J Korean Foot Ankle Soc.  2022 Dec;26(4):157-162. 10.14193/jkfas.2022.26.4.157.

Total Ankle Arthroplasty in Ankle Arthritis with Coronal Plane Deformity

• Yoon YK
• Park KH
• Park JY

• KMID: 2536710
• DOI: http://doi.org/10.14193/jkfas.2022.26.4.157

Abstract

Total ankle arthroplasty has become a viable motion-preserving alternative to ankle arthrodesis, especially in the last two decades. Recent improvements have been achieved in the strength of implant design and surgical technique. Nevertheless, addressing preoperative deformities is essential for successful outcomes of total ankle arthroplasty. Residual malalignment can produce instability and edge loading, causing acceleration of polyethylene wear, followed by osteolysis and an increased risk of revision surgery. Therefore, the accompanying deformities and their correction techniques need to be comprehensively elucidated and understood. In this article, we provide a review of the application of total ankle arthroplasty in arthritis with coronal plane varus and valgus deformities.

Keyword

Ankle; Osteoarthritis; Coronal plane deformity; Total ankle arthroplasty

Figure

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  Figure 1 Treatment algorithm for varus osteoarthritic ankle.

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  Figure 2 Incongruent varus ankle. After medial release, the modified Brostrom procedure was performed for residual lateral opening. Calcaneal lateral closing wedge osteotomy was performed to correct heel varus after implant insertion.

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  Figure 3 Congruent varus ankle. Postoperative radiograph shows neutral alignment after medial release and neutralizing tibial cutting.

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  Figure 4 Correction algorithm for extra-articular deformity after implant insertion in varus ankle arthritis.

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  Figure 5 Classification of valgus deformity and associated procedures. TAR: total ankle replacement.

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  Figure 6 Congruent valgus ankle. Postoperative radiograph shows neutral alignment through total ankle replacement (realignment with spacer effect).

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  Figure 7 Correctable flat foot deformity was addressed with calcaneal osteotomy, flexor digitorum longus transfer, and cotton osteotomy after implant placement.

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