nach oben

Erschienen in:

05.05.2024 | Original Article

Stabilizing effect of total ankle arthroplasty by distal translation and lateralization of talus in varus ankle deformity

verfasst von: T. Noguchi, M. Hirao, G. Okamura, Y. Etani, K. Ebina, H. Tsuboi, A. Goshima, A. Miyama, K. Takahi, K. Takami, S. Tsuji, S. Okada, J. Hashimoto

Erschienen in: MUSCULOSKELETAL SURGERY | Ausgabe 3/2024

Einloggen, um Zugang zu erhalten

Abstract

Background

In end-stage arthritis indicated for total ankle arthroplasty (TAA), full-thickness cartilage damage, subchondral bone defect/shaving, and fluttering of the talar dome occur, shortening the distance between the tibial and talar insertions of ligaments and leading to laxity of ligaments surrounding the ankle joint. Under such conditions, medial ligaments (including the deltoid ligament) would not be expected to function properly. To stabilize the ankle joint during the stance phase, medial ligament function under tension is important. This study therefore examined whether TAA contributes to lengthening of the medial tibio-talar joint as evaluated radiographically, as a preferable method for achieving tensile effects on medial ligaments.

Materials and methods

Twenty-four feet with end-stage varus deformity of the ankle joint that underwent TAA were retrospectively investigated, excluding cases with any malleolar osteotomy or fracture. Distance between proximal and distal insertions of medial ligaments, lateralization of the talus, and talar tilt angle under valgus/varus stress condition were evaluated pre- and postoperatively.

Results

Distance between proximal and distal insertions of medial ligaments was significantly elongated after TAA. At the same time, the talus showed significant lateralization. Furthermore, talar tilt under valgus/varus stress conditions was also significantly reduced after TAA.

Conclusion

TAA affects distal translation and lateralization of the talus in cases of varus ankle deformity. These effects might contribute to re-providing tensile force on lax medial ligaments, improving ligament function.

DeAngelis JP, Anderson R, DeAngelis NA (2007) Understanding the superior clear space in the adult ankle. Foot Ankle Int 28:490–493CrossRefPubMed

Imai K, Ikoma K, Kido M, Maki M, Fujiwara H, Arai Y, Oda R, Tokunaga D, Inoue N, Kubo T (2015) Joint space width of the tibiotalar joint in the healthy foot. J Foot Ankle Res 8:26. https://doi.org/10.1186/s13047-015-0086-5CrossRefPubMedPubMedCentral

Wiewiorski M, Hoechel S, Anderson AE, Nowakowski AM, DeOrio JK, Easley ME, Nunley JA, Valderrabano V, Barg A (2016) Computed tomographic evaluation of joint geometry in patients with end-stage ankle osteoarthritis. Foot Ankle Int 37(6):64451. https://doi.org/10.1177/1071100716629777CrossRef

Haraguchi N, Armiger RS, Myerson MS, Campbell JT, Chao EYS (2009) Prediction of three-dimensional contact stress and ligament tension in the ankle during stance determined from computational modeling. Foot Ankle Int 30(2):177–185. https://doi.org/10.3113/FAI-2009-0177CrossRefPubMed

Leardini A, O’Connor JJ, Giannini S (2014) Biomechanics of the natural, arthritic, and replaced human ankle joint. J Foot Ankle Res 7(1):8. https://doi.org/10.1186/1757-1146-7-8CrossRefPubMedPubMedCentral

Easley ME, Anastasio AT (2023) Range of motion after total ankle replacement: are we just stuck? Foot Ankle Int 15:10711007231215062

Faldini C, Mazzotti A, Belvedere C, Durastanti G, Panciera A, Geraci G, Leardini A (2020) A new ligament-compatible patient-specific 3D-printed implant and instrumentation for total ankle arthroplasty: from biomechanical studies to clinical cases. J Orthop Traumatol 21(1):16. https://doi.org/10.1186/s10195-020-00555-7CrossRefPubMedPubMedCentral

Burmester GR, Pope JE (2017) Novel treatment strategies in rheumatoid arthritis. Lancet 389(10086):2338–2348CrossRefPubMed

Hirao M, Hashimoto J, Tsuboi H, Ebina K, Nampei A, Noguchi T, Tsuji S, Nishimoto N, Yoshikawa H (2017) Total ankle arthroplasty for rheumatoid arthritis cases in Japanese patients: a retrospective study of mid to long-term follow-up. J Bone Joint Surg Open Access 2(4):e00033

10.

Niki H, Tatsunami S, Haraguchi N, Aoki T, Okuda R, Suda Y et al (2013) Validity and reliability of a self-administered foot evaluation questionnaire (SAFE-Q). J Orthop Sci 18(2):298–320CrossRefPubMedPubMedCentral

11.

