Distal tibial osteotomy may benefit older patients with medial ankle OA
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Physically active older patients with medial ankle osteoarthritis may have good outcomes after distal tibial osteotomy with joint distraction, according to published results.
In 21 patients (mean age: 68.2 years) with medial ankle OA, researchers performed arthroscopic synovectomy and microfracture followed by angled osteotomy and correction of the distal tibia and stabilization of the ankle joint after its condition improved. Researchers used an external fixator in all patients and performed joint distraction of approximately 5.8 mm. Researchers allowed full weight-bearing walking immediately after surgery for all patients.
Results showed significant improvements in the anteroposterior and lateral mortis angle during weight-bearing, talar tilt angle and anterior translation of the talus on ankle stress radiography. Researchers also found all patients had improved signal changes on MRI. Patients had significant improvements in VAS score from a mean of 9.1 points preoperatively to a mean of 1.6 points postoperatively and in American Orthopedic Foot & Ankle Society scores from a mean of 35.5 points preoperatively to a mean of 88.4 points postoperatively, according to results. Researchers noted no severe complications among patients.
“Additional studies with a larger number of older patients with ankle osteoarthritis and a high level of physical activity are needed to validate the suitability of [distal tibial osteotomy] with distraction arthroplasty using a circular external fixator as a treatment option for end-stage ankle osteoarthritis,” the authors wrote.
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