Patients with valgus ankle arthritis may have varus tibial plafond and mechanical axis
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Key takeaways:
- Patients with valgus ankle arthritis had a greater medial distal tibial angle vs. those with varus ankle arthritis.
- Inframalleolar alignment differed between patients with valgus vs. varus ankle arthritis.
LOUISVILLE, Ky. — Results presented at the American Orthopaedic Foot & Ankle Society Annual Meeting showed patients with primary valgus ankle arthritis may have a tibial plafond and lower limb mechanical axis in varus orientation.
“We think our study may help us understand how valgus ankle tilt develops and how they are aligned,” Jaeyoung Kim, MD, said in his presentation, which was a Roger A. Mann Award Finalist. “We think lower limb alignment analysis should be included in preoperative planning for joint preservation surgery for better ankle tilt correction and its maintenance.”
Kim and colleagues compared the medial distal tibial angle (MDTA), talar tilt, talar center migration, anterior distal tibial angle, Meary’s angle, hindfoot moment arm and mechanical axis deviation (MAD) between a control group and patients who were surgically treated for either valgus or varus ankle arthritis.
“Primary valgus ankle arthritis in this study refers to ankles with no history of fracture or syndesmosis diastasis, no rheumatoid arthritis and having talar tilt greater than 2°,” Kim said.
Patients in the valgus arthritis group had a smaller MDTA compared with the control group and greater MDTA compared with the varus group, according to Kim. He added patients in the valgus group had greater MAD vs. the control group but no differences in MAD when compared with the varus group.
“Interestingly, 74.2% of patients in the valgus group had a measurement of MDTA less than 90°,” Kim said.
Researchers found differences in inframalleolar alignment between the varus and valgus groups, with a lower medial arch and hindfoot valgus in the valgus group vs. the varus group.
“We performed a subgroup analysis in the valgus ankle arthritis group based on Meary’s angle. The cutoff was 20°. Group 1 had a Meary’s angle of 7.9°, which is a relatively higher arch group, and group 2 had a Meary’s angle of 31.6°, [which is a] relatively lower arch group,” Kim said. “Both groups had positive MAD, but the lower arch group had greater MAD.”
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Kim J, et al. Lower limb alignment in patients with primary valgus ankle arthritis: A comparative analysis with patients with varus ankle arthritis and controls. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; Sept. 20-23, 2023; Louisville, Kentucky.
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