Niki H, Aoki H, Inokuchi S, Ozeki S, Kinoshita M, Kura H, Tanaka Y, Noguchi M, Nomura S, Hatori M, Tatsunami S (2005) Development and reliability of a standard rating system for outcome measurement of foot and ankle disorders I: development of standard rating system. J Orthop Sci 10(5):457–465. https://doi.org/10.1007/s00776-005-0936-2CrossRefPubMedPubMedCentral

12.

Niki H, Aoki H, Inokuchi S, Ozeki S, Kinoshita M, Kura H, Tanaka Y, Noguchi M, Nomura S, Hatori M, Tatsunami S (2005) Development and reliability of a standard rating system for outcome measurement of foot and ankle disorders II: interclinician and intraclinician reliability and validity of the newly established standard rating scales and Japanese orthopaedic association rating scale. J Orthop Sci 10(5):466–474. https://doi.org/10.1007/s00776-005-0937-1CrossRefPubMedPubMedCentral

13.

Inoue E, Yamanaka H, Hara M, Tomatsu T, Kamatani N (2007) Comparison of disease activity score (DAS) 28-erythrocyte sedimentation rate and DAS28-C-reactive protein threshold values. Ann Rheum Dis 66(3):407–409CrossRefPubMed

14.

Konor MM, Morton S, Eckerson JM, Grindstaff TL (2012) Reliability of three measures of ankle dorsiflexion range of motion. Int J Sports Phys Ther 7(3):279–287PubMedPubMedCentral

15.

Coetzee JC, Castro MD (2004) Accurate measurement of ankle range of motion after total ankle arthroplasty. Clin Orthop Relat Res 424:27–31CrossRef

16.

Cobey JC (1976) Posterior roentgenogram of the foot. Clin Orthop Relat Res 118:202–207

17.

Katsui T, Takakura Y, Kitada C (1980) Roentgenographic analysis for osteoarthritis of the ankle. J Jpn Soc Surg Foot 1:52–57 (in Japanese)

18.

Monji J (1980) Roentgenological measurement of the shape of the osteoarthritic ankle (author’s transl). Nihon Seikeigeka Gakkai Zasshi 54(8):791–802 (in Japanese)PubMed

19.

Tanaka Y, Takakura Y, Hayashi K, Taniguchi A, Kumai T, Sugimoto K (2006) Low tibial osteotomy for varus-type osteoarthritis of the ankle. J Bone Joint Surg Br 88(7):909–913CrossRefPubMed

20.

Takakura Y, Tanaka Y, Kumai T, Tamai S (1995) Low tibial osteotomy for osteoarthritis of the ankle. Results of a new operation in 18 patients. J Bone Joint Surg Br 77(1):50–54CrossRefPubMed

21.

Campbell KJ, Michalski MP, Wilson KJ, Goldsmith MT, Wijdicks CA, LaPrade RF, Clanton TO (2014) The ligament anatomy of the deltoid complex of the ankle: a qualitative and quantitative anatomical study. J Bone Joint Surg Am 96(8):e62. https://doi.org/10.2106/JBJS.M.00870CrossRefPubMed

22.

Earll M, Wayne J, Brodrick C, Vokshoor A, Adellar R (1996) Contribution of the deltoid ligament to ankle joint contact characteristics: a cadaver study. Foot Ankle Int 17(6):317–324CrossRefPubMed

23.

Choi GW, Lee SH, Nha KW, Lee SJ, Kim WH, Uhm CS (2017) Effect of combined fibular osteotomy on the pressure of the tibiotalar and talofibular joints in supramalleolar osteotomy of the ankle: a cadaveric study. J Foot Ankle Surg 56:59–64CrossRefPubMed

24.

Hirao M, Oka K, Ikemoto S, Nakao R, Tsuboi H, Nampei A, Akita S, Shi K, Ebina K, Murase T, Sugamoto K, Yoshikawa H, Hashimoto J (2014) Use of a custom-made surgical guide in total ankle arthroplasty in rheumatoid arthritis cases. Tech Orthop 29:103–112CrossRef

25.

Hirao M, Hashimoto J, Ebina K, Tsuboi H, Takahi K, Nakaya H, Noguchi T, Kunugiza Y, Tsuji S, Yoshikawa H (2020) Radiographic effects observed in the coronal view after medial malleolar osteotomy at total ankle arthroplasty in rheumatoid arthritis cases. J Orthop Sci 25(6):1072–1078CrossRefPubMed

26.

