Supramalleolar osteotomies for ankle arthritis: a systematic review

Introduction We investigated the mid-term outcomes of supramalleolar osteotomies regarding “survivorship” [before ankle arthrodesis (AA) or total ankle replacement (TAR)], complication rate and adjuvant procedures required. Material and methods PubMed, Cochrane and Trip Medical Database were searche...

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Veröffentlicht in:Archives of orthopaedic and trauma surgery 2023-09, Vol.143 (9), p.5549-5564
Hauptverfasser: Christidis, Panagiotis, Lampridis, Vasileios, Kalitsis, Christos, Kantas, Theofanis, Biniaris, Georgios, Gougoulias, Nikolaos
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Sprache:eng
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Zusammenfassung:Introduction We investigated the mid-term outcomes of supramalleolar osteotomies regarding “survivorship” [before ankle arthrodesis (AA) or total ankle replacement (TAR)], complication rate and adjuvant procedures required. Material and methods PubMed, Cochrane and Trip Medical Database were searched from January 01, 2000. Studies reporting on SMOs for ankle arthritis, in minimum of 20 patients aged 17 or older, followed for a minimum of two years, were included. Quality assessment was performed with the Modified Coleman Methodology Score (MCMS). A subgroup analysis of varus/valgus ankles was performed. Results Sixteen studies met the inclusion criteria, with 866 SMOs in 851 patients. Mean age of patients was 53.6 (range 17–79) years, and mean follow-up was 49.1 (range 8–168) months. Of the arthritic ankles (646 ankles), 11.1% were classified as Takakura stage I, 24.0% as stage II, 59.9% as stage III and 5.0% as stage IV. The overall MCMS was 55.2 ± 9.6 (fair). Eleven studies (657 SMOs) reported on “survivorship” of SMO, before arthrodesis (2.7%), or total ankle replacement (TAR) (5.8%) was required. Patients required AA after an average of 44.6 (range 7–156) months, and TAR after 36.71 (range 7–152) months. Hardware removal was required in 1.9% and revision in 4.4% of 777 SMOs. Mean AOFAS score was 51.8 preoperatively, improving to 79.1 postoperatively. Mean VAS was 6.5 preoperatively and improved to 2.1 postoperatively. Complications were reported in 5.7% (44 out of 777 SMOs). Soft tissue procedures were performed in 41.0% (310 out of 756 SMOs), whereas concomitant osseous procedures were performed in 59.0% (446 out of 756 SMOs). SMOs performed for valgus ankles failed in 11.1% of patients, vs 5.6% in varus ankles ( p  
ISSN:1434-3916
0936-8051
1434-3916
DOI:10.1007/s00402-023-04867-1