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Fujimaki T, Kurokawa H, Ueno Y, Sasaki T, Pradana AS, Zainudin TNBT, Milo AM, Miyamoto T, Taniguchi A, Haro H, Tanaka Y. Assessment of Changes in Hindfoot Alignment of Total Ankle Arthroplasty for Ankle Osteoarthritis on Weightbearing Subtalar X-ray View. Foot Ankle Orthop 2023; 8:24730114231205299. [PMID: 37900557 PMCID: PMC10612447 DOI: 10.1177/24730114231205299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023] Open
Abstract
Background Recovering normal hindfoot alignment and correcting deformity of the ankle joint following total ankle arthroplasty (TAA) in osteoarthritis (OA) is essential for improving clinical outcomes and increasing long-term survival. We aim to evaluate hindfoot alignment following standard TAA compared to TAA with a total talar prosthesis ("combined TAA") in varus-type OA patients. Methods This retrospective study was conducted between 2010 and 2022. We included 27 patients (30 feet) who underwent standard TAA and 19 patients (22 feet) who underwent combined TAA. Hindfoot alignment at the subtalar joint was measured by weightbearing subtalar radiographic view before and after surgery. Results In the standard TAA, the angle between the tibial shaft axis and the articular surface of the talar dome joint (TTS) changed from 75 to 87 degrees (P < .01), the angle between the tibial axis and the surface on the middle facet (TMC) from 89 to 94 degrees (P < .01), and the angle between the tibial axis and the surface on the posterior facet (TPC) from 80 to 84 degrees (P < .01). The angle between the articular surface of the talar dome and the posterior facet of the calcaneus (SIA) decreased from 4.7 to -2.5 degrees (P < .01). In the combined TAA, TTS angle changed from 77 to 88 degrees (P < .01), TMC angle from 93 to 101 degrees (P < .01), TPC angle from 84 to 90 degrees (P < .05), and SIA from 6.6 to 2.1 degrees (P < .01). Varus deviation to the subtalar joint (TMC, TPC) significantly improved postoperatively in both groups. However, TPC was smaller than TTS and SIA was negative in standard TAA, and TPC was larger than TTS and SIA was positive in combined TAA. Conclusion The amount of correction of the subtalar joint differed depending on the ligament dissection of the subtalar joint and shape of the talar component. Level of Evidence Level III, retrospective cohort study.
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Affiliation(s)
- Taro Fujimaki
- Department of Orthopedic Surgery, Nara Medical University, Chou-shi, Yamanashi, Japan
- Department of Orthopedic Surgery, University of Yamanashi, Chou-shi, Yamanashi, Japan
| | - Hiroaki Kurokawa
- Department of Orthopedic Surgery, Nara Medical University, Chou-shi, Yamanashi, Japan
| | - Yuki Ueno
- Department of Orthopedic Surgery, Nara Medical University, Chou-shi, Yamanashi, Japan
| | - Takahide Sasaki
- Department of Orthopedic Surgery, Nara Medical University, Chou-shi, Yamanashi, Japan
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Ananto Satya Pradana
- Department of Orthopedic Surgery, Nara Medical University, Chou-shi, Yamanashi, Japan
| | | | - Anne Marie Milo
- Department of Orthopedic Surgery, Nara Medical University, Chou-shi, Yamanashi, Japan
| | - Takuma Miyamoto
- Department of Orthopedic Surgery, Nara Medical University, Chou-shi, Yamanashi, Japan
| | - Akira Taniguchi
- Department of Orthopedic Surgery, Nara Medical University, Chou-shi, Yamanashi, Japan
| | - Hirotaka Haro
- Department of Orthopedic Surgery, University of Yamanashi, Chou-shi, Yamanashi, Japan
| | - Yasuhito Tanaka
- Department of Orthopedic Surgery, Nara Medical University, Chou-shi, Yamanashi, Japan
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