Higuchi Y, Hirao M, Noguchi T, Etani Y, Ebina K, Okamura G, Tsuboi H, Miyama A, Takahi K, Takami K, Tsuji S, Okada S, Hashimoto J (2023) Early mobilization of dorsiflexion from 3 days after cemented total ankle arthroplasty with modified antero-lateral approach. J Orthop Sci S0949–2658(23):00128–00138. https://doi.org/10.1016/j.jos.2023.04.010CrossRef

27.

Sakata M, Hirao M, Noguchi T, Okamura G, Higuchi Y, Tabuse Y, Etani Y, Ebina K, Tsuboi H, Miyama A, Takahi K, Takami K, Tsuji S, Okada S, Hashimoto J (2024) Early full weight-bearing and gait exercise after cemented total ankle arthroplasty with modified antero-lateral approach. Mod Rheumatol. https://doi.org/10.1093/mr/roae005/7584926CrossRefPubMed

28.

Hirao M, Ebina K, Etani Y, Kaneshiro S, Tsuboi H, Noguchi T, Okamura G, Kunugiza Y, Nakaya H, Nishikawa M, Tsuji S, Takahi K, Owaki H, Hashimoto J (2021) Modified anterolateral approach for total ankle arthroplasty. Foot Ankle Orthop 6(2):24730114211013344. https://doi.org/10.1177/24730114211013342CrossRefPubMedPubMedCentral

Titel: Stabilizing effect of total ankle arthroplasty by distal translation and lateralization of talus in varus ankle deformity
verfasst von: T. Noguchi
M. Hirao
G. Okamura
Y. Etani
K. Ebina
H. Tsuboi
A. Goshima
A. Miyama
K. Takahi
K. Takami
S. Tsuji
S. Okada
J. Hashimoto
Publikationsdatum: 05.05.2024
Verlag: Springer Milan
Erschienen in: MUSCULOSKELETAL SURGERY / Ausgabe 3/2024
Print ISSN: 2035-5106
Elektronische ISSN: 2035-5114
DOI: https://doi.org/10.1007/s12306-024-00820-6

Effect of adjuvant chemotherapy on localized dedifferentiated low-grade osteosarcoma: a systematic review

Review

Platelet lysate for the treatment of osteoarthritis: a systematic review of preclinical and clinical studies

Open Access
Review

Relationship between the clinical outcomes and the systemic inflammatory response index and systemic immune inflammation index after total knee arthroplasty

Original Article

The gender role in the publishing of Authorships in high-impact orthopedic journals

Original Article

Achievements and complications related to final fusion surgery in early onset scoliosis at the end of “traditional dual growing rod mission”

Original Article

Multicenter survey about leg length discrepancy and total hip arthroplasty: preoperative and intraoperative management

Open Access
Original Article

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie erweitert durch Fallbeispiele, Videos und Abbildungen. Zur Fortbildung und Wissenserweiterung, verfasst und geprüft von Expertinnen und Experten der Gesellschaft für Arthroskopie und Gelenkchirurgie (AGA).

Jetzt entdecken!

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Nackenschmerzen nach Bandscheibenvorfall: Muskeltraining hilft!

15.01.2025
Nackenschmerzen
Nachrichten

Bei hartnäckigen Schmerzen aufgrund einer zervikalen Radikulopathie schlägt ein Team der Universität Istanbul vor, lokale Steroidinjektionen mit einem speziellen Trainingsprogramm zur Stabilisierung der Nackenmuskulatur zu kombinieren.

Die elektronische Patientenakte kommt: Das sollten Sie jetzt wissen

12.01.2025
Elektronische Patientenakte
Nachrichten

Am 15. Januar geht die „ePA für alle“ zunächst in den Modellregionen an den Start. Doch schon bald soll sie in allen Praxen zum Einsatz kommen. Was ist jetzt zu tun? Was müssen Sie wissen? Wir geben in einem FAQ Antworten auf 21 Fragen.

Was sich Menschen mit Frozen Shoulder wünschen

10.01.2025
Schultersteife
Nachrichten

Die Capsulitis adhaesiva des Glenohumeralgelenks, auch als Frozen Shoulder bezeichnet, belastet die Betroffenen weit über die körperlichen Beschwerden hinaus, wie eine italienische Studie ergeben hat.

Restriktive Sauerstoffgabe ohne Vorteil bei schwerem Trauma

09.01.2025
Traumatologische Notfallmedizin
Nachrichten

Ob schwer verletzte Personen besser restriktiv oder liberal mit Sauerstoff versorgt werden sollten, hat die Arbeitsgruppe der TRAUMOX2-Studie untersucht – mit klarem Ergebnis.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Stabilizing effect of total ankle arthroplasty by distal translation and lateralization of talus in varus ankle deformity