using a Lateral Trans-Fibular Total Ankle Replacement: A Weight-Bearing CT Assessment. Iowa Orthop J, 42(2), 36–46.
VandeLune, Christian, Nacime Salomao Barbachan Mansur, Caleb Iehl, Tutku Tazegul, Samuel J. Ahrenholz, Kepler Alencar Mendes de Carvalho, and Cesar de Cesar Netto. “Deformity Correction in Ankle Osteoarthritis Using a Lateral Trans-Fibular Total Ankle Replacement: A Weight-Bearing CT Assessment.Iowa Orthop J 42, no. 2 (2022): 36–46.
VandeLune C, Barbachan Mansur NS, Iehl C, Tazegul T, Ahrenholz SJ, de Carvalho KAM, et al. Deformity Correction in Ankle Osteoarthritis Using a Lateral Trans-Fibular Total Ankle Replacement: A Weight-Bearing CT Assessment. Iowa Orthop J. 2022;42(2):36–46.
VandeLune C, Barbachan Mansur NS, Iehl C, Tazegul T, Ahrenholz SJ, de Carvalho KAM, de Cesar Netto C. Deformity Correction in Ankle Osteoarthritis Using a Lateral Trans-Fibular Total Ankle Replacement: A Weight-Bearing CT Assessment. Iowa Orthop J. 2022;42(2):36–46.

Published In

Iowa Orthop J

EISSN

1555-1377

Publication Date

2022

Volume

42

Issue

2

Start / End Page

36 / 46

Location

United States

Related Subject Headings

  • Weight-Bearing
  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Prospective Studies
  • Osteoarthritis
  • Humans
  • Cohort Studies
  • Arthroplasty, Replacement, Ankle
  • Ankle Joint
  • Ankle