足と足首の臨床研究

抽象的な

Total Ankle Replacement in Varus Ankle Osteoarthritits

Matthias G Walcher, Alexej Barg, Steinert A, Maximilian Rudert, Maik Hoberg and Victor Valderrabano

About 50% of the cases with degenerative osteoarthritis of the ankle are asymmetric. Varus ankle osteoarthritis is far more frequent than valgus ankle osteoarthritis. Most of the cases of ankle osteoarthritis have posttraumatic aetiology. It is important to understand the deformity completely, and to distinguish simple deviations in the coronal plane from more-dimensional, complex cavovarus deformities involving the midfoot and the forefoot. Concomitant ligament and tendon imbalances and pathologies need to be identified and analysed. Correction planning needs to include the mechanical axis of the complete leg. Muscular imbalances need to be identified.

Even substantial deformities in varus ankle osteoarthritis can be treated with total ankle replacement successfully, if a plantigrade foot with balanced ligaments and tendons can be achieved. The corrective procedure may include realigning osteotomies, fusions, and correction of tendon and ligament pathologies.